Antiviral drugs

Question 1

antiviral treatments for herpesviruses are indicated for which members of the herpresvirus family?

Answer 1

VZV
HSV-1
HSV-2
CMV

Question 2

what type of drug is acyclovir?

Answer 2

nucleoside analogue

Question 3

what is the MOA of acyclovir?

Answer 3

competitive inhibitor of the viral genome DNA pol

chain termination upon incorporation into viral DNA

Question 4

what is required for acyclovir MOA?

Answer 4

phosphorylation of viral thymidine kinase enzyme

Question 5

what is the bioavailability of acyclovir?

Answer 5

low

15-20%

Question 6

what are the indications of acyclovir?

Answer 6

oral - genital herpes, varicella zoster

IV - neonate infections, severe disseminated mucocutaneous disease, HSV encephalitis, VZV in compromised patients

Question 7

what are the adverse effects of acyclovir?

Answer 7

nausea, headache, diarrhea

crystalline nephrotoxicity

Question 8

acyclovir use is cautioned in what condition?

Answer 8

concomitant adminstration of nephrotoxic agents

Question 9

what is valacyclovir?

Answer 9

prodrug of acyclovir

Question 10

what is the advantage of valacyclovir?

Answer 10

3-5x greater oral bioavailability

Question 11

what are the therapeutic indications for valacylcovir?

Answer 11

primary and recurrent genital herpes
varicella in older children and adults
zoster
orolabial herpes

Question 12

what type of drug is foscarnet?

Answer 12

analogue of pyrophosphate

Question 13

what is the MOA of foscarnet?

Answer 13

occupies site where pyrophosphate normally resides and blocks pyrophosphate release - blocks catalytic cycle

Question 14

does foscarnet require prior phosphorylation by thymidine kinase?

Answer 14

no

Question 15

what is the route of administration for foscarnet?

Answer 15

IV only

Question 16

what are the indications for foscarnet?

Answer 16

HSV and VZV resistance (to acyclovir)

CMV retinitis, CMV colitis, CMV esophagitis

Question 17

what are the adverse effects of foscarnet?

Answer 17

renal impairment

blood chem - changes Ca, P, Mg levels

Question 18

foscarnet use is cautioned in what condition?

Answer 18

concurrent administration of nephrotoxic drugs

Question 19

what type of drug is ganciclovir?

Answer 19

acyclic guanosine analogue

Question 20

what is the MOA of ganciclovir?

Answer 20

competitive inhibitor viral DNA pol

chain termination upon incorporation into viral DNA

Question 21

does ganciclovir require prior phosphorylation by viral kinase?

Answer 21

yes

Question 22

what are the therapeutic indications for ganciclovir?

Answer 22

CMV retinitis / colitis / pneumonitis / esophagitis

Question 23

what are the adverse effects of ganciclovir?

Answer 23

myelosuppression
bone marrow / CNS toxicity
phlebitis / rash / anemia / fever

Question 24

what type of drug is valganciclovir?

Answer 24

prodrug of ganciclovir

Question 25

what are the therapeutic indications for valganciclovir?

Answer 25

CMV retinitis | prevention of CMV disease post-transplantation

Question 26

what type of drug is trifluridine?

Answer 26

fluorinated nucleoside

Question 27

what is the MOA of trifluridine?

Answer 27

competitive inhibitor of thymidine for incorporation into newly synthesized genomes

Question 28

does trifluridine require prior phosphorylation for activation?

Answer 28

yes

Question 29

what type of drug is oseltamivir?

Answer 29

sialic acid analogue

Question 30

what is the MOA of oseltamivir?

Answer 30

binds to active site of neuraminidase to inhibit its function inhibits spread of progeny virions through the respiratory tract

Question 31

what is the bioavailability of oseltamivir?

Answer 31

80%

Question 32

what is the MOR of oseltamivir?

Answer 32

point mutations in H and N genes

Question 33

what are the therapeutic indications for oseltamivir?

Answer 33

influenza A and B | children 1 yo and older

Question 34

what type of drug is zanamivir?

Answer 34

sialic acid analogue

Question 35

what is the MOA of zanamivir?

Answer 35

same as oseltamivir binds to active site of neuraminidase to inhibit its function inhibits spread of progeny virions through the respiratory tract

Question 36

how is zanamivir administered?

Answer 36

inhalation

Question 37

what are the therapeutic indications for zanamivir?

Answer 37

influenza A and B | children 7 yo and older

Question 38

what type of drug is peramivir?

Answer 38

neuraminidase inhibitor

Question 39

what are the therapeutic indications for peramivir?

Answer 39

acute uncomplicated flu in patients who have been symptomatic for no more than 48 hours

Question 40

what type of drugs are amantadine and rimantadine?

Answer 40

symmetric tricyclic amines

Question 41

what is the MOA of amantadine and rimantadine?

Answer 41

inhibits activity of INFLUENZA A M2 protein - ion channel forming protein required for nucleocapsid release

Question 42

what are the therapeutic indications for amantadine and rimantadine?

Answer 42

flu within 48 hours to shorten duration

Question 43

what is the most common cause of bronchiolitis and pneumonia in children under 1 year?

Answer 43

respiratory syncytial virus (RSV)

Question 44

when is ribavirin treatment indicated?

Answer 44

premature infants immunocompromised patients with chronic lung or congenital heart disease

Question 45

what type of drug is ribavirin?

Answer 45

guanosine analogue

Question 46

what is the MOA of ribavirin?

Answer 46

interferes with synthesis of GTP inhibits viral mRNA capping inhibits RdRp of RSV and hep C virus

Question 47

what is the major adverse effects of ribavirin?

Answer 47

hemolytic anemia

Question 48

what are the contraindications for ribavirin?

Answer 48

pregnancy anemia ischemic vascular disease renal disease

Question 49

what are the protease inhibitors of HCV?

Answer 49

paritaprevir | simprevir

Question 50

what is the MOA of paritaprevir and simprevir?

Answer 50

protease inhibitors

Question 51

what are the NS5A inhibitors of HCV?

Answer 51

ledipasivir | omvitasivir

Question 52

what is the MOA of ledipasivir and omvitasivir?

Answer 52

HCV NS5A inhibitors

Question 53

what are the RNA polymerase inhibitors for HCV?

Answer 53

sofosbuvir | dasabuvir

Question 54

what is the MOA of sofosbuvir and dasabuvir for HCV?

Answer 54

RNA polymerase inhibitors

Question 55

what needs to be screened for prior to simepravir use? why?

Answer 55

NS3 Q80K polymorphism resistance

Question 56

what is unique about dasabuvir MOA?

Answer 56

non-nucleoside inhibitor of the RNA-dependent RNA pol