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10.10 Anti viral
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78
Microbiology
Professional
10/12/2011

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Term
What one antiviral prevents viral genome integration?
Definition
raltegravir (for HIV)
Term
What is amantadine/rimantadine used for?
Definition
influenza A
Term
What is Enfurvitide used for?
Definition
HIV
Term
Whati s maraviroc used for?
Definition
HIV
Term
What is acyclovir/valacyclovir used for?
Definition
HSV, VZV
Term
What is adefovir dipivoxil used for?
Definition
HBV
Term
What is cidofovir used for?
Definition
CMV, HSV, VZV, EBV, HHV-6
Term
What is entecavir used for?
Definition
HBV
Term
What is famciclovir/penciclovir used for?
Definition
HSV, VZV, EBV
Term
What is foscarnet used for?
Definition
HSV, VZV, CMV (EBV, HHV-6, HBV, and HIV)
Term
What ganciclovir/valganciclovir used for?
Definition
CMV, HSV, VZV, EBV
Term
What is lamivudine used for?
Definition
HBV, HIV
Term
What is ribavirin used for?
Definition
RSV, HCV, lassa virus
Term
What are NRTIs/NNRTIs used for?
Definition
HIV
Term
What is inteferon used for?
Definition
HPV, HBV, HCV
Term
What are protease inhibitors used for?
Definition
HIV, HCV
Term
What is interferon used for?
Definition
RNA tumor viruses
Term
What is oseltamivir/anamivir used for?
Definition
Influenza A and B
Term
What is Mab with poison used for?
Definition
HIV (in progress)
Term
How do viruses become resistant to DNA/RNA polymerase inhibitors?
Definition
change of phosphorylation pathway
change of polymerase substrate affinity
change in polymerase at NNRTI binding site
Term
What are mechanisms behind the side effects of DNA/RNA polymerase inhibitors?
Definition
host DNA/RNA replication inhibition, mitochondrial toxicity, etc.
Term
Name the anti-herpes agents.
Definition
acyclovir, valacyclovir, famciclovir, penciclovir, trifluridine, and vidarabine
Term
What durg is an acyclic guanosine derivative?
Definition
acyclovir, ganciclovir
Term
In what form is acylcovir given to the pat?
Definition
oral, IV, topical
Term
How is acyclovir cleared from the body?
Definition
glomerular filtratioln and tubular secretion
Term
What are the side effects of acyclovir (as well as valacyclovir, famciclovir, etc.)?
Definition
nausea, diarrhea, headache, tremors, delirum
Term
What is the difference between valacyclovir and acyclovir?
Definition
valacyclovir is an L-valyl ester of acyclovir that is converted to acyclovir when ingested
Term
What is famciclovir/how does it work?
Definition
prodrug of penciclovir (a guanosine analog); same mechanism as acyclovir except it doesn't cause chain termination
Term
What are the anti-cytomegalovirus agents?
Definition
gancylovir, valgancyclovir, cidofovir, foscarnet
Term
How do you get resistence to ganciclovir?
Definition
mutation in UL97 phosphotransferase
Term
What are the side effects of ganciclovir/valganciclovir?
Definition
myelosuppression
Term
What is the difference between valganciclovir and ganciclovir?
Definition
valg is a monovalyl ester prodrug of gancyclovir that is metabolized by intestinal and hepatic esterases when administered orally
Term
What is cidofovir/how does it work?
Definition
a cytosine analog whose phosphorylation is NOT dependent on viral enzymes (therefore resistance is due to mutation in DNA polymerase gene)
Term
What are the side effects of cidofovir?
Definition
nephrotoxicity (prevented by probenecid
Term
What is Foscarnet/how does it work?
Definition
inorganic pyrophosphate that inhibits viral DNA pol, RNA pol, and HIV RT. DOESN"T HAVE TO BE PHOSPHORYLATED
Term
How do you form resistence to foscarnet?
Definition
mutations in DNA pol
Term
What are the side effects of foscarnet?
Definition
hypo or hypercalcemia and phosphatemia, renal failure, genital ulcers
Term
What are the different types of antiretroviral agents?
Definition
NRTIs, NNRTIs, protease inhibitors, fusion inhibitors, CCR5 co-receptor inhibitors, integrase inhibitors
Term
What is zidovudine?
Definition
AZT; NRTI nucleoside
Term
What is stavudine?
Definition
NRTI nucleoside that can cause peripheral neuropathy
Term
What is lamivudine?
Definition
NRTI nucleoside that can be used for HBV. Can rarely cause pancreatitis
Term
What is emtrimcitabine?
Definition
NRTI nucleoside with HBV action; rarely causes pancreatitis
Term
What is abacavir?
Definition
NRTI nucleoside, hypersensitivity esp in HLA B5701
Term
What is didanosine?
