ANTIVIRAL

Question 1

Potent and selective inhibitor of influenza virus neuraminidase enzymes, which are glycoproteins found on the virion surface.

Oseltamivir
Enfuvirtide
Amantadine
Darunavir

Answer 1

Oseltamivir

Question 2

Binds to the first heptad-repeat (HR1) in the gp41 subunit of the viral envelope glycoprotein and prevents the conformational changes required for the fusion of viral and cellular membranes.

Enfuvirtide
Ritonavir
Nirmatrelvir
Acyclovir

Answer 2

Enfuvirtide

Question 3

Interferes with a viral protein, M2 (an ion channel), which is needed for the viral particle to become “uncoated” once it is taken inside the cell by endocytosis.

Enfuvirtide
Ritonavir
Amantadine
Foscarnet

Answer 3

Amantadine

Question 4

A HIV protease inhibitor, prevents HIV replication through binding to the enzyme, stopping the dimerization and the catalytic activity of HIV-1 protease

it inhibits the cleavage of HIV encoded Gag-Pol proteins in cells that have been infected with the virus

Enfuvirtide
Darunavir
Ritonavir
Nirmatrelvir

Answer 4

Darunavir

Question 5

Potent inhibitor of cytochrome P450 CYP3A4 isoenzyme present both in the intestinal tract and liver

Enfuvirtide
Darunavir
Ritonavir
Nirmatrelvir

Answer 5

Ritonavir

Question 6

has higher affinity for viral DNA polymerase than cellular DNA polymerase and incorporates into the DNA where the missing 2’ and 3’ carbons causes DNA chain termination.

competes so strongly for viral DNA polymerase that other bases cannot associate with the enzyme, inactivating it

Acyclovir
Foscarnet
Remdesivir
lamivudine

Answer 6

acyclovir

Question 7

selective inhibition at the pyrophosphate binding site on virus-specific DNA polymerases at concentrations that do not affect cellular DNA polymerases.

Acyclovir
Foscarnet
Remdesivir
lamivudine

Answer 7

Foscarnet

Question 8

Directly inhibits viral mRNA polymerase by binding to the nucleotide binding site of the enzyme

demonstrates an inhibitory action on viral mRNA guanylyltransferase and mRNA 2′-O-methyltransferase of dengue virus

Foscarnet
ribavirin
Remdesivir
lamivudine

Answer 8

ribavirin

Question 9

Binds to the viral RNA-dependent RNA polymerase, inhibiting viral replication through premature termination of RNA transcription

Foscarnet
ribavirin
Remdesivir
lamivudine

Answer 9

Remdesivir

Question 10

A synthetic nucleoside analogue and is phosphorylated intracellularly to its active 5’-triphosphate metabolite,

This nucleoside analogue is incorporated into viral DNA by HIV reverse transcriptase and HBV polymerase, resulting in DNA chain termination.

Foscarnet
ribavirin
Remdesivir
lamivudine

Answer 10

lamivudine

Question 11

Potent inhibitor of the viral reverse transcriptase

Remdesivir
lamivudine
tenofovir
efavirenz

Answer 11

tenofovir

Question 12

Direct inhibition of the reverse transcriptase enzyme of human immunodeficiency virus type 1 (HIV-1).

It directly binds reverse transcriptase and consequently blocks DNA-dependent and RNA-dependent polymerase activity

Remdesivir
lamivudine
Etravirine
efavirenz

Answer 12

Etravirine

Question 13

Inhibits HIV integrase to prevent the viral genome being incorporated into the human genome.

Etravirine
Raltegravir
Nucleozin
Interferon

Answer 13

Raltegravir

Question 14

Targets influenza A nucleoprotein, a multifunctional, RNA-binding protein necessary for virus replication. It induces the formation of nucleoptotein aggregates and inhibits its accumulation, interfering with viral replication

Etravirine
Raltegravir
Nucleozin
Interferon

Answer 14

Nucleozin

Question 15

Targets and inhibits human host cyclophilins, thereby inhibiting hepatitis C virus (HCV) replication in hepatocytes.

