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39 Cards in this Set
- Front
- Back
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Viruses come in 2 flavors:
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- DNA viruses;
- RNA viruses. |
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Name a drug interfering with uncoating of influenza.
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Amantadine
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Drugs that block viral DNA polymerases (3).
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Acyclovir;
Vidarabine; Ganciclovir. |
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Drug that blocks viral RNA polymerase (1).
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Ribavirin
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Drugs that block DNA virus assembly
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Protease inhibitors
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What are protease inhibitors important for?
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HIV/AIDS
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Name 2 drugs that block DNA synthesis as nucleoside analogs; tell which nucleotide they mimic.
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Acyclovir and Ganciclovir; they are guanosine analogs
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What is Acyclovir better against?
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Herpes viruses (Herpes simplex mostly)
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What changes the range of Ganciclovir (compared to Acyclovir)?
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The addition of a methoxy group
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We are hungry.
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Noi abbiamo fame.
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What is the difference between Acyclovir and guanosine?
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The sugar in Acyclovir is not cyclic anymore
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Acyclovir is processed to become phosphorylated for the first time by ...
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viral thymidine kinase
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What are the 2 levels of specificity of Acyclovir?
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- virus infected cells have the thymidine kinase enzyme, normal cells do not;
- triphosphate Acyclovir's affinity for viral DNA polymerase is much greater than for cellular DNA polymerase. |
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Clinical use of Acyclovir:
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- Treatment of genital HSV infections;
- Topical treatment in primary genital HSV and in mucocutaneous HSV infections in immunocompromised hosts |
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Why is Acyclovir not effective in eliminating latent infection?
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Because it blocks DNA synthesis, and a latent infection is when the virus is not replicating...
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Profound adverse effect of Ganciclovir:
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profound bone marrow suppression
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Bone marrow toxicity of Gancoclovir is potentiated with use of...
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AZT
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What are the 2 tricks to limit bone marrow toxicity when using Ganciclovir?
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- Topical injection;
- Induction/Maintenance therapy |
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What is the mechanism of Ribavirin?
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Blocks Inosinate dehydrogenase, which will block further down the synthesis of RNA
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Ribavirin is specific (T/F)
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FALSE
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What can reduce the toxicity of Ribavirin?
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Topical application as an aerosol
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In which cases would Ribavirin would be used?
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In life threatening conditions (Respiratory Syncytial Virus in infants, Parainfluenza virus infections in children)
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What are the adverse effects of Ribavirin?
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- Reversible hemapoietic toxicity;
- mutagenic, teratogenic, embryotoxic. |
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Mechanism of action of Amantadine.
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Blocks M2 protein (ion channel) in influenza virion; prevents viral uncoating
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Under which circumstances would one use Amantadine?
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- Used for prophylaxis in a documented influenza A epidemic.
- CNS effects (parkinson) |
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How does the Influenza virion get hold of our cells?
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The neuraminidase on the virion can attach to neuramidic acid on the surface of our cells
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Name neuraminidase inhibitors (2)
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Zanamivir;
Oseltamivir (tamiflu TM) |
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Influenza is efficient against which Influenza types
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Influenza A and B
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Amantadine works on Influenza ... only.
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Influenza A
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when is Zanamivir not recommended?
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For treatment of patients with underlying airways disease such as asthma or COPD.
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What are the 2 types of reverse transcriptase inhibitors?
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Nucleoside RT inhibitor;
non nucleoside RT inhibitor |
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Name an important frequent adverse effect of using AZT
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Myelosuppression
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M184V resistant mutants are resistant to A, but this mutation restores susceptibility to B.
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A = Lamivudine 3TC;
B = Zidovidine (AZT) |
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Name non nucleoside RT inhibitors
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Nevirapine
Efavirenz Defaviridine |
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Name a few protease inhibitors
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Saquinavir, Ritonavir, Nelfinavir, Idinavir
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Protease inhibitor allow are successful.
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FALSE
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What are some of the side effects caused by protease inhibitors?
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GI disturbances, hypercholesterolemia, hyperglycemia, hypertriglyceridemia, nephrothiasis (kidney stones)
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What are the 2 clinical criteria used to determine if HIV therapy should be used or not?
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- CD4 count
- RTPCR HIV count |
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What is the combination therapy most often used in HIV therapy?
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PI + 2NRTI
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