Treatment of Viral Pneumonia

Question 1

Influenza A and B

Answer 1

Oseltamivir (PO)
Zanamivir (Inhalation)
**Get flu vaccine to prevent.

Question 2

Influenza A

Answer 2

Amantadine (PO)
Rimantadine (PO)
**Get flu vaccine.

Question 3

RSV

Answer 3

Ribavirin (inhalation, IV)

**Palivizumab (IM) for prevention.

Question 4

Adenovirus

Answer 4

Cidofovir (IV)

**Vaccine for Types 4 and 7

Question 5

Rhinovirus

Answer 5

• *No Treatment

* *Alfa interferon (intranasal) and ribavirin (off label) for prevention

Question 6

Enteroviruses

Answer 6

No Treatment or Prevention

Question 7

Human Metapneumovirus

Answer 7

Ribavirin (IV)

Question 8

Hantavirus

Answer 8

Ribavirin (IV)

Question 9

Varicella-Zoster

Answer 9

Acyclovir (IV)
Valacyclovir (IV)
**VZ Vaccine

Question 10

MOA of Acyclovir

Answer 10

Inhibition of viral DNA synthesis via DNA polymerase inhibition.

Question 11

MOA of Amantadine

Answer 11

Inhibition of viral entry or uncoating.

Question 12

MOA of Cidofovir

Answer 12

Inhibition of viral DNA synthesis via DNA polymerase inhibition.

Question 13

MOA of Oseltamavir

Answer 13

Inhibition of release of flu virus from host cell.

Question 14

MOA of Ribavirin

Answer 14

Inhibition of viral nucleic acid synthesis.

Question 15

MOA of Rimantadine

Answer 15

Inhibiton of viral entry or uncoating

Question 16

MOA of Valcyclovir

Answer 16

Prodrug of acyclovir.

Inhibition of viral DNA synthesis via DNA polymerase inhibition.

Question 17

MOA of Zanamivir

Answer 17

Inhibiton of release of flu virus from infected cell.

Question 18

Metabolism of Acyclovir

Answer 18

Viral cells transform it to its active triphosphate form

Systemically elimination unchanged by glomerular filtration and tubular secretion.

Question 19

Metabolism of Amantadine

Answer 19

Systemically elimination by glomerular filtration and tubular secretion.

Question 20

Metabolism of Cidofovir

Answer 20

Metabolized by pyrimidine nucleoside monophosphate kinase to mono and then diphosphate analogs then finally to monophosphate choline.
Systemically elimination by glomerular filtration and tubular secretion.

Question 21

Metabolism of Oseltamavir

Answer 21

HEPATICALLY metabolized to the corboxylate active form of the drug.
Systemic elimination via glomerular filtration and tubular secretion.

Question 22

Metabolism of Ribavirin

Answer 22

Undergoes NON CYP metabolism in nucleated cells with systemic elimination of drug and its products in urine.

Question 23

Metabolism of Rimantadine

Answer 23

Extensive hepatic metabolism with renal elimination of drug and metabolites.

Question 24

Metabolism of Valcyclovir

Answer 24

Converted to acyclovir by first pass metabolism.

Systemic elimination by glomerular secretion and tubular secretion.

Question 25

Metabolism of Zanamivir

Answer 25

Renally eliminated unchanged.

Question 26

Toxicity of Acyclovir

Answer 26

Headache, nausea, elevated hepatic enzymes, nasopharyngitis, NEUTROPENIA. * *MAINTAIN HYDRATION to prevent renal precipitation. * *Use caution in renal impairment and with renotoxic drugs.

Question 27

Toxicity of Amantadine

Answer 27

Neurological effect, Nausea, ORTHOSTATIC HYPOTENSION. | **Contraindicated in glaucoma and breast feeding.

Question 28

Toxicity of Cidofovir

Answer 28

Neurological, Hematological, and tubular damage. | ***Black Box Warning for renal impairment.

Question 29

Toxicity of Oseltamavir

Answer 29

Minimal adverse effect. Potential for fatal neuropsychiatric effects in flu patients. Rare serious skin rash.

Question 30

Toxicity of Ribavirin

Answer 30

Fatigue, headache, nausea, myalgia, fever. | **BlackBox Warning for hemolytic anemia and M/F teratogenicity.

Question 31

Toxicity of Rimantadine

Answer 31

Minimal

Question 32

Toxicity of Valcyclovir

Answer 32

Headache, nausea, elevated hepatic enzymes, nasopharyngitis, NEUTROPENIA. * *MAINTAIN HYDRATION to prevent renal precipitation. * *Use caution in renal impairment and with renotoxic drugs.

Question 33

Toxicity of Zanamivir

Answer 33

Headache, tonsil/throat pain, cough, viral infection, | ***Not to be used with underlying pulmonary disease due to fatal bronchospasm.