Antivirals

Question 1

mechanism of oseltamivir

Answer 1

influenza neuraminidase inhibitor which presents release of viral progeny from host cell

Question 2

need to use oseltamivir in the first _____ hrs

Answer 2

48

Question 3

mechanism of acyclovir

Answer 3

guanosine analogue that is phosphorylated by HSV/VZV thymidine kinase in infected cells –> inhibits viral DNA polymerase by chain termination

Question 4

clinical use of acyclovir

Answer 4

HSV, VZV

Question 5

valcyclovir

Answer 5

prodrug of acyclovir that has better oral bioavailability

Question 6

famciclovir

Answer 6

form of acyclovir used for HZV (shingles)

Question 7

SEs of acyclovir, valcyclovir, famciclovir

Answer 7

crystalline nephropathy and ARF if not adequately hydrated

Question 8

mechanism of ganciclovir

Answer 8

guanosine analoque that is phosphorylated by CMV viral kinase in infected cells and inhibits viral DNA polymerase

Question 9

clinical use of ganciclovir

Answer 9

CMV

Question 10

valganciclovir

Answer 10

prodrug of ganciclovir with better bioavailability

Question 11

SEs of ganciclovir, valganciclovir

Answer 11

BM suppression, nephrotoxicity

Question 12

mechanism of foscarnet

Answer 12

pyrophosphate analogue that inhibits viral DNA/RNA polymerase as well as HIV reverse transcriptase, does not require phosphorylation for activation

Question 13

clinical use of foscarnet

Answer 13

resistant HSV and CMV

Question 14

SEs of foscarnet

Answer 14

nephrotoxicity –> electrolyte abnls –> seizures

Question 15

mechanism of cidofovir

Answer 15

inhibition of viral DNA polymerase, does not require phosphorylation

Question 16

clinical use of cidofovir

Answer 16

resistant HSV and CMV

Question 17

SEs of cidofovir

Answer 17

nephrotoxicity (give with IV saline and probenecid)

Question 18

mechanism of maraviroc

Answer 18

binds CCR5 on monocyte surface preventing interaction with viral gp120 –> prevents viral docking on host cells

Question 19

mechanism of enfuvirtide

Answer 19

ginds gp41 on virus to prevent viral fusion with host cell membrane

Question 20

abacavir, tenofovir, -ine antiHIV meds

Answer 20

NRTIs

Question 21

mechanism of NRTIs (abacavir, tenofovir, -ine)

Answer 21

competitively inhibit nucleotide binding to RT and terminate DNA chain (lack 3’ OH)

Question 22

Which NRTI used for ppx and during pregnancy to prevent vertical transmission?

Answer 22

zidovudine

Question 23

Which NRTI is associated with hypersensitivity? Via wihch HLA?

Answer 23

abacavir, HLA-B5701

Question 24

Which NRTI associated with pancreatitis?

Answer 24

didanosine

Question 25

SEs of NRTIs

Answer 25

BM suppression, peripheral neuropathy, lactic acidosis, lipodystrophy

Question 26

Which NRTI associated with anemia?

Answer 26

zidovudine

Question 27

mechanism of -vir- antiHIV drugs

Answer 27

NNRTIs - bind to and inhibit RT but not at active site

Question 28

SEs of -vir- antiHIV drugs

Answer 28

SJS, hepatotoxicity

Question 29

Which NNRTI is associated with vivid dreams and neuropsych symptoms?

Answer 29

efavirenze

Question 30

mechanism of -navir drugs

Answer 30

protease inhibitors - prevents cleavage of HIV mRNA products into their functional parts, so prevents maturation of new virus progeny

Question 31

SEs of -navir drugs

Answer 31

insulin resistance, lipodystrophy

Question 32

mechanism of -tegravir drugs

Answer 32

reversible integrase inhibitors - prevents HIV genome integration into host cell chromosome

Question 33

SEs of -tegravir drugs

Answer 33

myopathy

Question 34

mechanism of interferons

Answer 34

glycoproteins normally synthesized by virus-infected cells to facilitate their destruction

Question 35

clinical use of IFNa

Answer 35

HBV, HCV, condyloma acuminata, Kaposi sarcoma, hairy cell leukemia, RCC, melignant melanoma

Question 36

clinical use of IFNb

Answer 36

MS

Question 37

clinical use of IFNy

Answer 37

CGD

Question 38

SEs of IFNs

Answer 38

flu-like symptoms, neutropenia, myopathy

Question 39

mechanism of ribavirin in HCV

Answer 39

competitive inhibition of inosine monophosphate dehydrogenase which inhibits synthesis of guanine nucleotides

Question 40

mechanism of sofosbuvir

Answer 40

inhibits HCV RNA polymerase, chain termination

Question 41

mechanism of simeprevir

Answer 41

HCV protease inhibitor