ANTIVIRAL

Question 1

Acyclovir MOA

Answer 1

guanosine analog, is preferentially phosphorylated by viral thymidine kinase and inhibits
viral DNA polymerase, halting viral DNA synthesis by chain termination

Question 2

TK is produced at a ? rate in herpes

infected cells than in noninfected cells

Answer 2

higher

Question 3

Rapid intravenous infusion of acyclovir

Answer 3

reversible

obstructive nephropathy16

Question 4

prodrug of its active metabolite, acyclovir

Answer 4

Valacyclovir

Question 5

Valacyclovir vs Acyclovir

Answer 5

enhanced bioavailability

converts rapidly completely into acyclovir

Question 6

Valacyclovir has been shown to be superior to acyclovir

Answer 6

shortening the duration of pain from post-herpetic

neuralgia associated with zoster patients

Question 7

Longer intracellular half-life than acyclovir

Answer 7

Famciclovir

Question 8

prodrug of penciclovir

Answer 8

Famciclovir

Question 9

CMV retinitis in immunocompromised patients and for CMV prophylaxis in
transplant patients

Answer 9

Gancyclovir

Question 10

PO Gancyclovir

Answer 10

has very poor bioavailability

Question 11

Adverse effects Gancyclovir:

Answer 11

Bone marrow suppression, neutropenia, and thrombocytopenia; worsened
by concomitant administration of AZT

Question 12

Foscarnet MOA

Answer 12

Noncompetitive inhibition of viral DNA polymerases at the pyrophosphate-binding site

Question 13

Foscarnet active against viruses

resistant to acyclovir, famciclovir, or ganciclovir on basis of altered kinase activities

Answer 13

Does not require phosphorylation for antiviral activity

Question 14

Penile erosions

Answer 14

Foscarnet

Question 15

HSV or VZV infection resistant to acyclovir ganciclovir-resistant CMV

Answer 15

Foscarnet

Question 16

Cidofovir MOA

Answer 16

Nucleotide analogue

• Does not require phosphorylation by virus, but is converted by host cell kinases to diphosphate

Question 17

Cidofovir ADR

Answer 17

Renal—proteinuria and increased creatinine

Question 18

Zidovudine AZT

Answer 18

preferentially inhibits HIV

reverse transcriptase rather than human DNA polymerase

Question 19

Zidovudine SKIN ADR

Answer 19

dark streaks nails,
diffuse and oral hyperpigmented macules,
trichomegaly

Question 20

Zidovudine ADR

Answer 20

Bone marrow suppression with subsequent anemia and granulocytopenia is

Question 21

Didanosine

Answer 21

pyrimidine nucleoside analog

Question 22

Didanosine basic environment absorption

CANNOT COMBINE

Answer 22

ketoconazole, itraconazole, or quinolone

antibiotics because requirement of an acidic environment

Question 23

Abacavir moa

Answer 23

• A nucleoside reverse transcriptase inhibitor

Question 24

• Causes a hypersensitivity reaction in

Answer 24

approximately 5% of treated patients → can be fatal

upon rechallenge of abacavir

Question 25

Protease Inhibitors adr

Answer 25

lipodystrophy, which manifests as abnormal fatty deposits | known as the “buffalo hump” and “protease pouch

Question 26

Protease Inhibitors MOA

Answer 26

Block the protease enzyme responsible for final assembly of new viral proteins

Question 27

Indinavir can cause

Answer 27

gynecomastia and periungal pyogenic granulomas

Question 28

Several HIV medications including indinavir, zidovudine, and lamivudine

Answer 28

have been reported to cause periungual/paronychial eruptions | resulting in PG-like lesions22,23

Question 29

Interferons • Given IV, IM, IL, or SQ Effective in treatment of chronic hepatitis C and warts

Answer 29

Cytokines with broad antiviral, immunomodulating, and antiproliferative effects

Question 30

Interferons dose-related ADR ;

Answer 30

• Side effects: Fever, chills, headache, myalgia, arthralgia, GI symptoms

Question 31

granulocytopenia, thrombocytopenia, various neurotoxicities, alopecia, hepatotoxicity, and autoantibody formation

Answer 31

Interferons ADR

Question 32

Imiquimod | Does not exhibit direct antiviral activity,

Answer 32

but instead exerts its action through immunomodulation | Induces cytokines,(TNF)-α, (IFN)-γ, (IFN)-α, (IL)-12, stimulation of a cell-mediated immune response

Question 33

Podophyllin • A crude cytotoxic extract from the treatment OF

Answer 33

May apple plant, condyloma acuminatum

Question 34

Podophyllin MOA

Answer 34

antimitotic, arresting cells in | metaphase by binding to the protein tubulin