Antivirals Flashcards
Mention antiherpes agents that are active against CMV
Ganciclovir
Valganciclovir
Cidofovir
Foscarent
What’s in common between Penciclovir and Trifluridine?
Both are used topically only.
How does acyclovir work?
It’s a purine analog which depends on its activation on viral thymidine kinase then cellular enzymes which turns it into a triphosphate nucleotide that inhibits DNA polymerase enzyme.
Is acyclovir active against EBV and CMV? Yes or No?
No.
Mention some of the side effects of acyclovir.
Neurotoxicity
Nephrotoxicity
GIT disturbances
Local irritation
What’s an antiviral that is 3 to 5 times greater in serum levels than acyclovir?
Valacyclovir.
What’s Famciclovir metabolized into?
Penciclovir
How does Trifluridine work?
By inhibiting viral DNA synthesis.
How does Docasanol work?
By inhibiting viral fusion with host cell membrane and preventing viral entry.
What are the side effects of Ganciclovir?
Neutropenia, thrombocytopenia, carcinogenicity, teratogenicity
What’s in common between Cidofovir and Foscarent?
Both are nephrotoxic and both do not depend on viral enzymes in its activation so they’re useful in resistant cases.
Why does cidofovir have to be administered with a large dose of Probenecid?
Because it’s highly nephrotoxic.
Foscarent causes electrolyte disturbance in the form of..
Hypocalcemia, hypomagnesemia and hypokalemia.
Classify anti-respiratory viral drugs.
Inhibitors of entry: Palivizumab
Inhibitors of uncoating: amantadine and rimantadine
Inhibitors of viral mRNA synthesis: Ribavirin
Inhibitors of neuroaminidase (release): Oseltamivir and Zanamivir
Amantadine and rimantadine are active against both types of influenza? Yes or No?
No. They are active against influenza A only.
Only amantadine causes CNS manifestations. Why?
Because it crosses the BBB while rimantadine doesn’t.
What’s in common between rimantadine/amantadine and ribavirin?
They’re both teratogenic.
What’s in common between foscarent and ribavirin?
They both cause anemia.
What are the side effects of interferons?
Alopecia/Bone marrow depression/Influenza like syndrome/weight loss
What are the obsolete drugs used in HBV?
Lamuvidine due to resistance and Adefovir because of nephrotoxicity and low efficacy
What are the drugs used as 1st line treatment in HBV?
Entecavir and Tenofovir
What peptide binds to gp41 subunit of HIV envelope and prevents interaction with CD4 receptors?
Enfuvritide
What antiretroviral binds to CCR5? And why should a viral tropism test be done before its intake?
Maraviroc
Because some strains use CXCR4 instead of CCR5
What are the side effects of Maraviroc?
Malignancy and infection
Hepatotoxicity
Muscle pain
Many drug interactions as it’s metabolized by CYP3A4
Which NRTI doesn’t require dose adjustment and why?
Abacavir because it’s metabolized in the liver.
Zidovudine is an NRTI that causes..
Bone marrow depression
Pancreatitis occurs with the following NRTIs..
Stavudine and Didanosine
How are NNRTIs different from NRTIs?
They are highly selective and do not require activation by cellular enzymes.
Steven Johnson syndrome occurs with which class of antiretrovirals?
NNRTIs
What INSTI causes myopathy?
Raltegravir
Which class of antiretrovirals not recommended to be given with antacids?
INSTIs
Which class of antiretrovirals is HME inducer and which is inhibitor?
Inducer: NNRTIs
Inhibitors: Protease inhibitors
Mention 2 drugs that cause gynecomastia.
Ketoconazole and protease inhibitors.
Mention the class of antiretrovirals that cause buffalo hump.
Protease inhibitors
Hyperglycemia and hyperlipidemia can occur with..?
Protease inhibitors
Which protease inhibitor causes nephrolithiasis?
Indinavir
