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99 Cards in this Set
- Front
- Back
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What is Acyclovir?
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this is a gunosine analogue
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What activates Acyclovir?
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viral thymidine kinase
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How does Acyclovir work?
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inhibits DNA synthesis by competing for dGTP
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How does resistance to Acyclovir develop?
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decrease in viral thymidine kinase
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How is Acyclovir given?
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oral, topical, IV
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How does renal function affect Acyclovir?
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decreased renal function affects drug levels alot
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How is ValAcyclovir better?
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better bioavailability
food doesnt affect absorption twice daily form |
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What is Acyclovir used for?
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herpes of all kinds
prophylaxis in transplants and immunocompromised |
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What are the side effects of Acyclovir?
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N/V/HA
nephrotoxicity if dehydrated |
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Is Acyclovir safe for pregnancy?
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yes it is
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How does Docosanol work?
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this inhibits viral fusion to cell membrane
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What does Docosanol treat?
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cold sores/herpes simplex
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What do Ganciclovir/Valganciclovir do?
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this inhibits CMV DNA replication
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How is Ganciclovir/Valganciclovir activated?
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viral kinases
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How toxic is Ganciclovir/Valganciclovir?
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more toxic than acyclovir- because it is less selective
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What are the side effects of Ganciclovir/Valganciclovir?
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neutropenia, thrombocytopenia
rash HA/confusion/seizures abnormal LFTs |
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What does Cidofovir treat?
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resistant CMV and herpes
prevent renal tox with probenecid/hydration |
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What does Foscarnet treat?
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Resistant herpes and CMv
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How does Foscarnet work?
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inhibits DNA and RNA polymerase/reverse transcriptase
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How does Fomvirsen work?
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antisense compound to viral mRNA
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What does Fomvirsen treat?
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CMV retinitis
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What do oseltamivir/zanamivir do?
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these are neuraminidase inhibitors
blocking release of virus from cells |
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What do oseltamivir/zanamivir treat?
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influenza A and B
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how is oseltamivir given?
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oral
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how is zanamivir given?
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nasal
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What are the two major side effects of zanamivir?
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may worsen respiratory function in COPD
may cause bronchospasm |
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what are the side effects of oseltamivir?
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N/V
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What is ribavirin?
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a purine analogue (pure As Gold)
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What does ribavirin do?
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inhibits viral RNA synthesis, inhibits RNA pol and GTP synthesis
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What is ribavirin used against?
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RSV and hep C
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What is ribavirin given for IV?
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Lassa fever, SARS
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What is the major side effect of ribavirin?
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this is teratogenic
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What are the typical side effects of ribavirin?
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pulmonary problems
anemia depression GI upset lethargy |
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What is Palivizumab?
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antibody to RSV that provides passive immunity
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How is Palivizumab given?
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injected once a month
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What does Interferon A/B do?
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blocks viral entry
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What does Interferon 1 do?
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blocks transcription and translation of mRNA
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What does Interferon 2 do?
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blocks viral replication
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What does Interferon 3 do?
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blocks viral processing
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What does Interferon 4/5 do?
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blocks viral assembly and release
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How long do you have to treat Hep C with Interferon?
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about 12 weeks- 50-75% of people will clear the virus
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What are the toxicities of Interferon?
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flu like
aches/pains GI CNS depression anemia/neutropenia hypotension/edema |
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What is Boceprevir/Telaprevir?
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these are protease inhibitors against hep C
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What genotype are Boceprevir/Telaprevir used against?
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type 1 hep C
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What makes Boceprevir/Telaprevir dangerous?
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Strong inhibition of CYP3A4
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What are the side effects of Boceprevir/Telaprevir?
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anemia, neutropenia, leukopenia, fatigue, rash
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What is the DOC for Hep B?
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Lamivudine
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What is Lamivudine?
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a reverse transcriptase inhibitor used for HIV and HBV
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What is Adefovir?
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Hep B tx drug
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what may Adefovir cause?
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renal toxicity, lactic acidosis
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What is Zidovudine?
