Antivirals

Question 1

Aim of antivirals

Answer 1

To treat infections or diseases caused by viruses

Question 2

How antivirals generally work

Answer 2

Target steps in viral replication

Question 3

Effectiveness of antivirals

Answer 3

Only a small #of viruses respond

Question 4

Virus definition

Answer 4

Sub-microscopic infections agent that cannotgrow o reproduce outside a host cell

Question 5

Virus structure

Answer 5

RNA or DNA, capsid, lipid envelope

Question 6

Viral replication steps

Answer 6

Entry, uncoating, transcription, DNA replication, protein synthesis, assembly, release

Question 7

Types of infection

Answer 7

Acute, chronic, latent, progressive, cancer

Question 8

Main routes of transmission of sars-cov-2

Answer 8

Respiratory droplets and aerosols

Question 9

Types of COVID-19 treatment

Answer 9

Antivirals, anti-inflammatories, antibodies

Question 10

Remdesivir mechanism

Answer 10

Product metabolized to nucleoside monophosphate and triple phosphorylated, then incorporated into RNA and this RNA is terminated

Question 11

Paxlovid

Answer 11

Ritonavir-boosted nirmatrelvir

Question 12

Ritonavir mechanism

Answer 12

Protease inhibitor that increases nirmatrelvir levels

Question 13

Nirmatrelvir mechanism

Answer 13

Inhibits Mpro, a viral protease in all coronaviruses that affect humans

Question 14

Remdesivir adverse effects

Answer 14

Infusion site reactions, hypotension, nausea, vomiting, chest tightness, respiratory failure, altered liver enzymes, back pain, ECG abnormalities, renal impairment

Question 15

Paxlovid adverse effects

Answer 15

Change in taste, muscle aches, swollen joints, headache, blurred vision, changes in heart rate

Question 16

Remdesivir resistance

Answer 16

Mutations in the rna-dependent RNA polymerase so the ATP analogue isn’t incorporated

Question 17

Nirmatrelvir resistance

Answer 17

Mutations in Mpro binding site

Question 18

Influenza genetic material

Answer 18

RNA

Question 19

Herpes genetic material

Answer 19

DNA

Question 20

Antivirals for influenza

Answer 20

Oseltamivir and amantadine

Question 21

Osaltamivir mechanism

Answer 21

Sialic acid analogue that binds and inhibits neuraminidase so the virus cannot bud off

Question 22

Pharmacokinetics of oseltamivir

Answer 22

Pro/dung metabolized to active in liver and gi

Question 23

Adverse effects of oseltamivir

Answer 23

Nausea and gi discomfort

Question 24

Clinical uses of oseltamiviv

Answer 24

Prevention and treatment of a and B, including H1N1

Question 25

Resistance to oseltamivir

Answer 25

Mutations in neuraminidase

Question 26

Amantadine mechanism

Answer 26

Inhibits proton ion channel M2 necessary for uncaring of virus and protein synthesis

Question 27

Pharmacokinetics of amantadine

Answer 27

Distributes throughout all tissues and is excreted unchanged by kidney

Question 28

Adverse effects of amantadine

Answer 28

Gi disturbances, CNS disturbances, renal damage in patients with renal insufficiency

Question 29

Clinical uses of amantadine

Answer 29

Treatment of early infection by a, but not H1N1

Question 30

Resistance to amantadine

Answer 30

Mutation in M2

Question 31

Herpes types

Answer 31

1: cold sores, 2: genital herpes

Question 32

Acyclovir mechanism

Answer 32

Guanosine analogue that gets activated by viral thymidine kinase and then phosphorylated twice more by our cells, then incorporated into DNA and terminates the chain

Question 33

Pharmacokinetics of acyclovir

Answer 33

Oral, iv, or topical that distribute throughout body

Question 34

Adverse effects of acyclovir

Answer 34

Nausea, vomiting, diarrhea, headache, renal damage in dehydrated patients

Question 35

Clinical uses of acyclovir

Answer 35

Treatment of active herpes

Question 36

Resistance to acyclovir

Answer 36

Altered or deficient thymidine kinase

Question 37

HIV positive

Answer 37

Infected with virus, generally symptom free, clinical latency of 2-10 years without treatment

Question 38

AIDS

Answer 38

Opportunistic infections

Question 39

HIV coreceptors

Answer 39

CCR5 or CXCR4

Question 40

Categories of HIV antivirals

Answer 40

NRTIs, NNRTIs, INIs, PIs, viral fusion inhibitors

Question 41

Azidothymidine mechanism

Answer 41

Thymidine analogue activated by mammalian kinases and incorporated into DNA → termination

Question 42

Pharmacokinetics of azidothymidine

Answer 42

Well absorbed and distributed, glucuronidation

Question 43

Adverse effects of azidothymidine

Answer 43

Anemia, leukopenia, headaches, seizures, drug interactions due to glucuronidation

Question 44

Resistance to azidothymidine

Answer 44

Rt mutation, decreased kinase activation

Question 45

Nevirapine mechanism

Answer 45

Binds to non-catalytic site of rt

Question 46

Pharmacokinetics of nevirapine

Answer 46

Well absorbed and distributed, oxidized by CYP 3A4 and 2B6 and then undergoes glucuronidation

Question 47

Adverse effects of nevirapine

Answer 47

Rash, hepatotoxicity, drug interactions because it increases 3a4, so it increases metabolism of itself, oral contraceptives, azoles, methadone, PIs

Question 48

Resistance to nevirapine

Answer 48

Rt mutation

Question 49

Raltegravir mechanism

Answer 49

Inhibits viral integrate

Question 50

Resistance to raltegravir

Answer 50

Viral integrase mutation

Question 51

Ritonavir HIV mechanism

Answer 51

Inhibits HIV aspartyl protease and inhibits CYP3A4 to enhance other drugs

Question 52

Pharmacokinetics of ritonavir

Answer 52

Good bioavailability, metabolized by 3a4

Question 53

Adverse effects of ritonavir

Answer 53

Gi disturbances, insomnia, hyperglycemia, metabolic abnormalities

Question 54

Maraviroc mechanism

Answer 54

CCR5 receptor antagonist to prevent viral entry

Question 55

Adverse effects of maraviroc

Answer 55

Muscle/joint pain, cold symptoms, dizziness, gi disturbances, liver damage and allergic reactions