Antiviral & Antifungal Drugs

Question 1

What are the targets of viruses? (3)

Answer 1

lipoprotein envelope
protein capsid
DNA or RNA core

Question 2

What are the general approaches to attack viruses? (3)

Answer 2

Vaccination
Chemotherapy
Stimulation of host resistance mechanisms

Question 3

Viral drugs work by acting on different phases of viral attachment to the host. Name them. (5)

Answer 3

Phase 1: Attachment/penetration into host cell
Phase 2:Uncoating of the virus
Phase 3:Synthesis of viral DNA
Phase 4: Protein synthesis by host cell
Phase 5,6: Assembly and release of virus

Question 4

What phase does gamma globulin (IgG) work upon?

What is its mechanism of action?

Answer 4

Phase 1

It blocks the attachment of the virus to the host.

Question 5

What phase does amantadine (Symmetrel) work upon?

What is its mechanism of action?

Answer 5

Phase II: uncoating

It targets M2 protein and inhibits the acidification of the virus.

Question 6

What 2 drugs are given orally for prevention and treatment of early infection of influenza A virus?

Answer 6

amantadine (Symmetrel)

rimantadine (Flumadine)

Question 7

What drugs are neuraminidase inhibitors? (2)

Answer 7

Oseltamivir (Tamiflu)

Zanamivir (Relenza)

Question 8

What phase does Oseltamivir (Tamiflu) and Zanamivir (Relenza) which are neuramidase inhibitors work?

What is the mechanism of action?

Answer 8

Phase 1,6 drug: attachment and assembly/release

Inhibit neurominidase (sialidase) of influenza A and B.

Question 9

What drugs catalyze the cleavage of a sugar residue, preventing the spread of the virus in the respiratory tract?

Answer 9

neuramidase inhibitors

Oseltamivir (Tamiflu), Zanamivir (Relenza)

Question 10

What drug blocks viron release?

Answer 10

Tamiflu

Question 11

What drug requires herpes viral thymidine kinase for activation and is given for a variety of herpes infections?

Answer 11

Acyclovir (Zovirax)

Question 12

What phase does acyclovir (Zovirax) work upon?

What is its mechanism of action?

Answer 12

Synthesis of DNA/RNA

It competitively inhibits viral DNA polymerase.

Question 13

What drug is effective against herpes simplex virus strains that are deficient in thymidine kinase?

Answer 13

Foscarnet (Foscavir)

Question 14

What drug is used for the treatment of cytomegalovirus retinitis in pts with AIDS?

Answer 14

Foscarnet (Foscavir)

Question 15

What drug is used for the treatment of acyclovir-resistant mucocutaneous herpes simplex?

Answer 15

Foscarnet (Foscavir)

Question 16

What drug is used as an aerosol for severe lower respiratory tract infections due to respiratory syncytial virus?

Answer 16

Ribavirin (Virazole, Rebetol)

Question 17

What drug is used in conjunction with interferon alpha for the treatment of chronic hepatitis C?

Answer 17

Ribavirin (Virazole, Rebetol)

Question 18

What are the sites of action for HIV drugs? (2)

Answer 18

reverse transcriptase inhibitors (nucleoside and non-nucleoside)

protease inhibitors

Question 19

What was the was the first drug licensed for use in HIV treatment?

Answer 19

zidovudine (AZT)

Question 20

What HIV drug forms this combination?

zidovudine + lamivudine

Answer 20

Combivir

Question 21

What HIV drug forms this combination?

abacavir + lamivudine + zidovudine

Answer 21

Trizivir

Question 22

What drug interferes with the entry of HIV-1 into cells?

Answer 22

Fuzeon (enfuvirtide)

Question 23

What HIV drug inhibits the fusion of viral and cellular membranes?

Answer 23

Fuzeon (enfuvirtide)

Question 24

What antiviral drugs work on the attachment and penetration (Phase 1) site? (3)

Answer 24

Gamma globulin

Fuzeon

Tamiflu

Question 25

What are the sites of action for antifungal drugs? (4)

Answer 25

Damage cell membrane Block cell division Inhibit nucleic acid synthesis Inhibit cell wall biosynthesis

Question 26

What antifungal drugs damage the cell membrane as their site of action? (2)

Answer 26

Amphotericin B Azoles

Question 27

What antifungal drug blocks cell division?

Answer 27

Griseofulvin

Question 28

What antifungal drug inhibits nucleic acid synthesis?

Answer 28

5-Flucytosine

Question 29

What antifungal drug inhibits cell wall biosynthesis?

Answer 29

Caspofungin

Question 30

What are 2 key points to remember about the antifungal drug Ampohtericin B?

Answer 30

It is a broad spectrum agent. It is a polyene antibiotic.

Question 31

What antifungal drug: has both hydrophilic and hydrophobic regions binds to sterols in the fungal membrane prefers ergosterol over cholesterol

Answer 31

Amphotericin B

Question 32

What is the premier antifungal drug used to treat the most severe systemic mycoses (e.g. blastomycosis, histoplasmosis, cryptococcal meningitis)?

Answer 32

Amphotericin B Note: This is the gold standard.

Question 33

What antifungal drug is also known as "amphoterrible"? Why?

Answer 33

Amphotericin B because it causes renal toxicity (80%)!!

Question 34

What antifungal drug is: similar to amphotericin B used topically/orally for candida

Answer 34

NYstatin Note: NY= NY state

Question 35

What antifungal drug binds to microtubules to prevent mitotic spindle formation?

Answer 35

Griseofulvin

Question 36

What antifungal drug: NARROW spectrum treats athlete's foot can cause GI upset and headache otherwise minimal side effects

Answer 36

Griseofulvin

Question 37

What are synthetic antifungal agents called?

Answer 37

Azoles

Question 38

What antifungal agent inhibits ergosterol synthesis, leading to a damaged and leaky membrane?

Answer 38

Azoles

Question 39

What are key points to know about fluconazole (Diflucan)? (5)

Answer 39

Broad spectrum Treats most candida species Single oral dose Treats fungal meningitis Reaches high concentration in the CNS

Question 40

What antifungal drug: is a derivative of Diflucan primary treatment for **invasive aspergillosis**

Answer 40

Voriconazole

Question 41

What are key points to remember for the antifungal drug Itraconazole (Sporanox)? (3)

Answer 41

Broad spectrum Hydrophobic Low gastric pH for absorption

Question 42

What new antifungal drug prevents Candida and Aspergillus infections in immunocomparomised patients?

Answer 42

Posaconazole (Noxafil)

Question 43

What antifungal drug treats dandruff?

Answer 43

Ketoconazole