med chem quiz 9

obligate cellular parasites composed of nucleic acid core and a pretein outer shell

which viruses cause polio, colds, pneumonia, gastroenteritis, influenza, hepatitis, encephalitis, yellow fever, hemorrhagic fever, rubela, mumps, rabies, AIDS, Ebola

which viruses cause cold sores, conjunctivitis, genital herpes, encephalitis, shingles, chickenpox, mononucleosis, hepatitis, small pox, warts, URI

the most successful prophylaxis against viral disease

what is the biggest problem with trying to get a vaccine for a virus

what must vaccines be to provide a response

most common viral infection

virus most humans  are exposed to

virus characterized by chicken pox

virus characterized by blisters and lesions

phosphonate anti-herpes agent
indicated for acyclovir resistant HSV-1&2 and varicella Zoster
injection - not a cure
watch for renal impairment
selective inhibition of pyrophosphate bonding site - specific DNA polymerase

synthetic nucleoside anti-herpes agent
HSV-1&2
epstein-barr
oral, IV or topical
inhibits DNA polymerase and replication by being incorporated into DNA
dosage based on Creatinine clearance

prodrug form of the drug acyclovir
oral use only with rapid first-pass deesterification

synthetic nucleoside anti-herpes agent
only for use in CMV infections in immuno-compormised or transplant patients
known teratogenic - catergory C
MOA - 2 mechanisms, complete inhibition of DNA polymerase, DNA incorporation resulting in DNA chain termination
take with food
dose based on Crcl

synthetic nucleoside anti-herpes agent
ophthalmic implant

synthetic nucleoside anti-herpes agent
indicated for immunocompromised patients (not liver transplant)
prodrug ester of ganciclovir
MOA - 2 mechanisms - competitive inhibition of DNA polymerase, DNA incorporation resulting in DNA chain termination

synthetic nucleoside anti-herpes agent
ind - herpes labialis
moa - inhibits DNA polymerase following phosphorylation to the triphosphate
topical cream

synthetic nucleoside anti-herpes agent
ind - acute herpes zoster, genital herpes
prodrug form of penicilovir
oral use only
moa- inhibits DNA polymerase following phosphorylation to the triphosphate
can be taken without regard to meals

synthetic nucleoside anti-herpes agent
ind - patients that have failed ganciclovir or fascarnet
injection only, must be co-administered with probenecid
moa- inhibits DNA polymerase following phosphorylation to the diphosphate
class C

anti-herpes agent for oral and facial herpes simplex cold sores and lesions
10% cream for topical application
moa - inhibits viral replication of a number of lipid enveloped viruses

anti-sense anti-herpes agent
ind - CMV retinitis in immunocompormised patients
moa - antisense oligonucleotide
intravitreal injection only 
no longer available in the USA

synthetic nucleoside topical opthalmic anti-viral
known as IDU
ind - herpes simplex keratitis
moa - resembles thymidine, incorporated into a pseudostructure
don't use with boric acid solutions, sensitivity to light

synthetic nucleoside topical anti-viral
ind - keratoconjunctivitis
moa - interfers with DNA synthesis, not exactly known
stinging upon administration

synthetic nucleoside topical ophthalmic anti-viral
ointment
discontinued in the USA

anti-RSV
lyophillized powder for aerosol inhalation
infants and young children
accumulates in red cells
teratogenic

anti-RSV agent
safety and efficacy has NOT been established for treatmetn of RSV disease
blocks a critical step in membrane fusion process

treatment for Hep A

phosphonate nucleotide analog of adenosine used for HBV & HIV
moa - prodrug that inhibits HBV DNA polymerase

unmodified beta-L enantiomer of thymidine
HBV for 16 yo and up
no known activity against HIV
competitve inhibition of thymidine 5'-triphosphate

guanosine nucleotide
inhibits all three activities of HBV
no clinically relvant activity against HIV-1
must be taken on an empty stomach

peptidomimetic for HCV
used in combination with peginterferon and ribavirin
compensated liver disease
moa inhibits serine protease
take with high fat meal

peptidomimetic for HCV
used in combination with peginterferon and ribavirin
compensated liver disease
moa inhibits serine protease
take with high/low fat meal

anti-influenza agent
prophylaxis against influenza A
moa- uncoating
renally excreted

anti-influenza agent
prophylaxis against influenza A
moa- uncoating
metabolized by the liver
prodrug substrate for p-glycoprotein not the substrate

anit-influenza neuraminidase inhibitor
influenza A & B, symptomatic for less than 2 days
drug of choice in avian H5N1
moa - ethyl ester prodrug alters particle aggregation and release

anit-influenza neuraminidase inhibitor
influenza A & B, symptomatic for less than 2 days
useful in avian H5N1
moa - ethyl ester prodrug alters particle aggregation and release

cleavage of this, by neuramidase facilitates the spread of new virus and increases pathogenicity

IV only for H1N1