Alisporivir
Aplaviroc
Nucleozin
Interferon

Answer 15

Alisporivir

Question 16

Treatment of acute, uncomplicated illness due to influenza A and B infection in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours

prophylaxis of influenza in patients one year and older

Answer 16

OSELTAMIVIR

Question 17

S/E OSELTAMIVIR

Answer 17

Nausea, vomiting, psychiatric effects

Question 18

Enveloped viruses penetrate by fusion of the viral membrane with the cell membrane, while “naked” viruses penetrate the cell by phagocytosis of the virion and releasing viral genome into the host cytoplasm.

Answer 18

ENTRY INHIBITORS

Question 19

ENTRY INHIBITORS THAT ARE ANTI HIV

Answer 19

Enfuvirtide, Sifuvirtide

Question 20

Human rhinovirus inhibitor

amantadine
pleconaril
enfuvirtide
oseltamivir

Answer 20

Pleconaril

Question 21

Used in combination therapy for the treatment of HIV-1/AIDS

amantadine
pleconaril
enfuvirtide
oseltamivir

Answer 21

enfuvirtide

Question 22

adverse reaction of enfuvirtide

Answer 22

• Injection site reactions (pain, hardening of skin,erythema,nodules,cysts, itch)
• Peripheral neuropathy, insomnia, depression, cough, dyspnea,anorexia,arthralgia, infections (including bacterialpneumonia), and/oreosinophilia
• Hypersensitivity reactions

Question 23

Another antiviral drug target is the uncoating step during viral infection, which is the process of capsid disintegration, retaining the virus in the encapsulated state, and not allowing the virus to release its genomic material into the host cell to interrupt the virus replicative cycle before it proceeds to the reverse transcriptase step.

Answer 23

UNCOATING INHIBITORS

Amantadine, Rimantadine

Question 24

• For the chemoprophylaxis, prophylaxis, and treatment of signs and symptoms of infection caused by various strains of influenza A virus.
• Also, for the treatment of parkinsonism and drug-induced extrapyramidal reactions.

Answer 24

Amantadine

Question 25

adverse effect of amantadine

Answer 25

* Orthostatic hypotension, syncope, peripheral edema, dizziness, delusions, hallucinations, falls, xerostomia, and constipation * Serious adverse effects include **neuroleptic malignant syndrome,** psychosis, suicidal ideation, and CNS depression

Question 26

prevent viral replication by blocking proteolytic cleavage of protein precursors that are necessary for the production of infectious particles.  It should be noted that most viruses also encode proteases, which protect viral proteins by modulating host cell.

Answer 26

Protease inhibitors

Question 27

protease inhibitor that are Anti-HIV

Answer 27

Nelfinavir, Amprenavir, Fosamprenavir, **Darunavir**, Saquinavir, Atazanavir, Indinavir, Lopinavir, **Ritonavir**, Tipranavir, Simeprevir

Question 28

protease inhibitor that is used for COVID

Answer 28

Nirmatrelvir

Question 29

indication of this drug * co-administered with ritonavir, and with other antiretroviral agents, is indicated for the treatment of human immunodeficiency virus **(HIV) in children age 3 or above** and **adults with HIV-1 infection.** amantadine enfuvirtide acyclovir darunavir

Answer 29

darunavir

Question 30

adverse effect of darunavir

Answer 30

>10%: Dermatologic: **Skin rash** Endocrine & metabolic: **Increased serum cholesterol, increased LDL cholesterol, increased serum glucose** Gastrointestinal: Vomiting, nausea, diarrhea

Question 31

Has received FDA emergency use authorization, **in combination with ritonavir**, for the treatment of **Mild-to-moderate coronavirus disease 2019** (COVID-19) in **adults and pediatric patients** 12 years of age and older weighing at least 40 kg With positive results of direct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral testing Who are at high risk for progression to severe COVID-19, including hospitalization or death. a, acyclovir b. nirmatrelvir c. darunavir d. ritonavir

Answer 31

b. nirmatrelvir

Question 32

nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use

Answer 32

paxlovid not authorized for use for longer than five consecutive days.

