Pharm-Antivirals

Question 1

Acyclovir indications

Answer 1

Shingles, Chicken pox

Question 2

Cidofovir indications

Answer 2

Pox, HHV6-8

Question 3

Famciclovir indications

Answer 3

Shingles and HHV8 (Z8)

Question 4

Foscarnet indications

Answer 4

HHV6

Question 5

Ganciclovir indications

Answer 5

HHV6, HHV8

Question 6

Valacyclovir indications

Answer 6

Shingles, chicken pox, HHV8

Question 7

Valganciclovir indications

Answer 7

HHV6, HHV8 infection

Question 8

Pox virus family treatment options

Answer 8

cidofovir

Question 9

Varicella treatment options

Answer 9

acyclovir, valacyclovir

Question 10

Chicken pox treatment options

Answer 10

Acyclovir, valacyclovir

Question 11

HHV6 treatment options

Answer 11

Cidofovir, foscarnet, ganciclovir, valganciclovir

Question 12

HHV7 treatment options

Answer 12

Cidofovir

Question 13

HHV8 treatment options

Answer 13

ganciclovir, valacyclovir

Question 14

HHV8 infection treatment options

Answer 14

Ganciclovir, valganciclovir

Question 15

Which two drugs are prodrugs

Answer 15

Valacyclovir, valganciclovir

Question 16

Which drug is metabolized to another active drug

Answer 16

Famciclovir to penciclovir

Question 17

What are the two main mechanisms of action for these drugs

Answer 17

Competes with deoxyGTP or with deoxyCTP for incorporation into viral DNA

Question 18

Which drugs competes with deoxyCTP

Answer 18

Cidofovir

Question 19

Which drug also inhibits reverse transcriptases?

Answer 19

Foscarnet

Question 20

Acyclovir MOA

Answer 20

competitive inhibitor of DNA pol as a deoxyGTP analog

Question 21

Famciclovir MOA

Answer 21

competitive inhibitor of DNA pol as a deoxyGTP analog

Question 22

Ganciclovir MOA

Answer 22

competitive inhibitor of DNA pol as a deoxyGTP analog

Question 23

Valacyclovir MOA

Answer 23

competitive inhibitor of DNA pol as a deoxyGTP analog

Question 24

Valganciclovir MOA

Answer 24

competitive inhibitor of DNA pol as a deoxyGTP analog

Question 25

Cidofovir MOA

Answer 25

competitive inhibitor of DNA pol as a deoxyCTP analog

Question 26

Foscarnet MOA

Answer 26

competitive inhibitor of pyrophosphate binding site of DNA pol, making triphosphates unusable; also blocks reverse transcriptase

Question 27

Which drugs do not require sequential phosphorylation to triphosphate form for activation?

Answer 27

Cidofovir and foascarnet

Question 28

What is the significance of requiring triphosphorylation to active form?

Answer 28

Viruses lacking kinases will fail to alter drug to active form

Question 29

Describe the meta/elim of the antivirals

Answer 29

Mostly unchanged; renal elimination thus requiring dose adjustment

Question 30

Describe the cross-reaction hypersensitivity of the antivirals?

Answer 30

Allergic to one, allergic to all!

Question 31

Which drug has the mildest AEs?

Answer 31

Famciclovir (everybody loves family values)

Question 32

Acyclovir AEs

Answer 32

Neurotoxic inc seizure (makes you go crACY)

Question 33

Cidofovir AEs

Answer 33

Nephrotoxic; give with probenecid and hydration to minimize dose-dependent renal tubular necrosis (proximal tubule cell injury) beginning as soon as the first one or two doses

Question 34

Famciclovir AEs

Answer 34

none...

Question 35

Foscarnet AEs

Answer 35

Electrolytes - specifically chelates Ca2+ (FosCA2+rnet)

Question 36

Ganciclovir AEs

Answer 36

Anemia, pancytopenia or indiv cell line, teratogenic

Question 37

Valacyclovir AEs

Answer 37

Same as acyclovir, neurotoxicity w/ seizure

Question 38

Valganciclovir AEs

Answer 38

Same as ganciclovir, anemia, pancytopenia or indiv cell line, teratogenic

Question 39

These two drugs are neurotoxic

Answer 39

(CR)ACYclovir & ValACYclovir

Question 40

These two drugs cause anemia, pancytopenia, and are teratogens

Answer 40

Ganciclovir & Valganciclovir