AntiVirals Non-HIV

Question 1

Ribavirin

Answer 1

Guanosine analog blocks mRNA cap so RNApoly not work
Oral, with food, with interferons
Kidney excretion
HEMOLYTIC ANEMIA at high doses
TERATOGENIC
Broad viral spectrum: Influenza A/B, Parainfluenza, Resp. Syncytial Virus, Paramyxoviruses, HCV, HIV-1

Question 2

AntiHerpes Drugs

Answer 2

Acyclovir
Ganciclovir
Foscarnet

Question 3

Acyclovir

Answer 3

AntiHerpes
DNA Synthesis Inhibitor
Requires phosphorylation x3 and competes with dGTP then causes CHAIN TERMINATION or SUICIDE INHIBITION by DNApoly
Oral, IV, Topical
Kidney excretion
GOOD CSF
Minor toxicity
Broad range: HSV1/2, VZV, EBV, CMV
Resistance via kinase mutation or polymerase mutation
USED: Herpes simplex encephalitis, Neonatal HSV, Severe HSV or VZV

Question 4

Ganiciclovir

Answer 4

AntiHerpes, CMV treatment, and Post-Transplant!
Guanosine analog x3 phosphorylation and DNA replication inhibition
IV or directly to Eyeball
Kidney Excretion
GOOD CSF
MYELOSUPPRESSION (reversible) and mildly mutagenic

Question 5

Foscarnet

Answer 5

AntiHerpes, CMV treatment
Works different from others! BLOCKS PYROPHOSPHATASE BINDING SITE ON DNApoly, not dependent on kinase
IV admin
Kidney Exc.
GOOD CSF
Kidney toxicities, HYPOCalcemia because settles in bone
Acts against ALL HSVs and HIV

Question 6

AntiHepatitis Drugs

Answer 6

B (and C) - Interferons

Mostly C - Ribavarin, Simepravir, Sofosbuvir, Ledipasvir/Sofosbuvir

Question 7

Interferons

Answer 7

Hep B and HepC and Papillomavirus
Cytokine messenger system sets off things that interfere with vial lifecycle
Also increases protein production of Histocompatibility Complex protein synth, phagocytic activity of macrophages, proliferation and survival of T cells
Intramuscular, SC, IV admin
Minor CSF
Complex excretion due to catabolism
REALLY BAD FLU EFFECTS. Some myelosuppression and neurotoxicity

Question 8

Ribavirin

Answer 8

Number one treatment for HepC but has BROAD RANGE of activity (orthomyxo, paramyxo, arena, bunya, flavi).
Guanosine (purine) analog that requires x3 phosphorylation. Prevents capping of mRNA, stopping RNApoly from translating to proteins
Oral, Inhalation, some IV
Complex elim.
ANEMIA possible
TERATOGENIC, PREG CATC

Question 9

Simeprevir

Answer 9

Best for HepC1
Protease Inhibitor
Targets viral NS3/4A protease and therefore reduces the number of viral proteins that mature
Oral, with food
Liver elim.
Metabolized by some Liver enzymes, but
CONTRAINDICATED WITH BOOSTERS (RIFAMPIN AND COBISTAT), oral contraceptives, and statins
Rash, photosensitivity, sulfa moiety allergy
Not for preggers

Question 10

Sofosbuvir

Answer 10

ALL HepC GENOTYPES and those resistant to Protease Inhibitors (Simeprevir)
Uridine (pyrimidine) analog
Targets NS5B, which works with RNApoly, so stops RNApoly activity
CONTRAINDICATED with P-GP INDUCERS like RIFAMPIN

Question 11

Ledispavir/Sofosbuvir

Answer 11

ALL HepC GENOTYPES and those resistant to Protease Inhibitors (Simeprevir)
Inhibits NS5A protein, which interacts with NS5B and RNApoly

Question 12

AntiInfluenza Drugs

Answer 12

Amantidine
Oseltanivir
Zanamivir

Question 13

Amnatidine

Answer 13

Influenza A only (and therefore widespread resistance)
M2 Protein inhibitor prevents envelop bursting
Oral by Inhalation
Kidney excre.
Mild GI, Mild CNS lightheadedness, insomnia,

Question 14

Oseltanivir

Answer 14

Influenzas A and B
Sialic Acid Analog inhibits neuraminidase and prevents budding
Oral and some IV
minor CNS
Kidney excre.
HA, Mild GI
Pregnacy Cat C

Question 15

Zanamivir

Answer 15

Same as Oseltanivir with poor CNS