Drugs

Question 1

What are uses for favipiravir?

Answer 1

influenza - approved in Japan. No approved in UK

covid - some countries use it. Showed some improvement, but no improvement in mortality or oxygen support

Ebola - some evidence in mouse studies. Some effect in humans in early infection, but no effect in those with established infection

Nipah - animal models showed 100% survival after being administered a lethal dose of Nipah. Await human trials

Very weak data of activity to - West Nile, Yellow fever, enterovirus

Question 2

What is the mechanism of action of favipiravir?

Answer 2

inhibition of viral RNA-dependent RNA polymerase

it is a nucleoside analogue, which mimics both guanosine and adenosine, stopping primer extension

Question 3

What drug has be tried in JC virus PML?

Answer 3

Reduce immunosuppression

Nivolumab checkpoint inhibitor

Question 4

Drug resistance summary - check drug resistance summary in documents on work computer

Question 5

What is mechanism of action of paxlovid?

Answer 5

Paxlovid - Nirmatrelvir + Ritonavir

Ritonavir inhibits cytochrome p450 inhibiting first-pass metabolism, which takes place during absorption - increases levels of Nirmatrelvir

Protease inhibitor - inhibits viral Mpro protease
preventing viral assembly

Question 6

What is Inosine pranobex mechanism of action?

What is it used for?

Answer 6

Inosine pranobex stimulates the host immune system. Causes Th1 response, with T-cell differentiation and inflammatory cytokine production (IL2/TNF)

Indications as per NICE:
HSV 1/2 mucocutaneous
Genital Warts - HPV
SSPE - Measles

May have other benefits in other viral infections, but not fully studied yet