Antivirals

Question 1

Mention antiherpes agents that are active against CMV

Answer 1

Ganciclovir
Valganciclovir
Cidofovir
Foscarent

Question 2

What’s in common between Penciclovir and Trifluridine?

Answer 2

Both are used topically only.

Question 3

How does acyclovir work?

Answer 3

It’s a purine analog which depends on its activation on viral thymidine kinase then cellular enzymes which turns it into a triphosphate nucleotide that inhibits DNA polymerase enzyme.

Question 4

Is acyclovir active against EBV and CMV? Yes or No?

Answer 4

No.

Question 5

Mention some of the side effects of acyclovir.

Answer 5

Neurotoxicity
Nephrotoxicity
GIT disturbances
Local irritation

Question 6

What’s an antiviral that is 3 to 5 times greater in serum levels than acyclovir?

Answer 6

Valacyclovir.

Question 7

What’s Famciclovir metabolized into?

Answer 7

Penciclovir

Question 8

How does Trifluridine work?

Answer 8

By inhibiting viral DNA synthesis.

Question 9

How does Docasanol work?

Answer 9

By inhibiting viral fusion with host cell membrane and preventing viral entry.

Question 10

What are the side effects of Ganciclovir?

Answer 10

Neutropenia, thrombocytopenia, carcinogenicity, teratogenicity

Question 11

What’s in common between Cidofovir and Foscarent?

Answer 11

Both are nephrotoxic and both do not depend on viral enzymes in its activation so they’re useful in resistant cases.

Question 12

Why does cidofovir have to be administered with a large dose of Probenecid?

Answer 12

Because it’s highly nephrotoxic.

Question 13

Foscarent causes electrolyte disturbance in the form of..

Answer 13

Hypocalcemia, hypomagnesemia and hypokalemia.

Question 14

Classify anti-respiratory viral drugs.

Answer 14

Inhibitors of entry: Palivizumab
Inhibitors of uncoating: amantadine and rimantadine
Inhibitors of viral mRNA synthesis: Ribavirin
Inhibitors of neuroaminidase (release): Oseltamivir and Zanamivir

Question 15

Amantadine and rimantadine are active against both types of influenza? Yes or No?

Answer 15

No. They are active against influenza A only.

Question 16

Only amantadine causes CNS manifestations. Why?

Answer 16

Because it crosses the BBB while rimantadine doesn’t.

Question 17

What’s in common between rimantadine/amantadine and ribavirin?

Answer 17

They’re both teratogenic.

Question 18

What’s in common between foscarent and ribavirin?

Answer 18

They both cause anemia.

Question 19

What are the side effects of interferons?

Answer 19

Alopecia/Bone marrow depression/Influenza like syndrome/weight loss

Question 20

What are the obsolete drugs used in HBV?

Answer 20

Lamuvidine due to resistance and Adefovir because of nephrotoxicity and low efficacy

Question 21

What are the drugs used as 1st line treatment in HBV?

Answer 21

Entecavir and Tenofovir

Question 22

What peptide binds to gp41 subunit of HIV envelope and prevents interaction with CD4 receptors?

Answer 22

Enfuvritide

Question 23

What antiretroviral binds to CCR5? And why should a viral tropism test be done before its intake?

Answer 23

Maraviroc

Because some strains use CXCR4 instead of CCR5

Question 24

What are the side effects of Maraviroc?

Answer 24

Malignancy and infection
Hepatotoxicity
Muscle pain
Many drug interactions as it’s metabolized by CYP3A4

Question 25

Which NRTI doesn’t require dose adjustment and why?

Answer 25

Abacavir because it’s metabolized in the liver.

Question 26

Zidovudine is an NRTI that causes..

Answer 26

Bone marrow depression

Question 27

Pancreatitis occurs with the following NRTIs..

Answer 27

Stavudine and Didanosine

Question 28

How are NNRTIs different from NRTIs?

Answer 28

They are highly selective and do not require activation by cellular enzymes.

Question 29

Steven Johnson syndrome occurs with which class of antiretrovirals?

Answer 29

NNRTIs

Question 30

What INSTI causes myopathy?

Answer 30

Raltegravir

Question 31

Which class of antiretrovirals not recommended to be given with antacids?

Answer 31

INSTIs

Question 32

Which class of antiretrovirals is HME inducer and which is inhibitor?

Answer 32

Inducer: NNRTIs Inhibitors: Protease inhibitors

Question 33

Mention 2 drugs that cause gynecomastia.

Answer 33

Ketoconazole and protease inhibitors.

Question 34

Mention the class of antiretrovirals that cause buffalo hump.

Answer 34

Protease inhibitors

Question 35

Hyperglycemia and hyperlipidemia can occur with..?

Answer 35

Protease inhibitors

Question 36

Which protease inhibitor causes nephrolithiasis?

Answer 36

Indinavir