EXAM 4 review questions Flashcards
The three sites of action for current, preferred anti-Hep C agents are:
Protease inhibitors
NS5B and A inhibitors
____, is the oral, enhanced bioavailable and less frequently dosed prodrug of ganciclovir.
Valganciclovir
True or False?
Flucytosine is converted into 5-fluorouracil in the gastrointestinal tract due to bacteria conversion.
True
_______ is the HSV/VZV viral enzyme that performs the initial phosphorylation of acyclovir or penciclovir.
Thymidine kinase
_________ is/are the class(es) of antiretrovirals that is considered the most potent (requires the smallest amount of drug present to have the greatest impact on the host’s cell ability to replicate virus).
A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor
E. Integrase inhibitor
_________ is/are the class(es) of antiretrovirals that work at the point in the viral life cycle where the virus is converting viral RNA into viral DNA.
A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
_______ is the antiretroviral that has an adverse event described as subcutaneous nodules secondary to injection site inflammatory response.
Enfuvitide
______, when occurring in neonates, requires high-dose acyclovir therapy as the infection in this population can result in death.
A. Herpes simplex virus 1 or 2 (HSV) B. Varicella zoster virus (VZV) C. Cytomegalovirus (CMV) D. Hepatitis B (HepB) E. Hepatitis C (HepC)
A. Herpes simplex virus 1 or 2 (HSV)
________, is the oral, enhanced bioavailable and less frequently dosed prodrug of penciclovir.
Famciclovir
Name 1 of 5 agents that work via inhibition of Hep C RNA-dependent RNA polymerase NS5A:
Daclatasvir Ledipasvir Ombitasvir Elbasvir Velpatasvir
What class of antifungals inhibit nucleic acid synthesis?
Flucytosine
_____ is the nucleoside reverse transcriptase inhibitor (NRTI) that has an adverse event described as anemia related to accumulation of the monophosphate derivative.
Zidovudine
Retrovir
Up to 40% of patients receiving this antiviral for CMV can experience N/V/D?
Ganciclovir or valganciclovir
Provide the chemical reaction responsible for activating valganciclovir to ganciclovir
Deacetylation
Which enzyme is responsible for activating flucytosine?
Cytosine deaminase
________ mechanism of action actually involves 3 steps in the Hep B life cycle, making it unique among the Hep B oral agents.
Entecavir
______ is used for HIV but at a higher dose than is used for Hep B.
Lamivudine
What class of antifungals inhibit glucan synthesis?
Echinocandins
_________ is an antiviral, that is converted to its active form by host nucleotide triphosphates (not mediated by viral enzyme), inhibits CMV DNA polymerase, is nephrotoxic, is co-administered with probenicid to lessen toxicity (as probenicid decreases rate of tubular excretion) and extend the dosing interval and is primarily used for the treatment of cytomegalovirus infections.
A. Acyclovir B. Ganciclovir C. Cidofovir D. Foscarnet E. Oseltamivir
C. Cidofovir
_____ is the integrase inhibitor (INSTI) that is only available at a fixed dose combination with cobicistat
Elvitegravir
_________ is an anti-hepatitis antiviral that works by inhibiting HBV-polymerase via chain termination, as well as anti-HIV activity (inhibits HIV nucleoside reverse transcriptase), has few/no drug interactions, can be administered once daily with or without food, and has a benign adverse effect profile.
A. Lamivudine B. Entecavir C. Adefovir D. PEG-interferon (alpha-2a or alpha-2b) E. Ribavirin
A. Lamivudine
Which ‘-azole’ antifungal is associated with high rates of gastrointestinal adverse events?
Itraconazole
_________ is an antiviral, that does not require conversion to active form (either using viral or host enzymes), inhibits HSV, VZV and CMV DNA polymerase, can be used to treat resistant HSV and VZV, can accumulate in bone matrix and chelates calcium and magnesium resulting in hypocalcemia.
A. Acyclovir B. Ganciclovir C. Cidofovir D. Foscarnet E. Oseltamivir
D. Foscarnet
_______ is the antiretroviral that has an adverse event described as hypersensitivity more likely to occur in persons who are HLA*B5701 positive.
Abacavir
______, is used as an HSV antiviral when the virus has developed resistance to the drugs of choice.
A. acyclovir B. ganciclovir C. cidofovir D. foscarnet E. penciclovir
D. foscarnet
_________ is/are the class(es) of antiretrovirals which has a mechanism of action that occurs prior to the virus entering the cell.
A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor
B. Fusion inhibitor / Attachment inhibitor
This antiviral is cleared via both glomerular filtration but also glomerular filtration and can cause renal toxicity as well as being directly toxic to mucocutaneous tissue at the site of elimination.
Foscarnet
What class of antifungals inhibit ergosterol resulting in a hydrophilic pore and may also bind to human cholesterol?
