Antivirals

Question 1

What are the primary antivirals used to treat Herpes?

Answer 1

Acyclovir (IV/PO/Topical)
Valacyclovir (PO)
Famciclovir (PO)

Question 2

What is the mechanism of action of the antivirals for Herpes?

Answer 2

Inhibition of viral DNA polymerase
- activation by viral thymidine kinase (TK)

Question 3

How should you dose Acyclovir?

Answer 3

Ideal Body Weight

Question 4

Name a neuraminidase inhibitor that is commonly prescribed.

Answer 4

Oseltamivir (Tamiflu)

Question 5

What is the mechanism of action of Osteltamivir (Tamiflu)

Answer 5

Viral neuraminidase inhibitor
- prevents further replication

Question 6

How soon should Oseltamivir be started after the onset of symptoms?

Answer 6

Within 2 days

Question 7

By how many days does Oseltamavir decrease the duration of Influenza?

Answer 7

About 1 day

Question 8

What type of cells does HIV attack?

Answer 8

CD4+ T-Helper Cells

Question 9

HIV disease phase that presents as a flu-like illness with lymphadenopathy and a rash in about 50% of patients. These symptoms may last several weeks.

Answer 9

Acute Seroconversion (Phase 1)

Question 10

HIV disease phase with few or no signs and symptoms but CD4 T-Cell count is steadily declining. May last a few years to a decade or more.

Answer 10

Asymptomatic HIV (Phase 2)

Question 11

HIV disease phase where the immune system is damaged enough for significant opportunistic infections to develop.
OR
CD4 T-Cell count is less than 200 cells per microliter.

Answer 11

AIDS (Phase 3)

Question 12

What class of drugs are used to treat HIV?

Answer 12

Antiretroviral Therapy (ART)
Highly Active Antiretroviral Therapy (HAART)

Question 13

When treating a patient for HIV, what should you always be checking for in terms of treatment?

Answer 13

Drug Interactions

Question 14

What was the first anti-retroviral drug for HIV and when was it introduced?

Answer 14

Zidovudine (AZT)
1987

Question 15

Nucleoside/Nucleotide Reverse Transcriptase Inhibitor
(NRTIs)

Answer 15

Abacavir
Tenofovir
Emtricitabine
Lamivudine
Zidovudine

Question 16

A present HLA B*5701 gene may result in a hypersensitivity to what NRTI?

Answer 16

Abacavir (Ziagen)

Question 17

How are most NRTIs dosed?

Answer 17

Renal Dosing

Question 18

What two diseases can NRTIs currently be used for?

Answer 18

HIV
Hepatitis B

Question 19

Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

“All have -vir in the middle of the name”

Answer 19

Efavirenz
Nevirapine
Etravirine
Rilpiverine

Question 20

What NNRTI is considered a Pregnancy Category D drug?

Answer 20

Efavirenz

Question 21

Protease Inhibitors
(HAARTs)

“end in -navir”

Answer 21

Atazanavir
Ritonavir
Lopinavir

Question 22

Why are there a lot of drug interactions with protease inhibitors?

Answer 22

Strong CYP450 Inhibitors

Question 23

Using normally undesirable potent inhibition of drug-metabolizing enzymes of Ritonavir to increase the concentrations and half lives of other Protease Inhibitors.

Answer 23

Boosting

Question 24

What is the only protease inhibitor that is used without a booster?

Answer 24

Atazanavir

Question 25

HIV medication that blocks the integration of proviral genes into human DNA and is the newest class of anti-retroviral therapy and is now recommended as part of the 1st line therapy. Have very minimal drug interactions. "all have -tegr in the middle of their name"

Answer 25

Integrase Inhibitors - Raltegravir - Elvitegravir - Dolutegravir

Question 26

Inhibits CCR5 receptors on cell membranes and prevents the entry of HIV into the cell.

Answer 26

Maraviroc (CCR5 Inhibitor)

Question 27

Major adverse drug reaction of Maraviroc.

Answer 27

Hepatotoxicity (Black Box Warning)

Question 28

What enzyme metabolizes Maraviroc?

Answer 28

CYP450

Question 29

Genetic testing is required for all patients prior to initiating therapy with Maraviroc, what must be positive to use this drug?

Answer 29

CCR5 Positive

Question 30

Combination drug but in separate tablets and used to treat COVID-19.

Answer 30

Paxlovid (Nirmatreivir + Ritonavir)

Question 31

How many days does Paxlovid reduce the symptoms of COVID-19 by?

Answer 31

2 - 3 days

Question 32

What is the mechanism of action of Paxlovid?

Answer 32

Protease inhibitor that blinds to enzyme to prevent replication

Question 33

RNA polymerase inhibitor used to treat COVID-19 and Ebola. Can only be administered through IV.

Answer 33

Remdesivir

Question 34

Oral medication that must be taken within 5 days of symptom onset and is used to treat COVID-19. Acts as a ribonucleoside analog for viral RNA polymerase increase mutations.

Answer 34

Malnupiravir