06c: Antiviral Agents

Question 1

Orthoyxoviridae family of (RNA/DNA) viruses include (X) virus. Which drug class targets these?

Answer 1

ssRNA (neg-strand);
X = influenza

Neuraminidase inhibitors

Question 2

Give prototype examples of neuroaminidase inhibitors.

Answer 2

1. Oseltamivir
2. Peramivir
3. Zanamivir

Question 3

Which drug class(es) target Herpesviridae family of (RNA/DNA) viruses?

Answer 3

dsDNA;

1. Antiherpes nucleoside analogs
2. Noncompetitive DNA Pol inhibitors

Question 4

Acyclovir is a prototype drug that falls into which drug class?

Answer 4

Antiherpes nucleoside analogs

Question 5

Emtricitabine/Tenofovir are prototypes in which drug class?

Answer 5

NRTI (Nucleoside Reverse Transcriptase Inhibitors) for HIV

Question 6

Efavirenz is prototype of which drug class?

Answer 6

NNRTI (Non-Nucleoside Reverse Transcriptase Inhibitors) for HIV

Question 7

Dolutegravir is prototype of which drug class?

Answer 7

Integrase Strand Transfer Inhibitors (InSTI) for HIV

Question 8

Darunavir is prototype of which drug class?

Answer 8

Protease inhibitors (PI) for HIV

Question 9

Oseltamivir is a(n) (X) drug that acts (competitively/non-competitively) to (stimulate/inhibit) (Y) process.

Answer 9

X = neuroaminidase inhibitor
Competitively
Inhibit;
Y = virion release from target cell

Question 10

T/F: Neuroaminidase inhibitors work most effectively a week or so after symptom onset.

Answer 10

False - administer as soon as possible (under 48 hours after symptoms start)

Question 11

Resistance to Oseltamivir occurs via which mechanism?

Answer 11

Mutations in/around active site of neuroaminidase enzyme (decreased binding affinity of drug)

Question 12

(Oseltamivir/Zanamavir/Peramavir) has about 80% absorption and some GI adverse effects. If the strain of (X) virus proves resistant to this drug, (Oseltamivir/Zanamavir/Peramavir) may be an effective alternative.

Answer 12

Oseltamivir;
X = Influenza
Zanamavir

Question 13

(Oseltamivir/Zanamavir/Peramavir) is given via oral inhalation only and should be avoided in patients with (X) disease.

Answer 13

Zanamavir;

X = Resp/CV

Question 14

(Oseltamivir/Zanamavir/Peramavir) are excreted via renal route (unchanged).

Answer 14

All

Question 15

(Oseltamivir/Zanamavir/Peramavir) are used for prophylaxis in patients over (X) years old.

Answer 15

Oseltamivir: X = 1
Zanamavir: X = 5

Question 16

T/F: Resistance of neuraminidase inhibitors is uncommon.

Answer 16

True

Question 17

Your kid has chickenpox! (X) “chain terminator” drug is given, which inhibits (Y) process. Which virus family does this drug target?

Answer 17

X = acyclovir
Y = DNA synthesis

Herpesviridae (HSV and VZV)

Question 18

Common side effects of acyclovir include:

Answer 18

N/V, HA

Question 19

Exercise caution when using (oral/topical/IV) acyclovir with:

Answer 19

IV;

Other nephrotoxic agents

Question 20

T/F: Acyclovir has good oral bioavailability.

Answer 20

False

Question 21

HIV “chain terminator” drugs are (X), which structurally resemble (Y) but lack (Z).

Answer 21

X = NRTIs
Y = purine/pyrimidine nucleosides
Z = 3-OH group

Question 22

The key difference between NRTIs and NNRTIs structure is:

Answer 22

They’re structurally similar! But NNRTIs don’t get phosphorylated/incorporated into chain (just directly bind RT)

Question 23

Lactic acidosis with hepatic steatosis is a rare side effect of (X) HIV drugs.

Answer 23

X = NRTIs (Emtricitabine/Tenofovir)

Question 24

HIV patient on antiretroviral drugs has hyper-pigmented palms and soles. Which drug is likely causing this?

Answer 24

Emtricitabine (NRTI)

Question 25

(NRTI/NNRTI) drug, (X), can have significant drug interactions because it (induces/inhibits) CYP450 enzymes.

Answer 25

NNRTI;
X = Efavirenz
Both inhibits and induces

Question 26

Dolutegravir is a prototype of (X) drug class. It has (significant/low) drug interaction potential.

Answer 26

X = Integrase Inhibitor (for HIV)

Low

Question 27

Protease Inhibitors, such as (X), have which side effects?

Answer 27

X = Darunavir

GI, lipodystrophy, glucose intolerance, increased transaminases

Question 28

(Integrase/protease) inhibitor drug, (X), can have significant drug interactions because it (induces/inhibits) CYP450 enzymes.

Answer 28

Protease
X = Darunavir;
Inhibits

Question 29

When thinking of “drug interactions”, remember the acronym (X)! List the drug classes.

Answer 29

X = MAGIC

1. Macrolides
2. Azoles
3. Grapefruit juice
4. Inhibitors (Protease, NNRTI)
5. CV agents (Ca channel blockers)

Also Rifampin..