Olol Pa Pharm Test 3 Viral/parasite

Front 1

What are the pharmacological targets for parasites?

Back 1

1. Unique Essential Enzymes found only in parasites
2. Enzymes indispensible only in parasites
3. Indispensible biochemical fxns common to both parasite and host, however w/ different pharmacological properties.

Front 2

What form of the influenza virus infects humans only and what form infects all mammals?

Back 2

Humans only: B
All mammals: A

Front 3

What are the 5 agents used to treat Influenza A and respiratory viruses?

Back 3

-Amantadine
-Oseltamivir
-Ribavirin
-Rimatadine
-Zanamivir

Front 4

MOA of Amantadine?

Back 4

Inhibits uncoating of viral RNA w/in the infected sell which prevents replication.
*Rimantadine is 4x's more potent)

Front 5

ADE's of Amantadine?

Back 5

-N/V
-CNS: Nervousness, Insomnia

Front 6

MAO of Osteltamivir?

Back 6

Is a Neuraminidase inhibitor, so it interferes with the release of prgency influenza virus from the infected cell to the new host.
*Prevents the spread of infection

Front 7

What strain(s) or Influenza is Osteltamivir active against?

Back 7

A & B
*Requires early administration to minimize replication.

Front 8

What agents are availavle to treat HSV and VSV infections?

Back 8

-Acyclovir
-Valacyclovir
-Famciclovir
-Penciclovir
-Docosanol
-Trifluridine

Front 9

What viruses does acyclovir tx?

Back 9

-HSV-1
-HSV-2
-VZV

Front 10

What must happen for acyclovir to be activated?

Back 10

-Must be phosphorylated (by thymidine kinase)
*active metabolite only accumulates in the infected cells

Front 11

MOA of acyclovir?

Back 11

Inhibits viral DNA synthesis by:
1. Competition w/ deoxyGTP for viral DNA polymerase, resulting in binding to the DNA templateas an irreversible complex.
2. Chain termination following incorporation into the viral DNA

Front 12

What is acyclovir the DOC for?

Back 12

-Herpes Simplex encephalitis
-Neonatal HSZ infection
-Serious HSV or VZV infections

Front 13

What leads to acyclovir resistance?

Back 13

-Alteration in viral thymidine kinase or DNA polymerase
*Cross resistance to Valacylovir, famciclovir, and ganciclovir

Front 14

ADE's of acyclovir?

Back 14

-Nausea
-Diarrhea
-HA
-If given IV: reversible renal dysfunction or neurologic toxicity (tremors, delirium, seizures)

Front 15

What drug used to treat HSV is a diacetyl ester PRODRUG of 6-deoxypenciclovir?

Back 15

Famciclovir
*After PO admission it is converted by 1st pass metabolisn to penciclovir.

Front 16

What must happen for famciclovir to be activated?

Back 16

Phosphorylation by thymidine kinase (same as acyclovir)

Front 17

How is famciclovir's MOA similar to acyclovir?

Back 17

-Competitive inhibition of viral DNA polymerase to block DNA synthesis, BUT it does not cause chain termination.

Front 18

ADE's of Famciclovir?

Back 18

-HA
-Diarhhea
-Nausea

Front 19

What drug is the L-valyl ester of acyclovir?

Back 19

-Valacylcolvir
*Rapidly converted to acyclovir after PO admin by intestinal and hepatic 1st pass metabolism

Front 20

Compare the half lives of acyclovir and valacyclovir.

Back 20

Acyclovir: 3 hrs
Valacyclovir: 30 mns

Front 21

ADE's of Valacyclovir?

Back 21

-N/V
-Rash
-Agitation
-Dizziness
-HA
-Liver enzyme elevation
-Anemia
*At high doses: Hallicinations and Seizures

Front 22

What 4 agents are topical and tx HSV?

Back 22

1. Acyclovir (IV and PO also)
2. Docosanol (Herpes labialis)
3. Penciclovir (Recurrent Herpes labialis
4. Trifluidine (Herpes keratitis, acyclovir-resistant HSV)

Front 23

What is Foscarnet indicated for and how is it administered?

Back 23

-Acyclovir-resistant HSV and VZV
-IV

Front 24

Who is more susceptible to infection by CMV and what does CMV cause?

Back 24

-Immunocomprimised individuals(AIDS or organ transplant)
-Causes:
1. Retinitis
2. Colitis
3. Esophagitis
4. CNS dz
5. Pneumonitis
*CMV can be passed to the fetus

Front 25

What are the 4 main agents used to tx CMV?

Back 25

1. Ganciclovir (IV,PO, intraocular implant)
2. Valganciclovir (PO only)
3. Foscarnet (IV only)
4. Cidofovir (active diphosphate)(IV only)

Front 26

MOA of Foscarnet?

Back 26

Direct inhibition of DNA polymerase, RNA polymerase, and HIV reverse transcriptase directly w/o requiring activation by phosphorylation.
*Is an inorganic pyrophosphate compound.

Front 27

What agents are used to treat CMV retinitis?

Back 27

1. Valganciclovir (PO)
2. Ganciclovir (IV, PO, Intraocular)
3. Foscarnet (IV)
4. Cidofovir (IV)

Front 28

What agents are used for prophylaxis of CMV?

Back 28

1. Valganciclovir (PO)
2. Ganciclovir (PO)

Front 29

What cells does HIV infect?

Back 29

1. T helper cells (CD4+)
2. Macrophages
3. Dendritic cells

Front 30

What does HAART stand for?

Back 30

Highly Active Anti-Retroviral Therapy

Front 31

What are the 2 main categories of Antiretroviral Agents?

Back 31

1. Nucleoside and Nucleotide Reverse Trancriptase Inhibitors (NRTI)
2. Nonnucleotide Reverse Trancriptase Inhibitors (NNRTI)

Front 32

What is the only drug we talked about that is a Fusion Inhibitor used to treat HIV?

Back 32

Enfuvirtide

Front 33

What is the "Triple Treatment" of AIDS chemotherapy?

Back 33

-2 inhibitors of HIV reverse transcriptase
-1 protease inhibitor

Front 34

What is the most commonly used HAART drug combination?

Back 34

-1 NRTI
-1 NNRTI
-1 Protease inhibitor

Front 35

List some examples of Triple Treatment for HIV.

Back 35

1. AZT(azidothymidine)+3TC (lamivudine)+Crixivan
2. AZT+d4T(stavudine)+Invirase
3. 3TC+NVP(nevirapine)+Norvir
4. d4T+DMP(efavirenz)+Viracept
5. ABV+DMP+Agenerase

Front 36

What are the drugs that make up Combivir?

Back 36

AZT+3TC

Front 37

What are the drugs to tx Hepatitis B?

Back 37

1. Lamivudine
2. Adefovir
3. Entecavir
4. Interferon Alfa 2b

Front 38

What are the drugs to tx Hepatitis C?

Back 38

1. Ribavirin
2. Interferon Alfa 2b
3. Interferon Alfa 2a