Term
| Influenza internal antigens |
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Definition
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Term
| Influenza external antigens |
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Definition
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Term
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Definition
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Term
| Amantidine treats which type |
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Definition
| A only (B have structurally distinct M2 channels) |
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Term
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Definition
| Inhibits M2, prevents H+ influx, inhibits release of nucleocapsids to prevent replication |
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Term
| Why is Rimanditine better |
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Definition
| More potent, less CNS toxicity |
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Term
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Definition
| Cleaves terminal sialic acid residues (mucosal protection); necessary for release of viral progeny & entry into respiratory epithelial cells |
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Term
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Definition
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Term
| Stages blocked by NA inhibitors |
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Definition
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Term
| Oseltamivir, Zanamivir - age requirements |
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Definition
| Oseltamivir if >18, Zanamivir if >12 |
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Term
| NA inhibitors: do they block spread of virus or prevent infection? |
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Definition
| Block spread - limits progeny released |
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Term
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Definition
| Give within 48h to shorten Sx. Doesn't reduce incidence of 2ndary infections |
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Term
| NA inhibitors side effects |
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Definition
| Both - nausea, vomiting. Oseltamivir - neuropsychiatric, Zanamivir - bronchoconstriction |
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Term
| Ribivirin - structure/mechanism |
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Definition
| Guanosine analog that interferes with purine metabolism |
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Term
| Ribavirin - "error catastrophe" |
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Definition
| Makes a lot of mutations, drives virus to extinction |
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Term
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Definition
| Hemolytic anemia, birth defects |
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Term
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Definition
| Binds RSV F-glycoprotein (fusion) to inhibit entry and prevent infection |
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Term
| Palivizumab indicated patients |
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Definition
| Infants <2 with lung problems (from chronic bronchopulmonary dysplasia, prematurity) |
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Term
| Major targets for anti-herpes viruses |
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Definition
| Thymidine kinase, DNA polymerase. These drugs affect both, which is advantageous |
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Term
| Viral thymidine kinase function |
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Definition
| Phosphorylates to a mono-phosphate thymidine TMP form. Host converts to TDP then to TTP to be used in DNA synthesis |
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Term
| Why can HSV, VZV, EBV replicate in non-dividing cells |
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Definition
| They make their own TK and DNA polymerase |
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Term
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Definition
| Doesn't make a TK, but has UL97. Gancyclovir targets this |
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Term
| Two types of nuc acid synth inhibitors |
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Definition
| Chain terminators, competitive inhibitors |
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Term
| Vidarabine structure, main usage, problems |
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Definition
| Adenosine analog, prevent death from HSV encephalitis, administered IV. Toxicity issues |
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Term
| Alternative to Vidarabine; what are its advantages |
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Definition
| Acyclovir; higher selectivity & potency, so can be used at lower concentration with fewer side effects |
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Term
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Definition
| Poor water solubility & oral bioavailability (IV needed for high concentration). |
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Term
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Definition
| Cream form for cold sores |
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Term
| Good group of patients to use acyclovir |
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Definition
| Immunocompromised patients (HSV encaphalitis high mortality) |
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Term
| Valcyclovir - structural difference to acyclovir, and its advantage |
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Definition
| Valine ester of acyclovir, which improves oral bioavailability 3-5x |
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Term
| Valcyclovir risks if used IV |
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Definition
| Higher peak levels, more potent, renal toxicity (crystal formation) |
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Term
| Penciclovir traits and uses |
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Definition
| Guanosine analog, poor oral, used as topical cream for cold sores |
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Term
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Definition
| Prodrug of pencyclovir to improve bioavailability, improved resolution of VZV over acyclovir |
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Term
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Definition
| Guanosine analog; competitive inhibitor of DNA polymerase |
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Term
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Definition
| CMV (in immunocompromised patients). BUT - extremely toxic (Carcinogenic). Reduces Sx, duration, but doesn't prevent recurrence |
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Term
| Enzyme used by CMV (since it doesn't have a TK) |
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Definition
| Protein kinase UL97 phosphorylates gancyclovir instead |
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Term
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Definition
| Trifluorouridine, Idoxuridine |
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Term
| Trifluorouridine, idoxuridine uses |
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Definition
