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137 Cards in this Set
- Front
- Back
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Infectious agents are still a leading cause of death worldwide T/F?
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True
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In high income countries, the majority of people die from infectious disease T/F?
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False - from chronic disease
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In low income countries, the majority of people die from infectious disease, T/F?
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True
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What demographic group is particularly susceptible to infectious disease?
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Children
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Therapeutic stratgey that maximizes death of invading microbes but minimizes adverse effects in the host is a concept known as:
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Selective toxicity
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Microbes have features not present in human host: good or bad?
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Good - we can target these with Abx
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Resistance to drugs develop quickly and spreads quickly due to short generation time of bacteria - good or bad?
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Bad
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What organisms are obligate intracellular parasites?
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Viruses
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Viruses are bigger or smaller than a ribosome?
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Smaller (<10 nM)
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Name four components of virus:
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1. Nucleic acid
2. Lipid bilayer 3. Glycoproteins 4. Capsid proteins |
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What are the two main classes of viruses?
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DNA and RNA viruses (can be ds or ss)
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Herpesvirus is a DNA/RNA virus?
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DNA virus
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What drugs (2) blocks DNA replication and is used to treat herpes?
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Acyclovir
Gancyclovir |
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What drugs are DNA nucleoside analogues? (2)
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Acyclovir
Gancyclovir |
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What drug looks like guanine?
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Acyclovir
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Name two guanine nucleoside analogues:
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Acyclovir
Gancyclovir |
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Acyclovir activated (phosphorylated) by a viral protein called what?
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Thymidine kinase
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Phosphorylated or unphosphorylated form of acyclovir/ganciclovir inhibits viral DNA pol?
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Phosphorylated form
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Acyclovir and ganciclovir get incorporated into what part of the virus?
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DNA pol
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What drug is used to treat herpes simplex virus (HSV)?
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Acyclovir
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What important drug interaction occurs with acyclovir?
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Nephrotoxic drugs
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Acyclovir and nephrotoxic drugs can cause increased risk of renal damage T/F?
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True
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Acyclovir and Zidovudine (AZT) can cause what?
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Severe lethargy
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Acyclovir and what drug can cause severe lethargy?
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Zidovudine (AZT)
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What drug is used to treat CMV (usually retinitis)?
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Gancyclovir
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What is the main side effect of acyclovir and ganciclovir?
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Nephrotoxicity
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What is an important drug interaction with ganciclovir?
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Nephrotoxic drugs
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Phosphorylated or unphosphorylated form of acyclovir/ganciclovir inhibits viral DNA pol?
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Phosphorylated form
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Acyclovir and ganciclovir get incorporated into what part of the virus?
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DNA pol
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What drug is used to treat herpes simplex virus (HSV)?
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Acyclovir
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What important drug interaction occurs with acyclovir?
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Nephrotoxic drugs
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Acyclovir and nephrotoxic drugs can cause increased risk of renal damage T/F?
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True
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Acyclovir and Zidovudine (AZT) can cause what?
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Severe lethargy
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Acyclovir and what drug can cause severe lethargy?
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Zidovudine (AZT)
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What drug is used to treat CMV (usually retinitis)?
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Ganciclovir
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What is the main side effect of acyclovir and ganciclovir?
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Nephrotoxicity
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What is an important drug interaction with ganciclovir?
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Nephrotoxic drugs
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What drug blocks protein translation?
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Fomivirsen
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What drug is the first antisense RNA therapy?
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Fomivirsen
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Fomivirsen is used to treat what condition?
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CMV retinitis (Can also use gancyclovir)
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What anti-influenza agent blocks the uncoating process?
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Amantadine
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What drug can cause livedo reticularis?
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Amantadine
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What drug is used for Influenza A prophylaxis and treatment?
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Amantadine
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What drug inhibits viral uncoating?
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Amantadine
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What is the major side effect of amantadine?
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CNS effects
Can also cause livedo reticularis (severe life threatening rash) |
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Mutation in M2 channel (proton channel) causes resistance to what antiviral?
