Anti-Viral and Fungal

Question 1

What are virus

Answer 1

Obligate intracellular parasite

Uses host cell to replicate

Question 2

What issues

Answer 2

Limited proteins for drugs to target
Most targets intracellular
Toxicity common

Question 3

What are most drugs

Answer 3

Nuceloside analogue that inhibits nucleic acid synthesis

Question 4

What are Rx options for virus

Answer 4

Prophylaxis - PREP
PEP - post exposure
Overt
Suppressive if can’t eradicate from latent

Question 5

Examples of anti-viral

Answer 5

Aciclovir
Valaciclovir
Foscarnet
Oseltamivir / Zamivir

Question 6

Aciclovir

Answer 6

Oral, IV, ointment, cream
Low toxicity
Nucleoside analogue

Question 7

What is used if resistant to nucleoside analogue

Answer 7

Foscarnet

Question 8

What does Oseltamivir do

Answer 8

Blocks release of virus

Used in influenza

Question 9

HSV

Answer 9

Oral acyclovir

Question 10

Chicken pox

Answer 10

Treat if at risk of complication

• Baby
• Immunocompromised
• Pregnant

Question 11

Shingles

Answer 11

Rx within 72 hours to prevent post-herpetic neuralgia

Question 12

CMV

Answer 12

Rx if life or eye threatening as highly toxic

• HIV
• CMV retinits
• Post transplant pneumonitis
• Neonate with symptomatic congenital

Question 13

HIV

Answer 13

Combination ART

Question 14

Chronic hep B

Answer 14

Pegylated interferon

Nucleoside analogue - tenofovir

Question 15

Chronic hep C

Answer 15

Pegylated interferon
Ribavirin
Protease inhibitor - telaprevir
CAN CURE

Question 16

Influenza A and B q

Answer 16

Within 48 hours or any if immunocompromised

Question 17

RSV

Answer 17

Ribavirin but rare

Question 18

Resistance

Answer 18

Use forcarnet

HIV resistance test

Question 19

What do azole anti-fungal do

Answer 19

Block ergosterol synthesis

Question 20

AE

Answer 20

Hepatotoxic

p450 inhibitor

Question 21

Examples and use

Answer 21

Fluclonazole / Itraconazole

• Candida
• Aspergillus

Question 22

What do Polyenes do

Answer 22

Lysis of Ergosterol

Question 23

Examples

Answer 23

Amphotericin B

Nystatin

Question 24

When do you use Amphotericin

Answer 24

Broad spec
Used in severe fungal / meningitis
IV only

Question 25

SE

Answer 25

Nephrotoxic
Hypokalaemia
Flu

Question 26

Terbinafine

Answer 26

Used for tinea / nails

Question 27

Echincandins (Caspofungin)

Answer 27

Used candida / aspergillum