Antivirals

Question 1

Which antiviral medications block viral penetration/uncoating?

Answer 1

amantadine (uncoating) , enfuviritide, maraviroc (penetration)

Question 2

Which antiviral drugs inhibit viral DNA polymerases?

Answer 2

acyclovir, foscarnet, ganciclovir

Question 3

Which antiviral drugs inhibit viral RNA polymerases?

Answer 3

Foscarnet, ribavirin

Question 4

Which antiviral drugs inhibit viral reverse transcriptase?

Answer 4

zidovudine, didanosine, zalcitabine, lamivudine, stavudine, nevirapine, efavirenz

Question 5

Which antiviral drugs inhibit viral aspartate protease?

Answer 5

indinavir, ritonavir, saquinavir, nelfinavir

Question 6

Which of the antiviral medications inhibit viral integrase?

Answer 6

raltegravir

Question 7

Which antiviral agent inhibit viral neuraminidase?

Answer 7

Zanamivir, oseltamivir

Question 8

For viral drugs what is a trick to determine the use of most?

Answer 8

avir aids
ivir for influenza
over for “O shit I have herpes”

Question 9

How can the herpes virus confer resistance to ovir agents?

Answer 9

can dec production thymidine kinase or completely get rid of TK (- TK strain)

Question 10

S/E of acyclovir?

Answer 10

crystalluria mainly

Question 11

Gancyclovir indication.

Answer 11

HSV, VZV, CMV

Question 12

S/E gancyclovir?

Answer 12

crystalluria

Question 13

MOA foscarnet and how it is different from ganciclovir and acyclovir?

Answer 13

not an antimetabolite so doesn’t need to be phosphorylated but does inhibit viral DNA and RNA polymerase

Question 14

Describe the purpose of HAART in treating HIV?

Answer 14

HAART Highly active antiretroviral therapy:
decreases viral RNA,
reverses decline in CD4 cells
dec. the risk of opportunistic infections

Question 15

What is tenofovir and what is it commonly coformulated with?

Answer 15

an NtRTI commonly formulated with an NRTI

has a single phosphate residue and must be further phosphorylated to the triphosphate form

Question 16

Tenofovir unlike NRTIs doesn’t require what?

Answer 16

one phosphorylation step which is usually from the virus itself

Question 17

What drug class does Zidovudine, AZT belong to?

Answer 17

NRTI

Question 18

What drug class does Didanosine, DDI belong to?

Answer 18

NRTIs

Question 19

what drug class does Lamivudine, 3TC; emtricitabine FTC belong to?

Answer 19

NRTIs

Question 20

Zidovudine is what analog?

Answer 20

thymidine

Question 21

Didanosine is an analog of what?

Answer 21

inosine

Question 22

Lamuvidine is an analog of what?

Answer 22

cytosine

Question 23

Major S/Es of NNRTIs?

Answer 23

vivid dreams, maculopapular rash

Question 24

S/E zidovudine?

Answer 24

Bone marrow supression

Question 25

S/E didanosine?

Answer 25

pancreatitis, peripheral neuropathy, hyperuricemia, liver dysfunction

Question 26

What are the S/E of lamuvidine and emtricitabine?

Answer 26

least toxic of NRTIs, but some GI effects and neutropenia

Question 27

Best HIV prophylaxis post exposure prophylaxis drugs?

Answer 27

emtricitabine + tenofovir + raltegravir

Question 28

Best regimen for HIV prophylaxis during pregnancy?

Answer 28

2 NRTIs (emtricitabine or lamivudine) + (zidovudine or tenofovir) + ritonavir-boosted atazanavir or lopinavir

Question 29

What is the best method to go about treating HIV in general?

Answer 29

Integrase inhibitors combined with 2 NRTIs are used as complete treatment regimens

Question 30

NNRTIs have additive or synergistic effects when used in combination with what other antivirals?

Answer 30

NRTIs or protease inhibitors

Question 31

MOA of PI (protease inhibitors) ?

Answer 31

aspartate protease (pol gene encoded) is a viral enzyme that cleaves precursor polypeptides in HIV buds to form the proteins of the mature virus core

Question 32

What are the S/Es of indinavir?

Answer 32

crystalluria

Question 33

S/E, in general, of most protease inhibitors?

Answer 33

syndrome of disordered lipid and CHO metabolism central adiposity and insulin resistance

Question 34

MOA Intergrase inhibitors?

Answer 34

prevents integration of viral genome in host cell DNA

Question 35

Suffix to remember the integrase inhibitors?

Answer 35

tegravirs

Question 36

Name the antiviral medications considered fusion inhibitors?

Answer 36

enfuvirtide, maraviroc

Question 37

Basic MOA of enfuvirtide and maraviroc?

Answer 37

block entry of HIV into cells

Question 38

MOA enfuvirtide?

Answer 38

binds to gp41 and inhibits the fusion HIV-1 to CD4+ cells

Question 39

MOA maraviroc?

Answer 39

blocks the binding of the gp120 HIV protein to CCR5 on macrophage surface to prevent viral entry

Question 40

Are amantadine and rimantadine still used for prophylaxis of influenza A?

Answer 40

no

Question 41

MOA zanamivir and oseltamivir (tamiflu)

Answer 41

inhibit neuraminidase of influenza A and B (enzymes that prevent clumping of virions so that more particles are available for infecting host cells)

Question 42

Indication zanamivir and oseltamivir?

Answer 42

prophylaxis mainly, but may decrease duration of flu symptoms by 2-3 days

Question 43

MOA ribavirin?

Answer 43

inhibits IMP dehydrogenase and RNA polymerase

Question 44

Indication for use of ribavirin?

Answer 44

combined with Alpha-interferons for hep C; Lassa fever and Hantavirus

Question 45

S/E of ribavirin use?

Answer 45

anemia

Question 46

MOA sofosbuvir? Use?

Answer 46

nucleotide analog that inhibits RNA polymerase; Hep C

Question 47

What is Sofosbuvir usually combined with to make it more effective?

Answer 47

ribavirin or INT-a

Question 48

MOA of Simeprevir and use?

Answer 48

hepatitis C protease inhibitor

Question 49

What is simeprevir usually combined with?

Answer 49

ribavirin or INT-a

Question 50

What is the MOA of ledipasvir and use?

Answer 50

inhibits HCV NS5A protein that plays a key role in RNA replication and secretion

Question 51

What is the best way to remember the proteins associate with Hep C targets?

Answer 51

USE me for Hep C USE backwards Evir (NS3/4A) Svir (NS5A) Uvir (NS5B)