Question 33

side effects of Paxlovid include

Answer 33

* Impaired sense of taste, diarrhea, high blood pressure and muscle aches * In people with uncontrolled or undiagnosed HIV-1 **infection may lead to HIV-1 drug resistance** * Ritonavir **may cause liver damage**, so caution should be exercised when giving Paxlovid to patients with preexisting liver diseases, liver enzyme abnormalities or liver inflammation.

Question 34

the **drug of choice for the prophylactic** and **curative treatment of herpes simplex (genital herpes) virus and varicella-zoster (shingles) virus infection** acyclovir valcyclovir Valganciclovir

Answer 34

acyclovir

Question 35

used for the treatment of **herpes, varicella zoster, and cytomegaloviruses** acyclovir valcyclovir Valganciclovir

Answer 35

valcyclovir

Question 36

used for the treatment of **herpes, varicella zoster, and cytomegaloviruses** acyclovir valcyclovir Valganciclovir

Answer 36

valcyclovir

Question 37

is effective for the **treatment of AIDS-related CMV retinitis**, and for the **prophylaxis of cytomegalovirus** infection and disease in **high-risk solid organ transplant recipients.** acyclovir valganciclovir valacyclovir

Answer 37

valganciclovir

Question 38

Used to treat **herpes simplex**, **Varicella zoster**, **herpes zoster**, **herpes labialis**, and **acute herpetic keratitis**

Answer 38

ACYCLOVIR * **acyclovir topical cream** is indicated to treat **recurrent herpes labialis in immunocompetent patients** 12 years and older. * An acyclovir **ophthalmic ointment** is indicated to **treat acute herpetic keratitis.** * Acyclovir **oral tablets, capsules, and suspensions** are indicated to **treat herpes zoster, genital herpes, and chickenpox.**

Question 39

ADVERSER EFFECT OF ACYCLOVIR USE

Answer 39

Nausea, vomiting, diarrhea, **encephalopathy** (with IV use only), **injection site reactions** (with IV use only) and **headache**

Question 40

ADVERSER EFFECT OF ACYCLOVIR USE

Answer 40

Nausea, vomiting, diarrhea, **encephalopathy** (with IV use only), **injection site reactions** (with IV use only) and **headache**

Question 41

* For the treatment of **CMV retinitis** in patients with acquired immunodeficiency syndrome **(AIDS)** and for treatment of **acyclovir-resistant mucocutaneous HSV infections** in **immunocompromised** patients.

Answer 41

foscarnet

Question 42

* For the treatment of **CMV retinitis** in patients with acquired immunodeficiency syndrome **(AIDS)** and for treatment of **acyclovir-resistant mucocutaneous HSV infections** in **immunocompromised** patients.

Answer 42

foscarnet

Question 43

ADVERSE EFFECT OF FOSCARNET

Answer 43

1. **Nephrotoxicity** — Increase in serum creatinine levels occurs on average in 45% of patients receiving foscarnet. Other nephrotoxic drugs should be avoided. Nephrotoxicity is usually **reversible** and can be **reduced by dosage adjustment and adequate hydration**. 2. Electrolyte disturbances — Changes in **calcium, magnesium, potassium and phosphate levels** occurs commonly and regular monitoring of electrolytes is necessary to avoid clinical toxicity 3. ***Genital ulceration*** — Occurs more commonly in **men** and usually occurs during induction use of foscarnet. It is most likely a contact dermatitis due to high concentrations of foscarnet in urine. It usually resolves rapidly following discontinuation of the drug. 4. **CNS** — Paresthesia, irritability and **hallucinations.**