Polyenes
_______ is the antiretroviral that blocks gp120 binding to the chemokine co-receptor, CCR5.
Maraviroc
Name 1 of 3 echinocandins
Caspofungin (Cancidas®)
Anidulafungin (Eraxis®)
Micafungin (Mycamine®)
Cytosine deaminase is responsible for activation of what antifungal?
Flucytosine
_______ is the protease inhibitor that is only available as a fixed dose combination with ritonavir.
Lopinavir/r
_______ is an antiretroviral used exclusively for Hep B and can cause renal and bone toxicities
Adefovir dipivoxil
In a person who is chronically infected with Hep B, what are the results of the HBV laboratory tests?
Only HBsAg + Anti-HBc = positive
Hemolytic anemia is associated with this Hep C antiretroviral that is typically administered orally.
Ribavirin
Which class of antifungals has the mechanism of action of inhibition of ß-(1,3) D-glucan synthase?
Echinocandins
Reduction of N/V/D of 5-FC (flucytosine) can be accomplished by ______
Reducing the rate of administration
__________ is pregnancy category X and 2 forms of birth control are to be used when this medication is being taken by a woman of child-bearing potential.
Ribavirn
Name 1 of 3 agents that inhibit Hep C replication via binding to the hepatitis C protease enzyme:
Grazoprevir
Paritaprevir
Simeprevir
________ mechanism of action is that it inhibits RNA polymerase activity and inhibits the initiation and elongation of RNA fragments resulting in inhibition of viral protein synthesis
Ribavirin
_______ is the nucleoside reverse transcriptase inhibitor (NRTI) that has an adverse event described as hypopigmentation of the soles of the feet or palms of the hands.
Emtricitabine
True or False?
Amphotericin B should not be administered within the same Y-site iv as solutions providing electrolytes such as potassium, magnesium and calcium.
True
What class of antifungals bind to lanosterol 14a-demethylase inhibiting the production of ergosterol?
Azoles
This antiviral is administered with probenecid to reduce the tubular secretion rate thus reducing the risk for renal toxicity:
Cidofovir
_______ works as a host cytokine and has antiviral, antiproliferative and immunomodulatory effects. It is used for Hep B, Hep C and has been tried in numerous other viral conditions when no known therapeutic agent is known to work.
Interferon alpha 2 b (a is for Hep B)
A 4-gram cumulative dose of the deoxycholate formulation of amphotericin is set due to the likelihood for irreversible __________ toxicity.
Renal
Provide the enzyme that is responsible for activating valganciclovir to ganciclovir
Aldehyde oxidase
______, is described in the slides as a nearly perfect antiviral drug in that it is specific to its target (HSV). It also has poor activity against CMV. It is a guanine derivative that undergoes initial phosphorylation by the virus and then is subsequently dephosphorylated by the host cell enzyme.
A. acyclovir B. ganciclovir C. cidofovir D. foscarnet E. penciclovir
A. acyclovir
_______, is the CMV viral enzyme that performs the initial phosphorylation of ganciclovir.
CMV UL97 kinase
UL97 kinase
UL97 kinase phosphotransferase |
_________ is/are the class(es) of antiretroviral that is considered the most effective (has the greatest impact on the amount of mature virus being produced by an infected cell).
A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor
A. Protease inhibitor
____, is the oral, enhanced bioavailable and less frequently dosed prodrug of acyclovir.
Valacyclovir
Adequate hydration along with slow infusion rates reduces the renal tubule precipitation of what antiviral?
Acyclovir
_________ is/are the class(es) of antiretrovirals which has/have a mechanism of action that occurs after the host cell has begun making copies of the virus.
A. Protease inhibitor
B. Fusion inhibitor / Attachment inhibitor
C. Attachment inhibitor
D. Non-nucleoside / Nucleoside reverse transcriptase inhibitor
E. Integrase inhibitor
A. Protease inhibitor
Name 1 of 2 agents that inhibit Hep C replication via inhibition of the HCV RNA-dependent RNA polymerase NS5B:
Sofosobuvir
Dasabuvir
_________ is an anti-hepatitis antiviral that works by inhibiting multiple steps within HBV-polymerase activity, has no effect on HIV life cycle, must be dosed orally and with food, but has a similar side-effect profile compared to lamivudine.
A. Adefovir B. Entecavir C. Tenofovir D. PEG-interferon (alpha-2a or alpha-2b) E. Ribavirin
B. Entecavir
_________ is an anti-hepatitis antiviral that works by inhibiting various steps within hepatitis B and C life cycle including translation, transcription, protein processing and maturation, impact major histocompatibility complex, can mediate tissue damage, must be dosed subcutaneously, is combined with polyethylene glycol to allow for extended dosing interval, and a side effect profile including depression, influenza-like illness, and psychiatric symptoms.
A. Adefovir B. Entecavir C. Tenofovir D. PEG-interferon (alpha-2a or alpha-2b) E. Ribavirin
D. PEG-interferon (alpha-2a or alpha-2b)
