Antivirals and Treatment of common viral infections

Question 1

Name some antiviral drugs

Answer 1

Aciclovir, ganciclovir, ribavirin

Question 2

Name some immune modulation therapeutic options

Answer 2

Specific immunoglobulins, Human Normal Immunoglobulin, Lifting immunosuppression

Question 3

Aciclovir

Answer 3

Anti-herpesvirus drug
Side effects: accumulation causes neurotoxicity, maintain hydration in renal dysfunction

Question 4

Infected cells activate aciclovir to a monophosphate. Example of a p__-d___

Answer 4

pro-drug

Question 5

Aciclovir mechanism: Host cell kinases then add second and third ____ group

Answer 5

phosphate

Question 6

Aciclovir triphosphate competitively inhibits herpesvirus specific DNA p_____

Answer 6

polymerases

Question 7

Examples of herpesvirus

Answer 7

Genital herpes, herpes labialis/stomatitis, Disseminated herpes, Herpes keratitis, chickenpox and shingles

Question 8

Primary infection of chickenpox them lies dormant in dorsal root or cerebral ganglion and can later be reactivated and cause d______ s_____

Answer 8

dermatomal shingles

Question 9

When do we use IV acyclovir?

Answer 9

Severe herpes virus infections eg immunocompromised patients, encephalitis, disseminated

Question 10

What drug has better bioavailability than just aciclovir?

Answer 10

Valaciclovir (L-valyl ester pro-drug of aciclovir)

Question 11

What drug is used for CMV?

Answer 11

Ganciclovir

Question 12

Does valganciclovir have better or worse oral bioavailability than oral ganciclovir?

Answer 12

Better

Question 13

What antiviral doesn’t require activation by any kinase and inhibits all known human herpesviruses?

Answer 13

Foscarnet (has many side-effects like crystal induced nephropathy)

Question 14

What are the challenges of using Rituximab?

Answer 14

Risk of reactivation of TB or Hepatitis B.
Hypogammaglobulinaemia and bacterial infection risk.

Question 15

Measles is highly infectious with __-__ secondary infections

Answer 15

16-18

Question 16

Hallmarks of measles

Answer 16

High fever, morbiliiform rash (flat starts face and behind ears then spreads to body), Koplik spots (near 3rd molar tooth), cough, diarrhoea, conjunctivitis

Question 17

What is the antiviral for measles?

Answer 17

There isn’t one. Use MMR vaccine to prevent. Use immunoglobulin for infected patients.

Question 18

What is ribavirin being used for?

Answer 18

Hep E to clear bloodstream, prevents chronic infection.
Also used for Lassa Fever (in Africa)

Question 19

For Covid patients who present early, what is used?

Answer 19

Anti-virals

Question 19

For Covid patients who present later, what is used?

Answer 19

Immune modulators