PDA Exam 1 Viruses (through hepatitis)

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Neuraminidase Inhibitors:
1. Two drugs
2. Mechanism

1. Zanamivir, oseltamivir
2. Inhibits cleavage and release of virus

Zanamivir:
1. Treats..
2. Administration
3. Must be given within..
4. Adverse effects

1. Influenza A and B
2. Inhaled
3. Two days of onset of symptoms
4. None, since inhaled

Oseltamivir:
1. Treats..
2. Administration
3. Adverse effects (3)

1. Influenza A and B
2. Oral
3. Limited; hepatitis, elevated liver enzymes, anaphylaxis

Neuraminidase Inhibitors:
1. Drug interactions
2. Pregnancy category

1. None
2. C

Uncoating Agents:
1. Two drugs
2. Mechanism

1. Amantadine, rimantadine
2. Interferes with viral M2 protein; unable to uncoat

Amantadine/Rimantadine:
1. Treats..
2. Pregnancy category
2. Drug interactions (seizures)

1. Only influenza A
2. C
3. Bupropion, contrast agents, tramadol

Amantadine/Rimantadine: Adverse (4)

1. CNS effects
2. Congestive heart failure
3. Hypertension
4. Hematological

Where do each "hide out":
1. HSV 1 and 2
2. Zoster
3. HCMV

1. Neuronal cells
2. Neuronal cells
3. Immune cells

Purine Nucleoside Analogs (4)

1. Acyclovir
2. Gancyclovir
3. Pencyclovir
4. Deoxyguanosine

Acyclovir:
1. Treats what?
2. Must be given within..
3. Inhibits what?

1. HSV 1 and 2, zoster; prophylaxis for HCMV
2. 24 hours of onset
3. CYP 1A2

Acyclovir: Adverse (3)

1. Anaphylaxis
2. Hematological
3. Hematuria

Acyclovir:
1. Pregnancy category
2. Drug interactions: nephrotoxicity (2)

1. B
2. Cidofovir, sirolimus

Low Therapeutic Index (2)

1. Aminoglycosides
2. Ganciclovir

Ganciclovir:
1. Treats..
2. Pregnancy category
3. Adverse effects (1) and incidence rate

1. HCMV
2. C
3. Serious hematological; 30% incidence rate

Ganciclovir: Drug Interactions (4 drugs)

1. Tumor necrosis factor blockers
2. Hematologic disorders: clozapine, deferiprone, zidovudine

Famciclovir:
1. Treats..
2. Pregnancy category
3. Adverse effects (1)
4. Drug interactions

1. Same as acyclovir
2. B
3. Erythema (sunburn-like)
4. None

Cidofovir:
1. Mechanism
2. Phosphorylated by..
3. Pregnancy category

1. Inhibits viral DNA synthesis
2. Endogenous enzymes (bypasses viral selectivity and activation)
3. C

Cidofovir:
1. Treats..
2. Adverse effects (1) and incidence rate
3. Drug interactions: any drugs that cause..

1. HCMV retinitis, GCV-resistant HCMV, ACV-resistant HSV
2. Nephrotoxicity; 50% incidence
3. Nephrotoxicity

Foscarnet:
1. Mechanism
2. Adverse effects (2) and incidence rate
3. Therapeutic uses
4. Pregnancy

1. Inhibits viral DNA polymerase and HIV reverse transcriptase
2. Nephrotoxicity (50%), hypocalcemia
3. HCMV retinitis, GCV-resistant HCMV, ACV-resistant HSV and zoster
4. C

Foscarnet: Drug Interactions (4 causes)

1. Increased nephrotoxicity
2. QT interval
3. Increased seizures
4. Increased hypocalcemia

Hepatitis C vs. B
1. DNA/RNA?
2. Latency?
3. Which drugs can treat for both?

C vs. B:
1. RNA; DNA
2. No; yes
3. C drugs can treat B but B drugs can't treat C

Interferon:
1. Mechanism
2. Pregnancy category
3. Treats..

1. IFN-alpha binds/activates the JAK-STAT pathway
2. C
3. Hepatitis C or B

Interferon: Adverse (5)

1. Depression
2. Myelodepression
3. Neurotoxicity
4. Autoimmune disorders
5. Cardiovascular (hypotension, tachycardia)

Interferon: Drug Interactions
1. Increased seizures (3)
2. Increased myelosuppression (2)
3. Increased risk of infection (2)

1. Bupropion, contrast agents, tramadol
2. Clozapine, deferiprone
3. Leflunomide, natalizumab

Ribavirin mechanism: promotes Th cell type 1 over type 2 by.. (2)

1. Depleted GTP pools
2. Direct inhibition of HCV RNA polymerase

Ribavirin:
1. Pregnancy category
2. Adverse effects (2)
3. Treats..

1. X
2. CNS, hematological
3. Hepatitis C or B

Ribavirin: Drug Interactions
1. Increased myelosuppression (2)
2. Increased mitochondrial toxicities (peripheral neuropathy, pancreatitis, lactic acidosis) - 1

1. Azathioprine, mercaptopurine
2. Didanosine

Adefovir:
1. Mechanism
2. Adverse effects (1)
3. Pregnancy category

1. Competitive inhibitor of viral DNA polymerase
2. Nephrotoxicity
3. C

Adefovir:
1. Treats..
2. Drug interactions: anything that causes..

1. Hepatitis B only
2. Nephrotoxicity

Entecavir:
1. Mechanism (2)
2. Adverse effects (2)
3. Drug interactions
4. Pregnancy category

1. Inhibits viral DNA polymerase; inhibits reverse transcription
2. Hepatotoxicity; hepatic encephalopathy
3. None
4. C

Telbivudine:
1. Mechanism
2. Adverse effects (2)
3. Drug interactions
4. Pregnancy category

1. Competitive inhibitor of viral DNA polymerase
2. Myalgia, myopathy
3. None
4. B

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