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thymidine analogue, inhibits reverse transcriptase
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How does Zidovudine work?
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incorporated into DNA, and inhibits RT
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Where in the body can Zidovudine go?
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gets into the CNS
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What is Zidovudine used to treat?
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keep CD4 count up
psoriasis, t cell leukemia |
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How does resistance to Zidovudine develop?
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quickly with monotherapy
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What are the MAJOR side effects of Zidovudine?
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Neutropenia/anemia
Lactic Acidosis/Heptotoxicity |
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What are the drug interactions with Zidovudine?
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cimetidine/benzo inhibit metabolism
probenecid decreases elimination |
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What increases the risk of granulocytopenia with Zidovudine?
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acetaminophen, ganciclovir
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What is Lamivudine?
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this inhibits HIV reverse transcriptase and HBV polymerase
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What is the first choice drug you combine Lamivudine with?
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Zidovudine
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What is Lamivudine given as monotherapy for?
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HBV
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What is the drug of choice for treatment naive pts with HIV?
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Tenofovir/Emtricitabine
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What are the side effects of Didanosine?
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peripheral neuropathy
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What are the side effects of Zalcitabine?
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peripheral neuropathy
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What are the side effects of Stavudine?
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peripheral neuropathy
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What are the side effects of Abacavir?
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hypersensitivity
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What kind of drugs are Efavirenz, Nevirapine, Delaviridine, Etravirine?
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these are non nucleotide reverse transcriptase inhibitors
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How do non nucleotide reverse transcriptase inhibitors work?
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these directly inhibit viral RT by binding it
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What MUST non nucleotide reverse transcriptase inhibitors be used with?
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nucleoside analogues
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What non nucleotide reverse transcriptase inhibitor should NOT be used in pregnancy?
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Efavirenz
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What non nucleotide reverse transcriptase inhibitor causes hepatitis and stevens johnson?
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Nevirapine
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Can you use Protease inhibitors alone?
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NO, you should combined them NRTI's
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What are side effects of protease inhibitors?
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buffalo hump
abdominal fat increases thin face |
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What are the side effects of protease inhibitors?
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high TAG's and cholesterol
atherosclerosis Diabetes Depression abdominal pain |
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What is Atazanavir?
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this is a protease inhibitor, drug of choice!
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How is Atazanavir given?
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once a day orally
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What kind of drug is Darunavir?
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protease inhibitor
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What is Darunavir often combined with?
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Ritonavir
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What are the side effects of Darunavir?
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headache, nightmares
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What is Ritonavir?
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this is protease inhibitor
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What are the side effects of Ritonavir?
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inhibits CYP3A4
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What is ritonavir often given for?
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combined with other protease inhibitors to increase their bioavailability
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What does Ritonavir contain?
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alcohol
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What is Saquinavir?
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this is protease inhibitor
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How is Saquinavir given?
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with high fat food, grapefuits, because it has poor oral bioavailability
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What enzyme metabolizes Saquinavir?
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CYP3A, so inducers will decrease its effectiveness
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What are the side effects of Saquinavir?
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GI upset
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What is Indinavir?
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a protease inhbitor
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What does Indinavir have cross resistance with?
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ritonavir
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what are the side effects of Indinavir?
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kidney stone,s hyperbilirubinemia
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What are Amprenavir/fosamprenavir?
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these are protease inhibitors
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what should be avoided with Amprenavir/fosamprenavir, why?
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avoid metronidazole, because it contains propylene glycol
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What are the side effects of Amprenavir/fosamprenavir?
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SJS, rash
inhibits CYP3A4 |
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What is Tipranavir?
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this is a non pepiditic protease inhibitor
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What in Enfuvirtide?
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this is a viral fusion inhibitor
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How does Enfuvirtide work?
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binds viral envelope glycoproteins
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Is there cross resistance with Enfuvirtide?
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nope
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What is Raltegravir?
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this is an integrase inhibitor
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How does Raltegravir work?
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blocks integrase, prevents viral replication
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