Treatment of Viral Infections

Question 1

Drugs effective against herpes virus

Answer 1

Aciclovir

Valaciclovir

Question 2

Aciclovir

Answer 2

Effective against HSV1, 2 + HZ
Guanosine analogue
Inhibits action of Viral DNA polymerase
Very high therapeutic ratio
Topical, oral, IV

Question 3

Aciclovir Adverse effects

Answer 3

Psychiatric AEs, including Cotard’s syndrome

Question 4

Aciclovir toxicity manifestation

Answer 4

Lethargy
Confusion
Myoclonus

Question 5

Valcyclovir

Answer 5

Acyclovir ester-linked to valine

Greater oral bioavailability

Question 6

Aciclovir + Valcyclovir resistance

Answer 6

Mutation of viral thymidine kinase +/or DNA polymerase

Question 7

Drugs against CMV

Answer 7

Ganciclovir

Valganciclovir

Question 8

Ganciclovir

Answer 8

Synthetic analogue of deoxyguanosine

Inhibits viral DNA polymerase

Question 9

Valganciclovir

Answer 9

Valine ester of ganciclovir

Greater oral bioavailability

Question 10

Ganciclovir + Valganciclovir AEs

Answer 10

Bone marrow suppression

Question 11

Drugs effective against Retroviruses

Answer 11

Reverse transcriptase inhibitors
Non-nucleoside/Nucleotide reverse transcriptase inhibitors (NNRTIs)
Protease inhibitors
Integrase inhibitors
Fusion inhibitors
Entry inhibitors
Ribavirin

Question 12

Reverse transcriptase inhibitors

Answer 12

Nucleoside + nucleotide analogues (NRTIs)

Question 13

Nucleoside + nucleotide analogues MOA

Answer 13

Inhibit reverse transcriptase

Effective against retroviruses

Question 14

Nucleoside analogues

Answer 14

Retrovirus
Require 3 phosphorylations for incorportations
Zidovudine- thymidine analogue- AEs GI, haematological, hepatotoxic, myopathy
Lamivudine- cytidine analogue, AEs nausea, fatigue, headaches, cough

Question 15

Nucleotide analogues

Answer 15

Need 2 phosphorylations to be incorporated

Tenofovir- analogue of adenosine monophosphate, AEs renal insufficiency

Question 16

Non nucleoside/nucleotide reverse transcriptase inhibitors

Answer 16

Retrovirus
Bind to reverse transcriptase enzyme
Nevirapine- AEs- hepatitis

Question 17

Protease inhibitors

Answer 17

Retrovirus
Binds to viral proteases
Saquinavir- AEs GI, neuro, rash, QT prolongation

Question 18

Integrase inhibitors

Answer 18

Retrovirus

Inhibit integrase, enzyme that mediates integration of HIV DNA

Question 19

Fusion inhibitors

Answer 19

Retrovirus

Block gp41 on surface of HIV virion

Question 20

Entry inhibitors

Answer 20

Retrovirus

Block CCR5 receptor on surface of cell

Question 21

Ribavirin

Answer 21

Retrovirus
Guanosine analogue
Inhibitor of viral RNA dependent RNA polymerase
Effective against RNA viruses e.g. Hep C, viral haemorrhagic fevers, Resp. syncytial virus
AEs- bone marrow suppression, haemolytic anaemia, depression, cough

Question 22

Influenza drugs

Answer 22

Neurominidase inhibitors
M2 inhibitors
Ribavirin

Question 23

Neurominidase inhibitors

Answer 23

Influenza
Prevents viral activation
Oseltamivir
Zanamivir

Question 24

M2 inhibitors

Answer 24

Influenza
Inhibit M2 protein of virus to decrease H+ ion reflux
Inhibits uncoating + recoating

Question 25

Ribavirin

Answer 25

Also been used for influenza

Question 26

Hep C drugs

Answer 26

``` Protease inhibitors NSSA inhibitors NSSB inhibitors Ribavirin Pegylated interferon- interferon alpha or beta ```

Question 27

Hep C treatment

Answer 27

Depends almost completely on protease inhibitors, NSSA and NSSB inhibitors in varying compinations

Question 28

Hep B drugs

Answer 28

Reverse transcriptase inhibitors- Iamivudine, tenfovir | Interferon- PEGylated interferon

Question 29

Respiratory Syncytial virus drug

Answer 29

Monoclonal antibody against RSV fusion glycoprotein | Ribavirine, given by inhalation