Antivirals

Question 1

List the antivirals (or at least tell me what they end in)

Answer 1

End in “ovir” except for Foscarnet.. what a doucher

Question 2

MOA of acyclovir

Answer 2

Competes with deoxyguanosine triphosphate to competitively inhibit viral DNA polymerase

Question 3

What other antivirals share the same MOA as acyclovir? (4 others)

Answer 3

Famciclovir, Ganciclovir, Valacyclovir, Valganciclovir

Question 4

Acyclovir ADE?

Answer 4

Neurotoxicity; seizures

Question 5

Acyclovir clinical use?

Answer 5

Varicella zoster; chicken pox

Question 6

Cidofovir MOA?

Answer 6

Competes with deoxycytosine triphosphate to competitively inhibit viral DNA polymerase

Question 7

Cidofovir ADE?

Answer 7

Nephrotoxicity- monitor Cr and urinary protein; also worry about probenecid hypersensitivity

Question 8

Why would someone on cidofovir be worried about a probenecid hypersensitivity?

Answer 8

Cuz probenecid is commonly given in adjunct with cidofovir to minimize the potential for renal toxicity. Pts also receive hydration with normal saline

Question 9

Clinical uses of cidofovir?

Answer 9

Pox virus; HHV-6, 7, 8

Question 10

Famciclovir MOA?

Answer 10

Same as acyclovir (say it out loud anyway!)

Question 11

What is famciclovir metabolized to?

Answer 11

Penciclovir (which is the active product)

Question 12

Foscarnet MOA?

Answer 12

Blocks chain elongation by selectively inhibiting viral DNA polymerases and reverse transcriptases at the pyrophosphate binding site

Question 13

Foscarnet ADE?

Answer 13

Electrolyte imbalance (chelates Ca2+ ions)

Question 14

Clinical use of Foscarnet?

Answer 14

HHV-6

Question 15

Ganciclovir MOA?

Answer 15

Same as acyclovir (say it!)

Question 16

Ganciclovir ADE?

Answer 16

Pancytopenia; teratogen

Question 17

Ganciclovir clinical use

Answer 17

HHV-6 and HHV-8

Question 18

Valacyclovir MOA?

Answer 18

same as acyclovir (say it!)

Question 19

Valacyclovir ADE?

Answer 19

same as acyclovir (say it!)

Question 20

Valacyclovir clinical use

Answer 20

Varicella zoster, chicken pox, HHV-8

Question 21

So as far as Sweatman is concerned, what is the only difference between Acyclovir and Valacyclovir??

Answer 21

Valacyclovir can treat HHV-8 (and it is a prodrug)

Question 22

Which antiviral drugs have cross-hyperreactivity?

Answer 22

GAF VV: Ganciclovir, Acyclovir, Famciclovir, Valacyclovir, Valganciclovir

Question 23

How are all the antivirals eliminated from the body?

Answer 23

Renal.. must adjust for renal failure!

Question 24

What 2 antivirals are active without phosphorylation in the human cell?

Answer 24

Cidofovir, Foscarnet (these are the two that have different MOAs!… also the two that do not have cross-hypersensitivity!)