Anti-Virals: Non-HIV Quiz

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Questions and Answers

What is the primary mechanism of action of acyclovir?

  • Enhances the immune response
  • Inhibits viral protein production
  • Inhibits viral RNA synthesis
  • Inhibits the activity of viral DNA polymerase (correct)

What is one of the main adverse effects associated with ganciclovir?

  • Respiratory depression
  • Bone marrow suppression (correct)
  • Skin rash
  • Kidney damage

Which medication is primarily used for the treatment of chronic hepatitis B and C?

  • Adefovir
  • Interferon alfa (correct)
  • Ribavirin
  • Tamiflu

What type of infections does the cytomegalovirus primarily affect in immunocompromised patients?

<p>GI tract, lungs, and eyes (C)</p> Signup and view all the answers

What class of drugs are oseltamivir and zanamivir classified under?

<p>Antivirals for influenza (A)</p> Signup and view all the answers

Which of the following medications is used to treat herpes zoster?

<p>Acyclovir (D)</p> Signup and view all the answers

What is the mechanism of action for darunavir?

<p>It binds to HIV protease, preventing the cleavage of polyproteins. (B)</p> Signup and view all the answers

Which medication should be monitored for its impact on white blood cell counts?

<p>Ganciclovir (B)</p> Signup and view all the answers

What is a common adverse effect associated with darunavir?

<p>Hyperglycemia (D)</p> Signup and view all the answers

Which is NOT a common adverse effect of interferon alfa?

<p>Kidney failure (D)</p> Signup and view all the answers

Which type of antiretroviral medication does raltegravir belong to?

<p>Integrase strand transfer inhibitor (B)</p> Signup and view all the answers

What is a potential drug interaction concern for darunavir?

<p>Interactions with P450 inducers like rifampin (A)</p> Signup and view all the answers

What is a common adverse effect of amphotericin B?

<p>Nephrotoxicity (A)</p> Signup and view all the answers

Which antifungal medication is used to treat candidiasis?

<p>All of the above (D)</p> Signup and view all the answers

What is the mechanism of action of enfuvirtide?

<p>Prevents HIV from fusing with CD4 cell membranes (D)</p> Signup and view all the answers

Which of the following is NOT an adverse effect of amphotericin B?

<p>Hyperlipidemia (A)</p> Signup and view all the answers

What is the primary mechanism of action for nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)?

<p>Inhibits the synthesis of viral DNA by reverse transcriptase, causing premature termination. (C)</p> Signup and view all the answers

Which of the following is a side effect commonly associated with abacavir (Ziagen)?

<p>Syndrome of lactic acidosis with hepatomegaly (A)</p> Signup and view all the answers

What role do integrase inhibitors play in HIV treatment?

<p>They prevent viral DNA from integrating into the host genome. (B)</p> Signup and view all the answers

Which type of medication is efavirenz (Sustiva)?

<p>NNRTI (A)</p> Signup and view all the answers

What is a common nursing consideration for patients taking non-nucleoside reverse transcriptase inhibitors (NNRTIs) like efavirenz?

<p>Monitor liver function due to potential hepatotoxicity. (B)</p> Signup and view all the answers

What is the function of protease inhibitors in HIV treatment?

<p>They prevent the maturation of HIV viruses. (A)</p> Signup and view all the answers

What is a key interaction to be cautious of when administering abacavir?

<p>Monitor arterial blood gases with suspected acidosis. (B)</p> Signup and view all the answers

Which of the following statements about HIV therapy is correct?

<p>Combination therapy is important to minimize the risk of drug resistance. (A)</p> Signup and view all the answers

What is the primary mechanism of action (MOA) of isoniazid (INH)?

<p>Inhibits synthesis of mycolic acid (C)</p> Signup and view all the answers

Which adverse effect is commonly associated with both isoniazid and rifampin?

<p>Hepatotoxicity (A)</p> Signup and view all the answers

Which of the following medications is NOT classified as a first-line treatment for tuberculosis?

<p>Levofloxacin (A)</p> Signup and view all the answers

What is the primary use of rifabutin?

<p>For treatment of active tuberculosis in combination with other drugs (D)</p> Signup and view all the answers

Which drug interaction is a concern when prescribing isoniazid?

<p>Increased risk of hepatotoxicity with alcohol (C)</p> Signup and view all the answers

Flashcards

Acyclovir MOA

Inhibits viral DNA production by blocking viral DNA polymerase.

