Antivirals

Question 1

Oseltamavir/Zanamavir MOA

Answer 1

Inhibits flu Neuraminidase, prevents release of progeny virus

Question 2

Acyclovir MOA

Answer 2

Guanosine analog in HSV/VZV, phosphorylated by Thymidine Kinase, which inhibits DNA polymerase by chain termination

Question 3

Acyclovir Toxicity

Answer 3

Obstructive crystalline nephropathy, acute renal failure

Question 4

Ganciclovir MOA

Answer 4

Guanosine analog in CMV., which inhibits DNA polymerase by chain termination

Question 5

Ganciclovir Toxicity

Answer 5

Bone marrow suppression, renal toxicity

Question 6

Foscarnet MOA

Answer 6

Binds to pyrophosphate binding site and inhibits DNA/RNA polymerase and HIV Reverse transcriptase

Question 7

Foscarnet Toxicity

Answer 7

Nephrotoxic, electrolyte abnormalities that can lead to seizures

Question 8

Cidofovir MOA and Toxicity

Answer 8

Inhibits viral DNA polymerase

“Cido” nephrotoxic by killing renal cells

Question 9

“-Navir” Ritonavir/Saquinavir MOA

Answer 9

Protease inhibitor, which cleaves HIV protein products into functional parts and produces maturation.

Ritonavir inhibits CYP-450, thus can be used to increase concentration of other drugs

Question 10

“-Navir” Ritonavir/Saquinavir Toxicity

Answer 10

Hyperglycemia, GI intolerance, lipodystrophy

Rifampin is Contraindicated: because it is inducer which decreases concentration of drug

Question 11

Name NRTIs

Answer 11

Abacavir
Didanosine
Emtricitabine
Lamivudine "-Vudine"
Stavudine
Tenofovir
Zidovudine (AZT)

Question 12

NRTIs MOA

Answer 12

Inhibit nucleotide binding to Reverse Transcriptase, terminates DNA chain. Must be phosphorylated to be active (except Tenofovir)

Question 13

NRTIs Toxicity

Answer 13

Bone Marrow Suppression (reversed by G-CSF and erythropoeitin), peripheral neuropathy

Question 14

Name NNRTIs

Answer 14

Efavirenz, Nevirapine, Delaviridine

“Nevir Efer”

Question 15

NNRTIs MOA

Answer 15

Bind to Reverse Transcriptase in the hydrophobic pocket of p66 subunit. Do not require phosphorylation and do not compete with nucleotides.

Question 16

NNRTIs Toxicity

Answer 16

Rash and Hepatotoxicity.

Efavirenz- Vivid dreams and CNS symptoms, contraindicated in pregnancy

Question 17

Raltegravir MOA

Answer 17

Integrase inhibitor, prevents HIV genome integration into host chromosome

Question 18

Raltegravir Toxicity

Answer 18

Increased Creatine Kinase

Question 19

Enfuvirtide MOA

Answer 19

Binds gp-41, inhibits viral entry

Question 20

Maraviroc MOA

Answer 20

Binds CCR-5 on T-cells to inhibit interaction with gp-120