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Amantadine
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What antiviral is also found to decrease tremors in Parkinsons' Disease?
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Amantadine
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What antiviral was shown to also induce release of dopamine from nerve endings?
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Amantadine
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What anti-influenza agent blocks viral release?
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Oseltamivir (Tamiflu)
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What anti-influenza is good for both Influenza A and B?
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Oseltamivir (Tamiflu)
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What is the time frame for treatment of influenze A/B with oseltamivir?
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Within 48 hours onset
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What anti-influenza is a sialic acid analogue?
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Oseltamivir
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Sialic acid analogues (Oseltamivir) inhibits what viral enzyme?
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Viral neuraminidase
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What enzyme cleaves sialic acid residues to facilitate release from the host cell?
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Viral neuraminidase
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What anti-influenza drug can cause bronchospasm and is CI in patients with asthma?
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Zanamivir (Relenza) given by inhalation
Can cause allergic reactions |
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What drug is used by inhalation and is contraindicated in patients with asthma?
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Zanamivir (Relenza)
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What is the route of administration of oseltamivir?
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Oral
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What is the route of elimination of Oseltamivir?
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Unchanged via kidney
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Why must dose of oseltamivir be decreased in childen and patients with renal impairment?
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Oseltamivir is eliminated unchanged via the kidneys
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What antiviral blocks mRNA metabolism?
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Ribavirin
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What antiviral is used to treat chronic hepatitis C?
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Ribavirin
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What antiviral is commonly used with interferon to treat hepatitis C?
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Ribavirin
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What drug is a guanosine analogue and inhibits IMPDH?
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Ribavirin
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What drug is a guanosine analogue and inhibits IMPDH?
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Ribavirin
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What antiviral is linked to behavior problems (Suicide)
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Oseltamivir (Tamiflu)
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What antiviral is linked to behavior problems (Suicide)
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Oseltamivir (Tamiflu)
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What drug has ADR of hemolytic anemia?
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Ribavirin
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What drug has ADR of hemolytic anemia?
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Ribavirin
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What drug prevents activation/phosphorylation of Zidovudine?
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Ribavirin
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What drug prevents activation/phosphorylation of Zidovudine?
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Ribavirin
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What is the pregnancy category of Ribavirin?
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Pregnancy category X (Teratogen)
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What is the pregnancy category of Ribavirin?
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Pregnancy category X (Teratogen)
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How long is required for "washout" after long-term treatment of ribavirin?
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6 months
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How long is required for "washout" after long-term treatment of ribavirin?
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6 months
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What is a potentially safer derivative that may replace ribavirin?
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Viramidine
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What is a potentially safer derivative that may replace ribavirin?
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Viramidine
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What drug is a guanosine analogue and inhibits IMPDH?
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Ribavirin
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What are endogenous cytokines that cause immunomodulation?
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Interferons
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What are endogenous cytokines that cause immunomodulation?
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Interferons
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What antiviral is linked to behavior problems (Suicide)
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Oseltamivir (Tamiflu)
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What antiviral agent is used to treat chronic hepatitis B/C, Kaposi's sarcoma?
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Interferon alpha
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What antiviral agent is used to treat chronic hepatitis B/C, Kaposi's sarcoma?
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Interferon alpha
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What drug has ADR of hemolytic anemia?
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Ribavirin
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What drug given with interferon improves efficacy?
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Ribavirin
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What drug given with interferon improves efficacy?
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Ribavirin
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What drug prevents activation/phosphorylation of Zidovudine?
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Ribavirin
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What is the pregnancy category of Ribavirin?
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Pregnancy category X (Teratogen)
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How long is required for "washout" after long-term treatment of ribavirin?
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6 months
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What is a potentially safer derivative that may replace ribavirin?
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Viramidine
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What are endogenous cytokines that cause immunomodulation?
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Interferons
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What antiviral agent is used to treat chronic hepatitis B/C, Kaposi's sarcoma?
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Interferon alpha
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What drug given with interferon improves efficacy?