Ganciclovir use

Treats CMV retinitis in immunocompromised patients and CMV prevention in transplant patients.

Interferon's MOA (Hepatitis)

Blocks viral entry and viral protein synthesis to stop viral spread.

Oseltamivir use

Used to prevent or treat influenza A and B, including specific strains like H1N1 and H5N1.

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HSV Infections

Herpes simplex virus infections: oral herpes, genital herpes; Varicella-zoster virus: chickenpox, shingles.

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Cytomegalovirus (CMV)

A herpes virus remaining dormant, reactivating in immunocompromised individuals.

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Hepatitis Definition

Inflammation of the liver, often caused by a viral infection.

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Hepatitis Treatment

Combination therapies (e.g., interferon, ribavirin, antiviral drugs) depending on the type of hepatitis.

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What is tuberculosis?

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It mainly affects the lungs, but can also damage other organs.

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How is TB spread?

TB is spread through the air when an infected person coughs, sneezes, speaks, or sings. The bacteria are released in tiny droplets that can be inhaled by others.

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What are the first-line TB drugs?

The first-line drugs for treating TB are isoniazid (INH), rifampin, pyrazinamide (PZA), and ethambutol. These drugs are often used in combination.

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What are the adverse effects of isoniazid?

Isoniazid can cause hepatotoxicity (liver damage) and peripheral neuropathy (nerve damage).

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What is rifampin's MOA?

Rifampin inhibits mycobacterial protein synthesis. It stops the bacteria from making essential proteins needed for growth.

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HIV Replication Step 1

HIV attaches to CD4 receptors on host cells. CCR5 antagonists block this attachment.

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HIV Replication Step 2

HIV fuses with the cell membrane and enters the host cell. Fusion inhibitors prevent this fusion.

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HIV Replication Step 3

Viral RNA is converted to DNA by reverse transcriptase. Reverse transcriptase inhibitors block this step.

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HIV Replication Step 4

Viral DNA integrates into the host's DNA. Integrase inhibitors prevent this integration.

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HIV Replication Step 5

Host cells produce more HIV. Protease inhibitors stop the final maturation of HIV.

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NRTIs (Nucleoside/Nucleotide Reverse Transcriptase Inhibitors)

NRTIs are similar to DNA building blocks and stop HIV from creating its own DNA. They are often used in combination with other HIV drugs.

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NNRTIs (Non-Nucleoside Reverse Transcriptase Inhibitors)

NNRTIs directly bind to and block the reverse transcriptase enzyme, preventing HIV DNA production.

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Protease Inhibitors

Protease inhibitors prevent the final maturation of HIV. They're rarely used alone due to the risk of drug resistance and are typically combined with reverse transcriptase inhibitors.

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Darunavir MOA

Darunavir binds to HIV protease, stopping the enzyme from cleaving HIV polyproteins. This prevents the virus from maturing and becoming infectious.

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Darunavir Side Effects

Darunavir can cause hyperglycemia (high blood sugar), fat redistribution, high cholesterol, weakened bones, liver problems, and interactions with certain medications.

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Raltegravir MOA

Raltegravir inhibits integrase, a viral enzyme that helps HIV integrate its genetic material into the host's DNA.

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Raltegravir Side Effects

Common side effects of Raltegravir include headaches, trouble sleeping, and allergic reactions affecting the skin or liver.

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Enfuvirtide MOA

Enfuvirtide prevents HIV from fusing with the cell membrane of CD4 cells, blocking entry and infection.

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Enfuvirtide Use

Enfuvirtide is used to treat HIV infections that are resistant to other antiretroviral medications.

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Amphotericin B MOA

Amphotericin B binds to ergosterol in fungal cell membranes, increasing permeability, leading to leakage of cellular components and cell death.

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Amphotericin B Side Effects

Amphotericin B can cause serious side effects including infusion reactions, kidney damage, low potassium, and bone marrow suppression.

