7Feb

Antiviral Agents Flashcards | Quizlet

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Antiviral Agents Flashcards | Quizlet

 

-immune globulin
-palivizumab
-amantadine
-ribavirin
-acyclovir
-valacyclovir
-ganciclovir
-valganciclovir
-tenofovir
-lamivudine
-emtricitabine
-zanamivir
-oseltamivir
antibodies that bind to viruses to prevent entry into cells
- When injected IM during early stages, can partially alleviate progression of hepatitis, measles, rabies, polio, and other viral disorders
-possibility of anaphylaxis following IV treatment
monoclonal antibody used to block F protein of respiratory syncytial virus
-used for high risk infants
-administered IM prophylactically
a family of proteins/glycoproteins produced in response to infection, particularly viruses.
- Type I, III: Produced by infected cells
- Type II: Produced by immune cells
• Infected cells produce these to warn neighboring cells, repress protein synthesis
amantadine and rimantadine
• Block the M2 protein channel in the viral coat, preventing proton movement
• Virus depends on change in interior pH to open and release RNA; without this, virus can't replicate
which has fewer side effects, amantadine or rimantadine?
-no effect on influenza B, and since 2009, much influenza A is resistant, so no longer as commonly used for flu
-Nosocomial infections, H1N1 are exceptions
-other uses in parkinsons, shingles, and rubella
clinical uses for amantadine and rimantadine
- Purine analog that can be phosphorylated to mimic GTP
- Inhibits viral RNA polymerases, full mechanism unclear
• Tends to act more on viral than host RNA synthesis
• Can introduce mutations into viral RNA
• Also stops RNA capping, depletes GTP pool
• RNA or DNA viruses, including flu, RSV, even hemorrhagic fevers
• Used in combination with IFN for hepatitis C
• Administered orally for HCV, IV for hemorrhagic fever or severe flu, or as aerosol for respiratory infection.
Which drug has the following side effects
• Can cause depression, fatigue, rash, insomnia, nausea, itching
• Respiratory route: cough, sudden deterioration of respiratory function possible.
• Anemia in 10-20% of patients (number varies based on indication and any other drugs given in combination)
• Teratogenic: not safe for pregnancy, extra contraceptives needed for months surrounding treatment of either partner. Pregnant healthcare providers should avoid aerosols
• Xerostomia, changes in taste, especially with PEG-IFN
- Guanosine analog that is rapidly phosphorylated by herpesvirus thymidine kinase
- Triphosphate metabolite inhibits herpesvirus DNA polymerase, halting replication
- Virtually non-toxic, with serious adverse reactions essentially nil
herpes virus (HSV1 best)
-topical, oral, and IV
rare, but can get discomfort at site of application, phlebitis, nausea, vomiting, nephrotoxicity with IV use, and sometimes dry cracked lips and skin
adverse effects with acyclovir
more orally bioavailable than acyclovir due to first pass metabolism, and can be dosed less frequently
-similar GI effects with acyclovir and headaches
Ganciclovir and valganciclovir
• Similar structure and mechanisms of action to acyclovir/valacyclovir - Phosphorylated by viral enzyme, blocks DNA replication
• Less specificity for viral DNA vs. acyclovir/valacyclovir but higher cellular concentration and 100x greater efficacy for CMV
• Used primarily for CMV infections, often ophthalmic but others possible in immunosuppressed patients
- Prophylaxis in transplant patients
- Ganciclovir shows activity against HBV, but not approved for this indication
uses for ganciclovir and valganciclovir
Ganciclovir and valganciclovir
Which drugs have these side effects?
•Teratogenic, pregnancy category C (risk not ruled out)
• Myelosuppression is dose limiting
• Other symptoms: fever, rash, CNS symptoms, abnormal liver function tests
tenofovir, lamivudine, emtricitabine
• These drugs are also nucleoside analogs, and can inhibit DNA polymerases
• Can be used in Hep B infections, but also used in HIV since they inhibit reverse transcriptase
pyrimidine nucleoside that inhibits viral and cellular DNA synthesis
-used for herpes simplex keratitis
-teratogenic and visual haze can happen
zanamivir (inhaled) and oseltamivir (oral)
neuraminidase inhibitors for influenza A and B

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