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Ribavirin
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What is the dose-limiting toxicity of interferon?
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Myelosuppression, neutropenia
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What form of interferon is administered subcutaneously?
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Pegylated interferon
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Name a nucleoside/tide reverse transcriptase inhibitor (NRTI)
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Zidovudine (AZT)
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What drug is used for suppression of HIV infection and elevation of CD4 counts?
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Zidovudine (AZT)
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What drug given during pregnancy reduces the HIV transmission to fetus?
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Zidovudine (AZT)
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Does Zidovudine have to be phosphorylated?
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Yes it does
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What drug competes for reverse transcriptase and functions as chain terminators?
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Zidovudine (AZT) - NRTI
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NRTI's are/are not used in combination therapies?
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Are used in combination therapies
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What slows the selection of resistant organisms to drugs?
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Use of combination therapy
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HIV reverse transcriptase is/is not an error prone enzyme?
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Error prone enzyme
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Are there lots of drug interactions with Zidovudine?
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Yes, must be aware!
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What antiretroviral can cause granulocytopenia and anemia? Name 2
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Zidovudine (AZT) NRTI
Nevirapine (NVP) NNRTI |
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What anti-retroviral can cause CNS effects (headache, seizure, encephalopathy)?
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Zidovudine (AZT)
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What effect can zidovudine have on muscles?
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Muscle pain and weakness
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What acid-base disturbance can occur with all NRTIs?
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Metabolic acidosis from mitochondrial damage
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Hepatotoxicity can occur with Zidovudine T/F?
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True
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The azido group makes AZT more/less lipophilic?
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More lipophilic
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Name a Non-nucleoside reverse transcriptase inhibitor (NNRTI)
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Nevirapine (NVP)
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What virus is nevirapine used to treat?
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HIV
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What drug is a non-competitive inhibitor of HIV RT?
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Nevirapine (NVP)
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NNRTIs increases metabolism of protease inhibitors (T/F)?
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True
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Why must you monitor or adjust the dose of protease inhibitors when giving Nevirapine (NVP)?
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Increased metabolism of protease inhibitors with NVP
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Allergic reaction to nevirapine can cause what?
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Rash
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What blood dyscrasia can be caused by nevirapine?
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Granulocytopenia
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What GI effects can be caused by nevirapine?
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Diarrhea, nausea, pain
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What is the oral bioavailability of nevirapine?
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>90%
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Is nevirapine highly lipophilic and distributed to tissues?
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Yes, widely distributed
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How is nevirapine metabolized?
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Hepatic
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Name a protease inhibitor:
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Indinavir (IDV)
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What protease inhibitor is used in combination treatments for HIV and lowers the viral load, raises CD4?
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Indinavir (IDV)
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What enzyme does Indinavir inhibit?
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HIV protease
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What sequence of genes is cleaved by HIV protease?
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gag-pol-env
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Protease inhibitors are metabolized by what?
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CYP3A4
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What are GI effects of indinavir?
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Diarrhea, nausea, pain, vomiting
Less with IDV than other Protease Inhibitors |
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Are GI effects more or less common with indinavir?
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Less common
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Protease inhibitor effect on lipid metabolism causes what?
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"Buffalo hump" fat redistribution
Peripheral wasting, truncal obesity |
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What effect does indinavir have on glucose levels?
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Hyperglycemia
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What are the renal effects of indinavir?
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Nephrolithiasis
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What is HAART?
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Highly active anti-retroviral therapy
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What are the three classes of drugs at least required for HAART?
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1. Zidovudine (RT inhibitor)
2. Indinavir (Protease inhibitor) 3. Nevirapine (NNRTI) |
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Name an integrase inhibitor
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Raltegravir
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What enzyme phosporylates and activates ganciclovir?
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GMP kinase
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Acyclovir or ganciclovir inhibits DNA polymerization?
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Ganciclovir
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What enzyme phophorylates and activates acyclovir?
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Thymidine kinase
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Acyclovir or ganciclovir inhibits viral DNA pol and is a chain terminator?
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Acyclovir
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