Antiviral Drugs

Question 1

What are NRTIs

Answer 1

Nucleoside/nucleotide reverse transcriptase inhibitors

Question 2

How do NRTIs work

Answer 2

Competitively inhibit neucleotides binding to reverse transcriptase and terminate the DNA chain

Question 3

What’s the difference between nucleosides and nucleotides

Answer 3

Nucleosides need to be phosphorylated to get activated

Question 4

What are NRTIs side effects

Answer 4

Can cause mitochondrial toxicity and lactic acidosis

Question 5

Give examples of NRTIs and common ending

Answer 5

Mainly end with - dine

• lamivudine
• zidovudine
• stavudine
• didanosine
• abacavir

Question 6

Lamivoudine adverse effects

Answer 6

Can cause peripheral neuropathy

Question 7

What can lamivoudine treat other than HIV

Answer 7

It can also treat hepatitis B, alongside tenofovir (neucleotide)

Question 8

When is zidovudine used and what are it’s adverse effects

Answer 8

Used during pregnancy and breast feeding to reduce vertical transmission. May cause myelosppression (anemia and granulocytopenia)

Question 9

Stavudine side effect

Answer 9

Peripheral neuropathy

Question 10

Didanosine side effect

Answer 10

May cause pancreatitis

Question 11

Abacavir side effect

Answer 11

Hypersensitivity associated with HLA-B57:01 allele

Delayed rash

Question 12

What are NNRTIs

Answer 12

non-nucleoside reverse-transcriptase inhibitor

Question 13

NNRTIs mechanism of action

Answer 13

Bind to reverse transcriptase at different site than NRTIs, doesn’t requires phosphorylation to become active.

Question 14

Example of NNRTI

Answer 14

Nevirapine

Question 15

Nevirapine adverse effects

Answer 15

Can cause Rash, hepatoxicity and Steve Johnson syndrome (conjunctivitis and mucosal destination)

Question 16

HIV protease inhibitors ending suffix and examples

Answer 16

Ends with -Navir

Ritonavir is the most important since it inhibits p450 which enhances other PIs

Question 17

Which gene codes for HIV proteases

Answer 17

POL gene

Question 18

HIV protease inhibitors adverse effects

Answer 18

Hyperglycemia, dyslipidemia, lipodystrophy (buffalo hump) and insulin resistance

Question 19

Integrase inhibitor mechanism of action

Answer 19

Inhibits incorporation if HIV genome in to host cells DNA

Question 20

Example of integrase inhibitor

Answer 20

Raltegravir

Question 21

Give examples of fusion inhibitors

Answer 21

Enfuvirtide

Miraviroc

Question 22

Enfuvirtide path inhibited and way of administration

Answer 22

Enfuvirtide is given IV - it binds to GP41 inhibiting entry

Question 23

Miravoric path inhibited and way of administration

Answer 23

Miroviric is given orally - binds to CCR5 on Tcells inhibiting entry

Question 24

What is HAART

Answer 24

Highly active antiretroviral therapy

Question 25

Example of HAART

Answer 25

Two NRTIs and protease inhibitor or | Two NRRIs and NNRTI

Question 26

How to prevent mother to child transmission

Answer 26

Test for HIV, C Section, No breast feeding and antiretroviral therapy

Question 27

What is the antiretroviral therapy used for pregnant women

Answer 27

Two NRTIs backbone(Abacavir and Lamivudine) and ritonavir with any PI OR (Tenofovir and emtricitabine) and ritonavir with other PI

Question 28

Prophylaxis against HIV

Answer 28

Zidovudine and Lamivudine and Indinavir

Question 29

Drugs against hepatitis B

Answer 29

IFN-alpha, lamivudine (NRTI and DNA polymerase inhibitor) | Also tenofovir and entecavir and adefovir (nephrotoxicity)

Question 30

Treatment of Hepatitis C

Answer 30

IFN-alpha (pegylated- longer T1/2)) and Ribavirin(interferes with viral mRNA)

Question 31

Drugs for COVID 19

Answer 31

Remedesivir (prodrug, interferes with RNA-dependent RNA polymerase—> inhibiting viral RNA synthesis

Question 32

Inhibitors of viral uncoating

Answer 32

Amantadine and rimantadine (active against only influenza A and for prophylaxis)

Question 33

Neuroamidase inhibitors

Answer 33

Oseltamivir (Oral) and Zanamivir(inhaled or intranasal) (active against influenza A and B)

Question 34

What are anti herpetic drugs

Answer 34

DNA polymerase inhibitors

Question 35

How does resistance to acyclovir happen

Answer 35

Mutation in tymidine kinase

Question 36

What does acyclovir treat

Answer 36

Given for HSV, VZV and EBV treatment of primary and recurrent herpes genitalis—> oral, herpes labialis—> topical(given 4-5x daily while valcyclovir (3x daily)

Question 37

What is given for HSV infections in immunocompromised, VZV and encephalitis

Answer 37

I.V acyclovir

Question 38

What is given when herpes is resistant to cyclovir

Answer 38

Foscarnet

Question 39

What is given in CMV infections

Answer 39

Ganciclovir(can cause myelosuppression) | And Foscarnet