Antimicrobial therapy - anti-viral drugs

Question 1

What does it means that all anti viral drugs are virustatic

Answer 1

inhibit growth/ replication

Question 2

Give examples of Herpes viruses

Answer 2

Herbes simple virus
Varicella zoster virus
Epstein-barr virus
cytomegalovirus

Question 3

What is an antiviral that is active against both HSV and VZV

Answer 3

aciclovir

Question 4

How is aciclovir activated

Answer 4

Converted to active from by an enzyme (thymidine kinase) coded for by the virus genome

Question 5

What is the benefits of aciclovir being activated by virus genome

Answer 5

Specific for virus infected cells

Low toxicity for unaffected cells

Question 6

What do you do with acyclovir in patients with renal impairment

Answer 6

lower the does

Question 7

What antiviral drugs are used in the treatment of HSV and shingles instead of aciclovor and why

Answer 7

famciclovir and valaciclovir

better bioavailability

Question 8

ganciclovir is active against what herpes virus

Answer 8

cytomegalovirus

toxic given by IV fusion

Question 9

What is valganciclovir

Answer 9

prodrug of ganciclovir oral alternative

Question 10

What needs to be moniitored with valganciclovir and ganciclovir

Answer 10

Blood count for bone marrow toxicity

Question 11

When is foscarentt used

Answer 11

Used for some HSV, VZV and CMV infections when the infection is resistant to other antifungals

Question 12

What are features of fosxarent

Answer 12

Highly nephrotoxic and is only given by IV

Question 13

When is Cidofovir used

Answer 13

for CMV when other anti fungals are inappropriate

Question 14

Name all the different anti herpes virus drugs

Answer 14

Aciclovir - HSV/ VZV
Famciclovir and Valaciclovir - HSV and shingles (stronger)
ganciclovir CMV (IV)
valganciclovir  CMV (oral)
foscarnet HSV VSV CMV (IV) (last resort)
cidofovir - CMV (last resort)

Question 15

What is a nucleoside analogue

Answer 15

interfere with the action of the reverse transcription

Question 16

What therapy is used for HIV

Answer 16

Combination therapy of at least two drugs which are active on different stages of HIV replication

Question 17

What inhibitors can be used in therapy of HIV

Answer 17

Two nucleoside analogue reverse transcriptase inhibitors
plus non-nucleoside reverse transcriptase inhibitors
or a Protese inhibitor

Question 18

How is HIV therapy monitored

Answer 18

viral load and CD4+ cell count

Question 19

What is used to treat chronic hepatitis B and C

Answer 19

Interferon alpha
Lamivudine - hep B
Ribavain

Question 20

What is the advantage of interferon alpha

Answer 20

taken orally

Question 21

What is lamivudine mainly used to treat

Answer 21

HIV treatment and Hep B

Question 22

Zanamavir and oseltamivir are both used in the treatment of what

Answer 22

Influenza within 48 hours of symptoms or as prophalaxis

Question 23

What nucleoside analogue can be used for the treatment of respiratory syncytial virus

Answer 23

Ribavarin

Question 24

What is genotypic analysis

Answer 24

sequencing of part of viral genome

Question 25

What is drug monitoring for in antiviral therapy

Answer 25

ensure therapeutic index

Question 26

What antiviral drugs can be monitored

Answer 26

some anti HIV drugs and aciclovir

Question 27

What is an anti HIV for nucleoside analogue

Answer 27

Zidovudine

Question 28

In Ant- HIV what is the non-nucleoside reverse transcriptase inhibitors or the Protese inhibitor that is used in combination with zidovudine

Answer 28

non-nucleoside reverse transcriptase inhibitors - nevirapine Protease inhibitor -saquinavir