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30 Cards in this Set

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what would you use for tx of HCV:
subclass?
prototype?
virus family?
interferons
IFN alpha-2b

HCV=flavivirus + ssRNA
How would you treat HSV (herpes simplex virus):
subclass?
prototype?
virus family?
anti-herpes nucleoside analog
acyclovir

linear dsDNA Herpes virus
tx of influenza A:
sublass?
prototype?
virus family?

tx of influenza A and B:
subclass?
prototype?
M2 inhibitors
amantadine
orthomxyovirus: -RNA

neuraminidase inhibitors
oseltamivir
anti-herpes nucleoside analog?
acyclovir


used for herpes (ds linear DNA)
M2 inhibitor
amantidine

used for Influenza A (orthomyxo -strand RNA virus)
neuraminidase inhibitors
oseltamivir

used for Influenza A and B virus
(neg strand RNA)
what would you use for tx of HIV?

virus family?
NRTI--ziduvidine
NNRTI--efavirenz
PI--Lopinavir
FI--Enfuvirtide

+strand RNA virus (retro)
acyclovir
anti-herpes nucleoside analog used for HSV
amantidine
M2 inhibitor
used for influenza A
(orthomxyo-neg strand RNA virus)
Oseltamivir
neuraminidase inhibitor
used for influenza A and B
(orthomyxo -RNA)
ziduvidine
efavirenz
lopinavir
enfuvirtide
NRTI (nucleoside RT inhib)
NNRTI (non-nucleoside RT inhib)
PI (protease inhibitor)
FI (fusion inhibitor)
which IFNs are used in viral tx for hepatitis?
Only interferon α and β
where is IFN alpha produced?
leukocytes (B lymphs, macs)
what's used for tx of chronic HCV?
interferon alpha-2b:
recombinant purified IFN
what's pegylated IFN (PEG-IFN)?
covalent conjugate of recomb alpha IFN w/ monomethoxy polyethylene glycol (PEG)

greatly incr t1/2 of IFN
allows weekly (not daily) injections
IFN α-2b target site?
hepatocytes infected w/ HCV
(HBV usually resolves spontaneously)
IFN α-2b mech of action?
bind specific cell R's
induce intracell events:
transmemb signals and protein synth (e.g. protein kinase, RNase) which enhance mac phagocytosis, incr cytotox of T cells, inhib viral rep
IFN α-2b and ribavirin combo therapy?
for HCV
targets both RNA and DNA viruses
duration 24-48 wks
ribavirin doubles sustained viral response vs IFN α-2b alone but tx discontinuation more freq

PEG-IFN preferred tx (1x/wk)
side effects of IFN?
flu like sx, fatigue, periph neuropathy
marrow suppress (anemia, leukopenia, thrombocytopenia)
neuropsychiatric sx
S/E's of ribavirin?
reversible hemolysis, anemia
teratogen (cat X- use 2 types of contraception during and 6 months after tx)
antiherpes agents
nucleoside analogs except foscarnet and cidofovir

prototype=acyclovir
acyclovir
acyclic guanine nucleoside analog

active in vitro against HSV-1 and 2, VZV and EBV
molecular target of acyclovir?
virus encoded DNA pol
mech of acyclovir
inhib vDNA synthesis:

1st phosphorylation by viral thymidine kinase
2nd and 3rd by cellular phophatases

acyclovir triphosph comp inhib of HSV DNA pol and blks elongation of vDNA chain
resistance to acyclovir?
all anti-herpes agents require triphosphorylation to be active

altered/absent thymidine kinase resistant to acyclovir
acyclovir uses?
tx and or prophylaxis:
HSV-1
HSV-2
VZV

gangciclovir for CMV (immunocompromised pts)
S/E's of acyclovir?
well tolerated mostly:
acute renal failure: acyclovir crystals in renal tub (hydrate before infusion)
neuro tox (tremor, delirium, halluc, agitation) w/ renal failure
what is amantadine useful for?
prototype M2 inhibitor
active against influenza A ONLY (Not B)

for tx (w/in 30-48 hrs of onset) and prophylaxis

rimantadine--similar activity but better tolerated
mech of amantadine action?
block proton passage through ion ch of M2 proteins in virus membrane

pH-induced conform change in hemagglutinin req'd for fusion inhibited
S/E's of amantadine
CNS: agitation, anx, depress, dizzy, sleepy
GI: nausea, anorexia, diarrhea, constipation

rimantadine has milder CNS fx