Antiviral chemotherapy

Question 1

Amantadine

Answer 1

Influenza A, inhibits M2 proton channel in the viral envelope to prevent uncoating (useful in first 48 h or prophylactically); useful initial therapy for parkinson’s disease

Question 2

Rimantadine

Answer 2

Influenza A, inhibits M2 proton channel in the viral envelope to prevent uncoating (useful in first 48 h or prophylactically

Question 3

Zanamivir/Oseltamivir

Answer 3

Influenza A and Influenza B; Inhibits neuramidase; Oseltamivir drug of choice for prevention of bird flu

Question 4

Acyclovir/Valacyclovir/Famciclovir/penciclovir

Answer 4

Herpes virus; phosphorylated thymidine kinase (viral)-substrate inhibitor for DNA polymerase, chain termination; trifluridine for herpes keratitis

Question 5

Ganciclovir

Answer 5

CMV retinitis (IV for acute); same mechanism as acyclovir but more active for CMV; AE: bone marrow suppression, CNS effects; Valganciclovir (oral or occular implant)

Question 6

Foscarnet

Answer 6

Alternative for CMV retinitis; Pohsphonate derivative, inhibits DNA pol. and reverse transcriptase with the pyrophosphate binding site; AE:reduced renal function

Question 7

Cidofovir

Answer 7

CMV retinitis; mimics deoxycytidine monophosphate, must be administered w/ probenecid

Question 8

Ribavirin

Answer 8

Influenza A and B and RSV; Mixed MOA; used orally in combo w/ IFN for Hep C

Question 9

Fomivirsen

Answer 9

CMV retininhibits translation of viral RNA

Question 10

IFN

Answer 10

Hep B and Hep C; protein kinase pohsphorylates and inactivates initiation factors