Antiviral

Question 1

zanamivir / oseltamivir

Answer 1

1) inhibit neuraminidiase –> dec. release of progeny virus

2) prevent influ A / B

Question 2

ribavirin

Answer 2

1) inhibit inosine monophosphate dehydrogenase –> inhibit guanine nucleotide synthesis
2) use in RSV / chronic hep C
3) hemolytic anemia / teratogenic

Question 3

acyclovir, famciclovir, valacyclovir

Answer 3

1) monophosphorylated by HSV/VZV thimidine kinase (not effected by uninfected cells) –> few adverse side effects
2) guanosine analog inhibiting viral DNA polymerase by chain termination

Question 4

acyclovir clinical use

Answer 4

HSV / VZV; not used for EBV / CMV

Question 5

acyclovir toxicity

Answer 5

obstructive crystallin neprhopathy + acute renal failure if inadequate hydration

Question 6

ganciclovir mechanism

Answer 6

guanosin analog that inhibits viral DNA polymrease

Question 7

ganciclovir clinical use

Answer 7

CMV in immunocompromised patients

Question 8

ganciclovir toxicity

Answer 8

1) pancytopenia

2) renal toxicity

Question 9

foscarnet mechanism

Answer 9

1) viral DNA polymerase inhibitor binding to pyrophosphate-binding site of the enzyme.

does not require viral kinase activation

Question 10

foscarnet spectrum

Answer 10

CMV retinitis in immunocompromised patients when ganciclovir fails

Question 11

foscarnet toxicity

Answer 11

nephrotoxicity

Question 12

cidofovir

Answer 12

1) inhibit viral DNA polymerase (does not require kinase phosphorylation)
2) CMV retinitis
3) nephrotoxicity (coadminister w/ probencid + IV saline)

Question 13

protease inhibitors mechanism of action

Answer 13

inhibits HIV-1 protease / pol gene –> inability to assemble new virons

1) hyperglycemia, lipodystrophy, nephropathy, hematuria

Question 14

NRTIs mechanism

Answer 14

1) competitvely inhibit nucleotide binding

2) bone-marrow suppression, peirphreal neuropathy, lactic acidosis, pancreatitis

Question 15

HIV prophylaxis / during pregnancy

Answer 15

ZDV

Question 16

NNRTIs

Answer 16

bind to reverse transcriptase

rash / hepatotoicity. delavirdine / efavirenz –> contraindicated in pregnancy

Question 17

integrase inhibitors: raltegravir

Answer 17

inhibits HIV integration into host cell chromosome by reversibly inhibiting HIV integrase.

hypercholesterolemia

Question 18

fusion inhibitors

Answer 18

1) enfuvrtide –> block gp41 –> no viral entry

2) maraviroc –> bind CCR5 on T cell / monocyte surface –> no interaction w/ GP120

Question 19

interferon

Answer 19

1) glycoproteins –> dec. protein synth

2) neutropenia / myopathy

Question 20

IFNa

Answer 20

1) chronic hep B/C, kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

Question 21

IFNb

Answer 21

multiple sclerosis

Question 22

IFN y

Answer 22

CGD