| Opthalmic solutions for herpes keratitis. Toxic if systemic; incorporated into viral DNA |
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Term
| Trifluorouridine, idoxuridine - which one has lower irritation |
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Definition
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Term
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Definition
| Nucleoside phosphonate; not dependent on phosphorylation by viral enzymes, unlike acyclovir |
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Term
| Cidofovir purpose and mechanism |
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Definition
| Treats HCMV retinitis; selective inhibitor of viral DNA synthesis; nephrotoxic side effect |
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Term
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Definition
| Block pyrophosphate binding site to inhibit herpes polymerase |
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Term
| When do you use foscarnet |
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Definition
| Life-threatening cases (risks of myelosuppression, teratogenic, CNS effects, renal tox) |
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Term
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Definition
| Antisense oligonucleotide which binds to a CMV mRNA transcript (Immediate Early IE gene) |
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Term
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Definition
| Intravitreal injection, HCMV retinitis, immunocompromised patients |
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Term
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Definition
| Nucleoside reverse transcriptase inhibitor (NRTI); Non-nucleoside RT inhibitor (nNRTI), Protease inhibitor |
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Term
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Definition
| Mimics nucleoside to chain terminate by incorporation or competitive inhibit at reverse transcriptase |
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Term
| Zidovudine (AZT) category, mechanism |
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Definition
| NRTI, incorporated into growing DNA to terminate elongation |
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Term
| Zidovudine side effect and treatment for that side effect |
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Definition
| Granulocytopenia (Tx w/ G-CSF), anemia (Tx w/ erythropoeitin) |
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Term
| Lamivudine category, mechanism, favorable properties |
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Definition
| NRTI, chain terminator, oral F0 = 80%, may be able to cross BBB |
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Term
| Lamivudine - additional use besides HIV; side effect |
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Definition
| Also for Hep B; can cause anemia |
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Term
| Didanosine use, side effects |
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Definition
| NRTI, AZT (Zidovudine)-resistant HIV; many general effects and rare ones including peripheral neuropathy, pancreatitis |
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Term
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Definition
| NRTI, Competitive inhibitor, low toxicity |
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Term
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Definition
| NRTI, also works on Hep B |
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Term
| Non-nucleoside RT inhibitor mechanism: |
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Definition
| Allosteric binding to reverse transcriptase (non-competitive inhibition) |
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Term
| Nevirapine traits & resistance |
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Definition
| Most frequently used NNRTI; rapid resistance may develop if used alone, and resistance to one NNRTI may result in resistance to all |
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Term
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Definition
| Hepatotoxicity, fatal rash |
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Term
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Definition
| NNRTI, part of preferred combo |
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Term
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Definition
| Tenofovir, emtricitabine, efavirenz |
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Term
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Definition
| NNRTI, lower efficacy, rarely used, many drug interactions |
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Term
| Intro to protease inhibitors: retrovirus polyprotein cleavage strategy (GAG, PR, PT) |
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Definition
| Retrovirus polyprotein is cleaved by PR to become GAG, PR, RT. Next, PR cleaves GAG into multiple products that activate the RT. Final step doesn't happen until HIV has entered cells |
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Term
| Where do protease inhibitors act |
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Definition
| Virions leaving an infected cell; Extracellular, infectious virions; Virions just entering cells |
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Term
| Other virus type that protease inhibitors could theoretically be designed to target |
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Definition
| Any plus strand virus with polyprotein processing; but, HIV is the easiest to do because the protease is REQUIRED to activate virion for infection |
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Term
| General HIV protease bad side effect |
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Definition
| LIPODYSTROPHY or produce/worsen diabetes; must always be used in combination to avoid selecting for resistant types |
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Term
| Indinavir specific problem |
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Definition
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Term
| Ritonavir specific problem |
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Definition
| Induces AND inhibits CYP450 - unpredictable effect on blood triglycerides |
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Term
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Definition
| Fusion inhibitor; binds GP41 to prevent fusion |
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Term
| Purpose of PEGylating INF |
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Definition
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Term
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Definition
| PEG-INF, Ribavirin, Protease inhibitor (targeting NS3-4A protease) |
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Term
| Which type of Hep C still isn't cured |
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Definition
| Genotypes 1a, 1b - the most prevalent in North America. New drugs targeting NS5 protease may work against this |
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Term
| Ribavirin side effects from this combo |
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Definition
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Term
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Definition
| Nucleotide analog; inhibits HCV and NS5A (RNA dept RNA pol cofactor), used for treatment against HCV genotypes 2, 3, 4, AND 1 |
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