antiviral pharmacology
Terms
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- Viral adsorption and penetration into the cell is blocked by ---------.
- Gama-globulins (non-specific).
- Uncoating of the virus after its penetration into the cell is blocked by --------.
- Amantadine (influenza A).
- Antiviral chemotherapy: Early viral protein synthesis is blocked by --------.
- Fomivirsen (CMV).
- Antiviral chemotherapy: Viral nuclei acid synthesis is blocked by --------.
- Purine, pyrimidine analogs; reverse transcriptase inhibitors.
- Late viral protein synthesis and processing is blocked by --------.
- Methimazole (variola); protease inhibitors.
- Antiviral chemotherapy: Packaging and assembly of new viron is blocked by --------.
- Rifampin (vaccinia).
- Mechanism of action of Amantadine.
- Blocks viral penetration/uncoating; may buffer pH of endosome. Also causes the release of dopamine from intact nerve terminals. "Amantadine blocks influenza A and rubellA and causes problems with the cerebellA."
- Clinical uses of Amantadine.
- Prophylaxis for influenza A; Parkinson's disease.
- Symptoms of Amantadine toxicity.
- Ataxia, dizziness, slurred speech. (Rimantidine is a derivative with fewer CNS side effects.) "Amantadine blocks influenza A and rubellA and causes problems with the cerebellA."
- Mechanism of action of Zanamivir.
- Inhibits influenza neuraminidase.
- Clinical use of Zanamivir.
- Both influenza A and B.
- Mechanism of action of Ribavirin.
- Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase.
- Clinical use of Ribavirin.
- RSV (respiratory syncytial virus).
- Symptoms of Ribavirin toxicity.
- Hemolytic anemia. Severe teratogen.
- Mechanism of aciton of Acyclovir.
- Perferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase.
- Clinical use of Acyclovir.
- HSV, VZV, EBV. Mucocutaneous and genital herpes lesions. Prophylaxis in immunocompromised patients.
- Symptoms of Acyclovir toxicity.
- Delirium, tremor, nephrotoxicity.
- Mechanism of action of Ganciclovir.
- Phosphorlation by viral kinase; perferentially inhibits CMV DNA polymerase.
- Clinical use of Ganciclovir.
- CMV, especially in immunocompromised patients.
- Symptoms of Ganciclovir toxicity.
- Leukopenia, neutropenia, thrombocytopenia, renal toxicity. More toxic to host enzymes than acyclovir.
- Mechanism of action of Foscarnet.
- Viral DNA polymerase inhibitor that binds to the pyrophophate binding site of the enzyme. Does not require activation by viral kinase. "FOScarnet = pyroFOSphate analog."
- Clinical use of Foscarnet.
- CMV retinitis in immunocompromised patients when ganciclovir fails.
- Foscarnet toxicity.
- Nephrotoxicity.
- Saquinavir, ritonavir, indinavir, nelfinavir, amprenavir are example of this type of anti-HIV drug.
- Protease inhibitor.
- Mechanism of action of protease inhibitors.
- Inhibit assembly of new virus by blocking protease enzyme.
- Symptoms of protease inhibitor toxicity.
- GI intolerance (nausea, diarrhea), hyperglycemia, lipid abnormalities, thrombocytopenia (indinavir).
- Zidovudine (AZT), didanosine (ddI), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), and abacavir are examples of --------- reverse transcriptase inhibitors.
- Nucleoside.
- Nevirapine, delavirdine, and efavirenz are examples of --------- reverse transcriptase inhibitors.
- Non-nucleoside.
- Mechanism of action of reverse transcriptase inhibitors.
- Preferentially inhibit reverse transcriptase of HIV; prevent incorporation of viral genome into host DNA.
- Symptoms of reverse transcriptase inhibitor toxicity.
- Bone marrow supression (neutropenia, anemia), periphral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), megaloblastic anemia (AZT).
- Highly active antiretroviral therapy (HAART) generally entails combination therapy with ---------- and -----------.
- Protease inhibitors, reverse transcriptase inhibitors.
- When should HIV therapy be initiated?
- When patients have low CD4 counts (<500 cells/mm3) or high viral load.
- Mechanism of action of Interferons.
- Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis.
- Clinical use of Interferons.
- Chronic hepatitis B and C, Kaposi's sarcoma.
- Symptoms of Interferon toxicity.
- Neutropenia.