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Study Notes

Anti-Virals: Non-HIV

  • Herpes Viruses (HSV): Infections of the mouth, face, and genitals. Varicella-zoster virus (VZV) causes chicken pox and shingles.
  • HSV Medications: Acyclovir/Zovirax, Valacyclovir/Valtrex, Famciclovir/Famvir.
    • Acyclovir/Zovirax MOA: Inhibits viral DNA synthesis by converting it into an inhibitor of viral DNA polymerase. It treats oral and genital herpes simplex.
    • Adverse Effects (AE): GI upset, headache, IV infusion site irritation, nephrotoxicity.
  • Cytomegalovirus (CMV): A herpes virus that remains dormant but can reactivate in immunocompromised patients. Causes GI, lung, and eye infections.
    • CMV Medications: Ganciclovir/Cytovene, Valganciclovir/Valcyte, Cidofovir/Vistide.
    • Ganciclovir/Cytovene MOA: Suppresses viral DNA synthesis.
    • CMV Indications: CMV retinitis in immunocompromised patients, and prevention in transplant patients.

Hepatitis

  • Definition: Inflammation of the liver, typically caused by viral infection.
  • Symptoms: Widespread liver inflammation, scarring (fibrosis), necrosis, and bile flow disruption.
  • Medications: Interferon alfa/Intron A, Roferon-A, Ribavirin/Rebetol, Lamivudine/Epivir, Adefovir/Hepsera, Simeprevir/Olysia, Sofosbuvir/Solvaldi.
  • Interferon Alfa MOA: Binds to host cell membranes, blocks viral entry, and inhibits viral protein synthesis. Used for chronic Hepatitis B and C
  • Adverse Effects (AE): Flu-like symptoms, depression, heart damage, bone marrow suppression.

Influenza

  • Definition: Respiratory infection characterized by fever, chills, cough, sore throat, muscle aches.
  • Treatment: Primarily managed with vaccines.
  • Medications: Oseltamivir/Tamiflu, Zanamivir/Relenza, Amantadine/Symmetrel, Rimantadine/Flumadine.
  • Oseltamivir/Tamiflu MOA: Stops viral spread by inhibiting replication enzymes. It is used for prophylaxis/treatment for influenza A and B types and H1N1, H5N1.

Antivirals: HIV

  • Definition: Immune system impairment causing opportunistic infections.
  • HIV Replication: HIV attaches to CD4 receptors, fuses with host cell membrane, transcribes RNA into DNA with reverse transcriptase, integrates into host DNA, and produces more HIV.
  • HIV Medications: Combination therapy (ART) is standard.
    • Reverse Transcriptase Inhibitors (RTIs): Nucleoside/Nucleotide (NRTIs) and Non-Nucleoside (NNRTIs).
    • Protease Inhibitors: Suppress viral maturation.
    • Integrase Strand Transfer Inhibitors: Prevent integration of viral DNA into host DNA.
    • HIV Fusion Inhibitors: Prevent fusion of HIV with host cell membrane.
    • Examples: Abacavir/Ziagen, Zidovudine/Retrovir, Lamivudine/Epivir, Efavirenz/Sustiva, Darunavir/Prezista, Raltegravir/Isentress.
    • Adverse Effects: Hypersensitivity reactions, lactic acidosis, hepatomegaly, CNS symptoms.

Anti-Fungals

  • Types: Polyenes, Azoles.
  • Polyenes (e.g., Amphotericin B): Bind to ergosterol in fungal membranes, disrupting cell integrity (broad spectrum).
  • Azoles (e.g., Itraconazole, Fluconazole): Inhibit ergosterol synthesis, causing cellular leakage.
  • Adverse Effects (AE): Infusion reactions, nephrotoxicity, hypokalemia, hepatotoxicity, cardiac suppression.
    • Specific Examples of AE: infusion reactions, nephrotoxicity, hypokalemia, hepatotoxicity, bone marrow suppression, cardiac suppression

Anti-Tuberculosis

  • Definition: Infectious disease caused by Mycobacterium tuberculosis.
  • Pathology: Airborne droplets harboring the bacteria which inspire into the lungs triggering inflammation, forming tubercles.
  • Medications: Isoniazid (INH), Rifampin, Pyrazinamide (PZA), Ethambutol, Streptomycin, Ethionamide, etc.
  • Isoniazid (INH) MOA: May inhibit synthesis of mycolic acid. It's indicated for prophylaxis and treatment alongside other TB drugs.
  • Rifampin MOA: Inhibits mycobacterial protein synthesis.
  • Adverse Effects (AE): Hepatotoxicity, peripheral neuropathy.
  • Precautions and Monitoring: Monitor liver enzyme levels, teach the patient about signs of liver disease.

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