Anti-Viral/RetroViral/Parasitic Pharm

Question 1

Acyclovir MOA

Answer 1

Tri-phosphate inhibits DNA polymerase&raquo_space; halts viral replication

Question 2

Valacyclovir advantages

Answer 2

Improved bioavailability &raquo_space; allows for decreased dosing frequency

Question 3

Acyclovir and Valacyclovir Indication/spectrum of activity

Answer 3

HSV-1
HSV-2
VZV

Question 4

Acyclovir pharmacokinetics/dynamics

Answer 4

Oral formulation&raquo_space; poor bioavailability
Renal elimination&raquo_space; requires dose adjustments
Penetrates well into CNS

Question 5

Ganciclovir MOA

Answer 5

Inhibits DNA synthesis via UL54 (DNA polymerase

Valganciclovir is prodrug

Question 6

Ganciclovir Indication/Spectrum of Activity

Answer 6

Main clinical use&raquo_space; CMV

HSV
VZV
HHV4
EBV

Question 7

Ganciclovir Adverse Effects

Answer 7

MC&raquo_space; neutropenia, leukopenia, & thrombocytopenia

Nephrotoxicity, CNS effects, GI upset

Question 8

Acyclovir Adverse Effects

Answer 8

Nephrotoxicity&raquo_space; with high-dose IV admin (give maintenance IV fluids with high doses)
GI discomfort
CNS effect&raquo_space; lethargy, tremors, confusion, seizures, encephalopathy

Question 9

Ganciclovir pharmacokinetics

Answer 9

IV formulation only
Concentrates intracellularly
Penetrates central nervous system well
Renal elimination

Question 10

Foscarnet MOA

Answer 10

Binds directly to and inhibits viral-specific DNA polymerase

Question 11

Foscarnet pharmacokinetics

Answer 11

Active drug&raquo_space; no phosphorylation needed
IV only
Penetrates CNS well
Renal elimination

Question 12

Foscarnet Adverse Effects

Answer 12

Major nephrotoxicity and electrolyte depletion

Less significant  neuropathy, paresthesia, cytopenia

Question 13

Foscarnet Indication/spectrum of activity

Answer 13

CMV
HSV
HHV6

Overcomes viral resistance to acyclovir and ganciclovir

Question 14

Cidofovir MOA

Answer 14

Inhibits DNA synthesis via blocking DNA polymerase

Converted to the active form by cellular kinases

Question 15

Cidofovir pharmacokinetics

Answer 15

IV formulation
Poor CNS penetration
Renal elimination

Question 16

Cidofovir adverse effects

Answer 16

Very high risk of nephrotoxicity

Cytopenia

Question 17

Cidofovir Indication for Use

Answer 17

Main use&raquo_space; CMV, adenovirus, acyclovir, and ganciclovir resistant viruses

Rarely used due to high risk of nephrotoxicity

Question 18

Letermovir MOA

Answer 18

Inhibits CMV DNA terminase complex to block viral packaging

Question 19

Letermovir pharmacokinetics

Answer 19

IV and oral formulations
High bioavailability
Hepatically metabolized&raquo_space; screen for drug interactions

Question 20

Letermovir adverse effects

Answer 20

Well tolerated

GI upset, HA, peripheral edema

Question 21

Letermovir Indication for use

Answer 21

Prevention of CMV reactivation after allogeneic hematopoietic cell transplant ONLY

Question 22

Drugs commonly used to treat influenza?

drug names

Answer 22

Oseltamivir (Tamiflu)
Peramivir (Rapivab)
Zanamivir (Ralenza)

Baloxavir (Xofluza)

Question 23

Remdesivir MOA

Answer 23

Inhibits RNA-dependent RNA-polymerase

Question 24

Remdesivir Indication for Use

Answer 24

Lower risk of mortality in patients on low-flow O2

No benefit in patients requiring high-flow O2, ventilation, ECMO

Question 25

Redesivir adverse effects

Answer 25

GI related side effects

Rare liver impairment

Question 26

Drugs commonly used to treat malaria?

drug names

Answer 26

Artemether-Lumefantrine (Coartem) &raquo_space;1st line therapy for uncomplicated Malaria

Artesunate&raquo_space; 1st line for severe Malaria

Chloroquine &
Hydroxychloroquine&raquo_space; used less due to high rate of resistance

Question 27

Most commonly used drug to treat Helminths (parasitic worms)?

(drug name)

Answer 27

Albendazole