Anti-viral Agents

What kind of cells does HIV destroy?

Helper T cells

What two enzymes are needed for HIV to replicate?

reverse transcriptase

integrase

What are the 3 approached to antiviral therapy?

1. vaccination

2. stimulate hosts natural resistance

3. chemotherapy

What are the general mechanisms of antiviral drugs?

1. prevent virus from entering host cell

2. stop transcription/translation of virus

3. prevent maturation of virus

What is the mechanism of an HIV infection?

1. binding to host cell

2. fusion

3. reverse transcription

4. integration

5. replication

6. assembly

7. budding

What are the drug classes used to treat HIV?

Entry Inhibitors

Nucleoside Analogs (NRTIs)

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Integrase Inhibitors

What are the general side effects of HIV treatment?

decreased appetite

N/V/D

increased cholesterol

hepatotoxicity

rash

mood changes

Examples of entry inhibitors?

Enfuvirtide

Maraviroc (Selzentry)

What is the MOA of Enfuvirtide?

Binds gp41 therefore inhibiting fusion to host cell

What is the. MOA of Maraviroc (Selzentry)?

blocks CCR5, inhibiting gp120 from binding host cell

What is a downside to Maraviroc (Selzentry)?

uses CYP450, DDI

What are examples of nucleoside analogs (NRTIs) for HIV?

Emtricitabine

Tenofovir

What is the MOA of NRTIs?

added to RNA/DNA chain, decoy, stops chain from growing

What kind of drugs are Emtricitabine, Tenofovir?

NRTIs

What are examples of NNRTIs for HIV?

Efavirenz

Rilpivirine

What is the MOA of NNRTIs?

inhibit reverse transcriptase therefore inhibiting DNA synthesis

What kind of drugs are Efavirenz and Rilpivirine?

NNRTIs

What is an example of an integrase strand transfer inhibitor?

Elvitegravir

What kind of drug is Elvitegravir???

Integrase inhibitor

What is the MOA of Elvitegravir?

inhibits integrase therefore blocking integration of viral genome into host DNA

What is the current recommendation for HIV treatment?

to use meds from ≥2 classes

(NRTI + another drug class)

What is Cobicistat?

HIV booster, reduces HIV drug metabolism by inhibiting CYP450 enzymes

How is Hep B spread?

blood and body fluids

What is the goal of treatment for Hep B?

suppress replication and slow disease

What drugs are used to treat Hep B?

Lamivudine

Interferon-A

What are Lamivudine and Interferon-A used to treat?

Hep B

What kind of drug is Lamivudine?

NRTI

What is the MOA of Interferon-A (Intron A)?

inhibits viral entry, uncoating, and mRNA + ptn synthesis, also warns neighbor cells to heighten antiviral defenses.

What is a downside to using Interferon-A (Intron A)??

serious side effects since it is pro-inflammatory

How is Hep C spread?

blood

What is the goal of hep C treatment?

eliminate the virus

What drugs are used to treat Hep C?

Daclastasavir (Daklinza)

Sofosbuvir (Sovaldi)

What is the MOA of Daclastasavir (Daklinza)?

NS5A inhibitor, inhibits viral replication and assembly

What is the MOA of Sofosbuvir (Sovaldi)?

NS5B RNA polymerase inhibitor

What drugs are used to treat influenza?

Amantadine (Osmolex ER)

Oseltamivir (Tamiflu)

Zanamivir (Relenza)

What are the following drugs used to treat?

Amantadine (Osmolex ER)

Oseltamivir (Tamiflu)

Zanamivir (Relenza)

influenza

What is the MOA of Amantadine (Osmolex ER)?

blocks influenza uncoating after it enters cell

What are downsides to amantadine?

often develops resistance

needs to be dosed with 48hrs

What type of drugs are Oseltamivir (Tamiflu) and Zanamivir (Relenza)?

neuraminidase inhibitors

Examples of neuraminidase inhibitors?

Oseltamivir (Tamiflu)

Zanamivir (Relenza)

What is the MOA of Oseltamivir (Tamiflu) and Zanamivir (Relenza)?

inhibits neuraminidase therefore blocks the release of viral particles

What is important when giving neuraminidase inhibitors?

early dosing is crucial

What are the side effects of Zanamivir (Relenza)?

cough

bronchospasm

What is the DOC for herpes?

Acyclovir (Zovirax)

What kind of drugs are Acyclovir and Valacyclovir?

Non-nucleoside polymerase inhibitors

Examples of Non-nucleoside polymerase inhibitors?

Acyclovir

Valacyclovir

What is unique about Acyclovir?

it is a prodrug, requires thymidine kinase from infected cells to activate

What are the side effects of acyclovir?

numbness + tingling

hair loss

agitation

What is an example of an entry inhibitor for herpes?

Docosanol (Abreva)

What is the MOA of Docosanol (Abreva)??/

inhibits fusion of HSV to host cell, therefore preventing entry

What drugs are used to treat RSV?

Ribavirin

Palivizumab

What is the MOA of Ribavirin (Moderiba)?

guanosine analog, interferes with viral replication

What form is Ribavirin (Moderiba)?

aerosol

What is the MOA of Palivizumab (Synagis)?

mAb against RSV glycoprotein