Exam 4 - Antivirals (Kays)

Question 1

Acyclovir:

______ in HSV and VZV converts acyclovir to acyclovir monophosphate

Answer 1

viral thymidine kinase

Question 2

Acyclovir:

_______ convert acyclovir monophosphate to acyclovir diphosphate then to triphosphate

Answer 2

humane cellular kinases

Question 3

Acyclovir:

MOA?

Answer 3

inhibits viral DNA replication

competitively inhibits viral DNA pol

Question 4

Acyclovir:

Resistance mechanisms against it seen in HSV and VZV?

Answer 4

absent/altered production of viral thymidine kinase (aka TK deficient)
and altered viral DNA pol

Question 5

Acyclovir:

Bioavailabiltiy ______ with increasing dose

Answer 5

decreases!!

Question 6

Acyclovir:

adjust for renal dysfunction??

Answer 6

yasss

Question 7

Acyclovir:

ADEs?

Answer 7

Oral is well tolerated
Nephrotoxicity (crystalline)
Neurotoxic
Thrombophlebitis with IV form

Question 8

Famciclovir/Penciclovir:

does it need to be activated by thymidine kinase still?

Answer 8

yeet

Question 9

Famciclovir/Penciclovir:

Dose adjust in renal dysfunction?

Answer 9

yeet

Question 10

Ganciclovir:

Dose adjust in renal dysfunction?

Answer 10

yeet

Question 11

main ADE with ganciclovir?

Answer 11

bone marrow suppression

Question 12

main ADE with valanciclovir?

Answer 12

hematologic toxicity

Question 13

Letermovir:

used mainly for what disease state?

Answer 13

CMV PROPHYLAXIS

Question 14

Letermovir:

Renally adjust in dysfunction?

Answer 14

not really…

only if below 10 mL/min

Question 15

Foscarnet:

10-20% of drug gets sequestered where?

Answer 15

the bone

Question 16

Main ADEs with foscarnet?

Answer 16

Nephrotoxicity
(hydrate pts!!)
hypocalcemia/phosphotemia

Question 17

Foscarnet:

adjust for renal dysfunction?

Answer 17

Yeet

Question 18

what are the neuramindase inhibitors

Answer 18

zanamivir
oseltamivir
peramivir

Question 19

MOA of amantadine and rimantadine?

Answer 19

block uncoating of viral RNA within the host cell

Question 20

Which neuramindase inhibitor is administered via inhalation?

Answer 20

zanamivir

Question 21

which neuramindase inhibitor is given IV?

Answer 21

Peramivir

Question 22

which neuramindase inhibitor is given orally

Answer 22

oseltamivir

Question 23

neuramindase typically helps the virus with what step?

Answer 23

typically helps/promotes the release of the virus from infected cells

Question 24

neuramindase is typically found on the surface of human or viral cells?

Answer 24

viral

Question 25

neuramindase inhibitor attach to ______ inside _____

Answer 25

to virus; inside inside host cell

Question 26

which neuramindase inhibitor is approved for flu treatment patients 7 and above and can do prophylaxis for ages 5 and above

Answer 26

zanamivir…kids gotta be able to inhale it

Question 27

Zanamivir: not recommended for who?

Answer 27

people under 7…

and pts with asthma or COPD

Question 28

TREATMENT regimen for oseltamavir

Answer 28

BID x5 days

Question 29

ChemoPROPHYLAXIS regimen for oseltamivir

Answer 29

QD x 10 days

Question 30

Oseltamivir is approved for treatment of flu for patients above what age?

Answer 30

above 2 weeks

Question 31

Oseltamivir is approved for prophylaxis of flu for patients above what age?

Answer 31

1 year of age

Question 32

Live attenuated vaccine and zanamivir/oseltamivir relation?

Answer 32

do not do vaccine until 48 hours AFTER stop of zanamivir/oseltamivir
or do not give zanamivir/oseltamivir until 2 weeks after live vaccine

Question 33

which neuramindase inhibitor do you have to renally adjust?

Answer 33

oseltamivir

Question 34

how many doses to do of peramivir

Answer 34

just one dose!!