Antivirals

Question 1

Anti-Influenza drugs

Answer 1

Oseltamivir, Zanamivir, Rimantadine

Question 2

mechanism: oseltamivir, zanamivir

Answer 2

inhibit neuraminidase; inhibit viral progeny release

Question 3

sialic acid analogs

Answer 3

oseltamivir, zanamivir

Question 4

adverse effects: oseltamivir, zanamivir

Answer 4

GI upset

**zanamivir may exacerbate COPD/asthma

Question 5

flu strain treated by oseltamivir and zanamivir

Answer 5

A and B

Question 6

inhibitors of viral genome replication: HSV and VZV

Answer 6

acyclovir, valacyclovir

Question 7

inhibitors of viral genome replication: CMV

Answer 7

ganciclovir, valganciclovir

Question 8

Inhibitors of viral genome replication: HSV, VZV, CMV

Answer 8

cidofovir, foscarnet

Question 9

Antihepatitis Virus

Answer 9

ribavirin
INF a

Question 10

hepatitis B

Answer 10

lamivudine
tenofovir
adefovir
entecavir
telbivudine

Question 11

hepatitis C

Answer 11

simeprevir
sofosbuvir
ledepasvir
daclatasvir
dasabuvir

Question 12

Does acyclovir cure HSV/VZV infections?

Answer 12

no, mangement

Question 13

mechanism: acyclovir, valacyclovir

Answer 13

nucleoside analog
guanine attached to acyclic moiety

Question 14

acyclovir is activated by

Answer 14

thymidine kinase

Question 15

ACV monophosphate is converted to

Answer 15

ACV triphosphate

Question 16

resistance to acyclovir

Answer 16

mutation/loss of thymidine kinase

Question 17

mechanism: ribavirin

Answer 17

inhibits guanine synthesis, mutates viral DNA

Question 18

ribavirin is activated by

Answer 18

host kinases

Question 19

ribavirin inhibits

Answer 19

RNA polymerase

Question 20

Clinical Use: Ribavirin

Answer 20

Hep C, RSV (aerosol)

Question 21

adverse effects: ribavirin

Answer 21

hemolytic anemia
teratogen
pruritis

Question 22

resistance: ribavirin

Answer 22

genotype 1 HCV

Question 23

administration: ribavirin

Answer 23

oral, inhalation

Question 24

excretion: ribavirin

Answer 24

urine

Question 25

adverse effects: acyclovir

Answer 25

crystalline nephropathy renal failure with poor hydration

Question 26

administration: acyclovir

Answer 26

oral, IV, topical

Question 27

excretion: acyclovir

Answer 27

urine

Question 28

prodrugs have higher

Answer 28

oral bioavailability

Question 29

mechanism: ganciclovir

Answer 29

guanosine analog

Question 30

initial phosphorylation of ganciclovir is done by

Answer 30

UL97

Question 31

clinical use: ganciclovir

Answer 31

CMV first line

Question 32

adverse effects: ganciclovir

Answer 32

bone marrow suppression nephrotoxicity CNS toxicity teratogen

Question 33

resistance: ganciclovir

Answer 33

mutated tyrosine kinase

Question 34

administration: ganciclovir

Answer 34

IV, opthalmic

Question 35

excretion: ganciclovir

Answer 35

urine

Question 36

why is ganciclovir more toxic?

Answer 36

better substrate for kinases= higher toxicity, less selectivity

Question 37

mechanism: foscarnet

Answer 37

nucleoside analog, viral DNA/RNA inhibitor

Question 38

foscarnet inhibits

Answer 38

HIV RT

Question 39

clinical use: foscarnet

Answer 39

CMV 2nd line acyclocvir resistant HSV broad spectrum for viral illnesses

Question 40

adverse effects: foscarnet

Answer 40

nephrotoxicity electrolyte imbalance seizures

Question 41

resistance: foscarnet

Answer 41

mutated DNA polymerase

Question 42

administration: foscarnet

Answer 42

IV

Question 43

excretion: foscarnet

Answer 43

urine

Question 44

mechanism: cidofovir

Answer 44

nucleotide analog, inhibits viral DNA polymerase

Question 45

clinical use: cidofovir

Answer 45

CMV, HSV (3rd line)

Question 46

adverse effects: cidofovir

Answer 46

nephrotoxicity

Question 47

administation: cidofovir

Answer 47

IV

Question 48

excretion: cidofovir

Answer 48

urine

Question 49

what can reduce the toxicity of cidofovir?

Answer 49

probencid

Question 50

mechanism: trifluridine

Answer 50

thymidine analogue, requires host kinases

Question 51

clinical use: trifluridine

Answer 51

HSV 1/2 Keratitis, CMV

Question 52

adverse effects: trifluridine

Answer 52

hypersensitivity

Question 53

administation: trifluridine

Answer 53

opthalmic, topical

Question 54

INF-a mechanism

Answer 54

cytokine, anti-viral state activates JAK/STAT

Question 55

clinical use: INF-a

Answer 55

chronic HBV/HCV, condyloma acuminatum, HHV-8, hairy cell leukemia, renal cell carcinoma, malignant melanoma

Question 56

INF-a adverse effects

Answer 56

neutropenia, myopathy, depression, flu-like symptoms

Question 57

administration INF-a

Answer 57

IM, IV

Question 58

excretion INF-a

Answer 58

urine

Question 59

mechanism: lamivudine

Answer 59

cytosine analog, inhibits HIV RT and HBV polymerase

Question 60

clinical use: lamivudine

Answer 60

HBV, HIV

Question 61

adverse effects: lamivudine

Answer 61

headache, fever, nausea

Question 62

resistance: lamivudine

Answer 62

mutated polymerase

Question 63

mechanism: sofosbuvir

Answer 63

HCV RNA dependent RNA polymerase

Question 64

clinical use: sofosbuvir

Answer 64

HCV w/ ledipasvir

Question 65

adverse effects: sofosbuvir

Answer 65

headache, fever, nausea

Question 66

telaprevir mechanism

Answer 66

HCV protease inhibitor

Question 67

clinical use: telaprevir

Answer 67

HCV w/ peg-interferon, ribavirin

Question 68

adverse effects: telaprevir

Answer 68

rash, pruritis, fatigue, GI, anemia, CYP3A inhibition

Question 69

resistance: telaprevir

Answer 69

develops rapidly

Question 70

mechanism: simeprevir

Answer 70

HCV protease inhibitor

Question 71

clinical use: simeprevir

Answer 71

HCV w/ ribavirin, simeprevir, ledipasvir

Question 72

adverse effects: simeprevir

Answer 72

photosensitivity, rash

Question 73

rimantidine/amantadine mechanism

Answer 73

inhibits M2 protein, inhibits viral uncoating

Question 74

clinical use: rimantidine

Answer 74

Flu A PPX or treatment

Question 75

adverse effects: rimantadine

Answer 75

severe CNS, GI

Question 76

mechanism of resistance: rimantadine

Answer 76

mutated M2 protein, widespread resistance

Question 77

Ozeltamivir/zanamavir mechanism

Answer 77

NA inhibitor

Question 78

Ozeltamivir/zanamavir clinical use

Answer 78

flu A and B

Question 79

adverse effects oseltamivir

Answer 79

headache, GI

Question 80

zanamivir adverse effects

Answer 80

headache, sore throat, asthma ex.

Question 81

Ozeltamivir/zanamavir resistance

Answer 81

NA mutation

Question 82

administration Ozeltamivir

Answer 82

oral

Question 83

administation zanamivir

Answer 83

inhaled