Antivirals

Question 1

Valacyclovir unique characteristics? (3)

Answer 1

increased bioavailability
absorption not effected by food
fewer doses

Question 2

Acyclovir use (3)

Answer 2

DOC herpes
organ transplant prophylaxis
chronic for immunocompromised

Question 3

Acyclovir SE

Answer 3

nephrotoxic w/ high IV doses

Question 4

Docosanol MOA and use

Answer 4

inhibits viral fusion to cell membrane- virus can’t enter the cell

OTC for cold sore

Question 5

Ganciclovir SE (4)

Answer 5

neutropenia
thrombocytopenia
seizures
abnormal LFTs

Question 6

Cidofovir use and SE

Answer 6

resistant CMV and herpes

renal toxicity- need to use probenecid or hydrate

Question 7

Foscarnet use (2) and toxicity?

Answer 7

IV
resistant CMV and herpes

renal toxicity

Question 8

Fomvirsen MOA, use, and SE (2)

Answer 8

antisense compound to viral mRNA

intraocular for CMV retinitis

ocular inflammation, visual haze

Question 9

Oseltamivir (Tamiflu) use (2) and dose (2)

Answer 9

influenza, bird flu

oral, take w/ food to prevent N/V

Question 10

Zanamivir (Relenza) use (2), and cautions

Answer 10

influenza A and B

inhaled/nasal
caution in COPD, asthma

Question 11

Amantidine MOA, use, and SE (2)

Answer 11

inhibits viral uncoating
treatment and prophylaxis of flu A
hallucinations, N/V

Question 12

Rimantidine characteristics

Answer 12

no CNS entry- no hallucinations

Question 13

ribavirin MOA (2), forms (3)

Answer 13

purine analogue- inhibits viral RNA synthesis
inhibits RNA polymerase

aerosol, IV, oral

Question 14

Ribavirin use (3), SE (4)

Answer 14

RSV
hep C (w/ interferon)
SARS

pulm. toxicity, anemia, depression, teratogenic

Question 15

Palivizumab MOA & use

Answer 15

Ab to RSV

injection prophylaxis for high risk pts once/mo.

Question 16

Lamivudine MOA & use (2)

Answer 16

reverse transcriptase inhibitor
DOC for Hep B
HIV w/ Zidovudine

Question 17

Adefovir use & SE (2)

Answer 17

Hep B

renal toxicity, lactic acidosis

Question 18

Entacavir use

Answer 18

Hep B

Question 19

Interferon MOA

Answer 19

interferes w/ every stage of replication: blocks viral entry, transcription/translation of mRNA, viral processing, viral release

Question 20

Interferon SE (5)

Answer 20

flu-like sx
nausea
depression **
neutropenia
anemia

Question 21

Boceprevir, Telaprevir, Simeprevir MOA

Answer 21

inhibit serine protease needed for Hep C replication

Question 22

Boceprevir, Telaprevir, Simeprevir SE (4)

Answer 22

incr. effect w/ interferon/ribavirin

exacerbate anemia, neutropenia, fatigue assoc. w/ ifn-alfa/ribavirin

Question 23

Sofosbuvir/Lepidasivir MOA & SE (3)

Answer 23

halts HCV reproduction

irritability**
fatigue
lethargy

Question 24

Dasabuvir, Ombitasivir, Paritaprevir, Ritonavir (Viekira) MOA, SE (2)

Answer 24

inhibit RNA polymerases

fatigue
insomnia

Question 25

Zidovudine (Retrovir) use (5)

Answer 25

``` combined w/ lamivudine enters CNS- can treat AIDs dementia prophylaxis safe in pregnancy- decr. transmission to newborns ```

Question 26

Zidovudine (Retrovir) SE (5)

Answer 26

``` anemia neutropenia CNS GI somnolence w/ gancyclovir ```

Question 27

Tenofovir (Viread)/Emtricitabine (Emtriva) MOA, use, SE (2)

Answer 27

inhibits reverse transcriptase DOC mild GI, flatulence

Question 28

didanosine (ddI, Videx) SE & use

Answer 28

peripheral neuropathy | combo w/ Zidovudine

Question 29

Zalcitabine (ddC, Hivid) drug type, SE (2)

Answer 29

NRTIs peripheral neuropathy oral ulcers

Question 30

stavudine (Zerit) drug type, SE

Answer 30

NRTI peripheral neuropathy

Question 31

NRTIs causing peripheral neuropathy (3)

Answer 31

Didanosine (ddI, Videx) Stavudine (Zerit) Zalcitabine (ddC, Videx)

Question 32

NRTIs causing lactic acidosis (4)

Answer 32

Zidovudine Zalcitabine Didanosine Stavudine

Question 33

NRTIs causing anemia/granulocytopenia (2)

Answer 33

Zidovudine | Didanosine

Question 34

NNRTIs (2), use

Answer 34

Efavirenz Nevirapine use only w/ nucleoside analogues, interact w/ protease inhibitors

Question 35

preferred NNRTI? NNRTI for pregnancy?

Answer 35

Efavirenz Nevirapine

Question 36

protease inhibitor DOC?

Answer 36

Atazenavir (Reytaz)

Question 37

DOC #2 for protease inhibitors

Answer 37

Darunavir (Prezista)

Question 38

Protease inhibitors SE (5)

Answer 38

``` altered body fat elevates cholesterol & TGs diabetes depression abd pain ```

Question 39

Protease inhibitors tx guidelines (2)

Answer 39

don't interrupt therapy many drug interactions - St. John's Wort

Question 40

Atazanavir (Reyataz) SE & dose

Answer 40

may incr. bilirubin once/day dosing

Question 41

Darunavir (Prezista) SE (2)

Answer 41

HA | nightmares

Question 42

Saquinavir use cautions (3)

Answer 42

incr. bioavailability w/ high fat diet, grapefruit, or ritonavir inhibition of CYP3A may cause interactions or toxicity GI side effects

Question 43

Ritonavir (Norvir) use (3)

Answer 43

inhibits CYP3A4 metabolism combined w/ other drugs to increase bioavailability many drug interactions

Question 44

Ritonavir SE (3)

Answer 44

GI burning/tingling elevated LFTs

Question 45

Lopinavir/ritonavir (Kaletra) SE (3)

Answer 45

diarrhea nausea elevated LFTs w/ hepatic disease

Question 46

Indinavir (Crixivan) interactions (2) & SE (2)

Answer 46

cross-resistance w/ ritonavir metabolized by CYP3A4- many drug interactions kidney stones hyperbilirubinemia

Question 47

Amprenavir/Fosamprenavir SE

Answer 47

rash/SJS

Question 48

Tipranavir (Aptivus) use (2)

Answer 48

non-peptidic protease inhibitor- may work w/ resistance | combined w/ ritonavir

Question 49

Enfurvirtide (Fuzeon) MOA, use, & SE (2)

Answer 49

binds to viral envelope glycoprotein, prevents fusion of virus & entry into the cell no cross-resistance with other drugs- used late in disease injection site rxn pneumonia

Question 50

Raltegravir (Isentress) MOA (2), use

Answer 50

blocks integrase, prevents viral replication used when other drugs stop working