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31 terms

PDA Exam 1 Viruses (through hepatitis)

STUDY
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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