Antifungals/Antivirals (Ch.8)

define immunodeficiency

& give an example

- a state in which the body's immune system does not function properly

- HIV/AIDS

immunocompromised (2)

can't fight off fungal infections

- undergone chemo, corticosteroid use autoimmune diseases or organ transplants

define immunosupression

decreased activation or deficiency of the body's immune system

Know the classes of anti-influenza virus drugs. Can you recognize

neuraminidase inhibitors by their names?

wat does it end with

1. neuraminide inhibitors

2. M3 inhibitors

3. RdRp inhibitors

"-mivir"

What viruses belong to the herpes virus family?

1. HSV 1-2

2. Varicella-Zoster (chicken pox)

3. Cytomegalovirus

What percentage of world population is estimated to be infected with herpes virus?

67%

How do you recognize antiviral (anti-HSV) drugs?

"-clovir"

How do -clovir's work? What do they inhibit in viral life-cycle? (1)

stops viral replication & kills the host cell (virus)

What does HSV thymidine kinase do?

activates antiviral drugs by adding first phosphate group

Which virus is responsible for shingles?

varicella zoster virus

What is abreva (Docosanol 10%) cream used for?

HSV-1 (oral herpes)

What is the difference between oral and genital herpes

HSV1 - oral

HSV2 - genital

Which patient population is susceptible opportunistic viral infections?

immunocompromised patients

Chronic Hep C infection can lead to what diseases?

liver cirrhosis and/or cancer

What is the most common route of Hep C?

blood-borne; liver is the major target

Does every HIV patient have AIDS?

no

Why do HIV+ patients often take a combination (cocktail) of antiviral drugs? What is this treatment called?

reduces mortality, improve quality of life, decreases viral load, prevents transmission/drug resistance

called highly active antiretroviral therapy (HAART)

What are the different types of HIV drugs and their suffixes? (3)

NRTI/NNRTIs: "-ivir"

PIs: "-navir"

INSTIs: "-tegravir"

How is Hep C now considered mostly a "curable" disease

new direct acting antivirals (DAAs) have been newly developed and have a 90% cure rate

Why are viruses no considered living organisms?

they rely on their host to live

What is the most common form of oral fungal infection? How is it treated?

oral candidiasis

- acute, chronic or angular cheilitis

treated with azoles or nystatin

Which class of drugs inhibit synthesis of 1,3-beta glucans? and wat do they do and does it end with

echinocandins, decreases cell wall integrity & kills the cells

-"fungin"

Wich polyene comes in oral suspension which is used to gargle. Is it safe to swallow it?

nystatin; safe to swallow

How do polyenes work? 4 parts

what can they aso bind to u and do what after

bind to ergosterol,

forms a pore,

important ions leak out

& the cell dies;

can also bind to cholesterol & damage the cell membrane (nephrotoxicity)

Which drugs belong to the polyene class?

Amphotericin B: treats serious, systemic fungal infections

Nystatin: treats superficial infections, adverse reactions include vomiting and diarrhea

what does Amphotericin B:

treats serious, systemic fungal infections

what does nysatin treat

and adveres reactions

treats superficial infections, adverse reactions include vomiting and diarrhea

What is the most common sterol present in fungal cell plasma membrane. Which drug classes target its synthesis?

ergosterol

azoles & polyenes target its synthesis

How do azoles work?

interferes w/synthesis of ergosterol (cellular component of fungi) which alters the membrane permeability

What can azoles inhibit in human cells?

inhibits purine transport

Any possible drug-drug interactions? with azoles

inhibits CYPA34 which increases toxicity of drugs that use that enzyme to metabolize

What are the risk factors for fungal infections (4)

1. immunocompromised patients

2. very young or old patients

3. patients with DMT2

4. patients with poor circulation

What are two main types of fungal infections?

superficial (most common) & systemic

What are two common types of fungi (that contribute to human disease)?

candidia-like & tinea

Define superficial infection

skin, mucosa, dermatophytes & candida (tx topically)

define systemic infection

systemic: opportunistic mycoses, endemic mycoses

VZV stands for

what cinditon plus age

and treament

varicella zoster virus

- chicken pox or shingles (60+)

tx: aciclovir or valacyclovir

Define CMV

what coditon

and wat treatment

cytomegalovirus

- common in AIDS patients; retinitis & colitis

tx: -"ciclovir"