Definition
NRTI nucleoside that can cause pancreatitis
Term
What is entecavir?
Definition
NRTI nucleoside with HBV action only
Term
What is telbivudine?
Definition
NRTI nucleoside with HBV action only
Term
What is tenofovir?
Definition
NRTI nucleotide that can rarely cause renal dysfunction; has HBV action
Term
What is adefovir?
Definition
NRTI nucleotide that rarely causes renal dysfunction and has HBV action ONLY
Term
What is nevirapine?
Definition
NNRTI that causes hepatic dysfunction
Term
What is efavirenz?
Definition
NNRTI that causes CNS dysfunction and rarely hepatic dysfunction. Also is a teratogen
Term
What is the mechanism of action of AZT (zidovudine)?
Definition
deoxythymidine analog that enters the cell via passive diffusion and then is converted to triphosphate by mammalian thymidine kinase. Causes chain termination
Term
What is the mechanism of resistance against zidovudine?
Definition
mutations in RT gene
Term
What diseases can you usezidovudine against?
Definition
HIV1, HIV2 and HTLVs
Term
T/F AZT helps prevent mother to newborn transmission of HIV.
Definition
true
Term
What are the side effects of zidovudine?
Definition
GI intolerance, headaches and insomnia
Term
NNRTIs are substrates and inhibitors of ___.
Definition
CYP3A4
Term
Which NNRTI do you use to prevent transmission of HIV from mother to newborn?
Definition
nevirapine (not efavirenz because its teratogenic)
Term
Which NNRTI do you use to prevent transmission of HIV from mother to newborn?
Definition
nevirapine (not efavirenz because its teratogenic)
Term
Which NNRTI do you use to prevent transmission of HIV from mother to newborn?
Definition
nevirapine (not efavirenz because its teratogenic)
Term
Indinavir, ritonavir, saquinavir, nelfinavir, fos-amprenavir, lopinavir/ritonavir, tipranavir, darunaivr are all exampels of...
Definition
protease inhibitors
Term
How do protease inhibitors work?
Definition
inhibits proteases that cleave precursor molecules to produce mature, infectious virions,
Term
What are the side effects of protease inhibitors?
Definition
syndrome of altered body fat distribution, insulin resistance and hyperlipidemia
Term
What are contraindications for protease inhibitors?
Definition
it is an inhibitor/substrate for CPY3A4; careful with other drugs
Term
What is the name of the drug that is a CCR5 antagonist?
Definition
Maraviroc
Term
How does enfuvitide work? How is it given to the patient?
Definition
efurvitide (T-20) binds to the gp41 subunit of gp 160 preventing the conformational changes required for fusion of the viral and cellular membranes; given via subq injection
Term
What type of drug is raltegravir?
Definition
integrase inhibitor
Term
What are the drugs for hep B?
Definition
polymerase inhibition (lamivudine or emtricabine, entecavir, telbuvidine, tenofovir or adefovir)
pegylated interferon alpha
Term
What is the treatment for hep C?
Definition
pegylated interferon alpha + ribavirin +/- protease inhibitors (boceprevir, telaprevir)
Term
What is the mechanism of interferon alpha to treat viral infection?
Definition
induce host cell enyzmes that inhibit viral RNA translation and cause degradation of viral mRNA and tRNA
bind to membrane receptors on cell surface
May also inhibit viral penetration, uncoating, mRNA synthesis and translation and virion assembly release
Term
Why is interferon alpha pegylated?
Definition
a linear or branched polyethylene glycol (PEG) is attached covalently to increase half-life and steady drug concentrations. Allows less frequent dosing
Term
What is ribavirin/how does it work?
Definition
a guanosine analog that is phosphorylated intracellularly by host enzymes. Inhibits capping of viral messenger RNA, viral RNA dependent RNA polymerase, and replication of DNA and RNA viruses
Term
What are the oral NS3 protease inhibitors?
Definition
boceprevir and telaprevir
Term
How do NS3 protease inhibitors work?
Definition
inhibit a nonstructural hep C protein responsible for proteolytic processing of other non-structural proteins
Term
NS3 protease inhibitors are generally used in combination with...
Definition
interferon alpha and ribavirin
Term
List the anti-influenza agents.
Definition
amantidine, rimantadine, zanamivir, oseltamivir
Term
How do amantadine and rimantidine work?
Definition
they are cyclic amines that inhibit the uncoating of viral RNA.
Term
How do viruses get resistant to amantadine/rimantadine?
Definition
mutations in the RNA sequence coding for the structural M2 protein
Term
How do zanamivir and oseltamivir work?
Definition
inhibit the enzyme neuraminidase by inhibiting the replication of influenza A and B (most avian strains too)
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