Fitz - Antiviral Pharm

Question 1

2 drugs that tx influenza A only

Answer 1

• amatadine

- rimatadine

Question 2

2 drugs that tx influenza A & B

Answer 2

• oseltamivir

- zanamavir

Question 3

drug used to tx RSV

Answer 3

ribavirin

Question 4

nuraminidase inhibitors

Answer 4

• oseltamivir

- zanamavir

Question 5

MOA: nuraminidase inhibitors

Answer 5

inhibition of neuraminidase leads to inability of virus to cut loose from the cell membrane and therefore inhibits viral spread

Question 6

ROA: oseltamivir

Answer 6

oral

Question 7

AE: oseltamivir

Answer 7

nausea

Question 8

ROA: zanamivir

Answer 8

inhaled

Question 9

AE: zanamivir

Answer 9

bronchospasm in asthmatics

-avoid in asthmatics, COPDers, pts with resp dz

Question 10

olstamivir inidications

Answer 10

tx and prevention of flu A & B in pts >/= 1 yo

Question 11

zanamivir indications

Answer 11

tx of flu A & B in pts >/= 7 yo & prevention in pts >/= 5 yo

Question 12

neuraminidase window of efficacy

Answer 12

w/ in 48 of first s/s

Question 13

adamantanes

Answer 13

• amatadine

- rimantadine

Question 14

MOA: adamantanes

Answer 14

block M2 ion channel causing inhibition of endosome acidification and therefore the uncoating/maturation of the virus

Question 15

amatadine distribution and clearance

Answer 15

• dist to CNS

- renal eliminiation

Question 16

rimatadine distribution and clearance

Answer 16

• no CNS dist

- mixed hepatic and renal clearance

Question 17

MOA: ribaverin

Answer 17

inhibition of viral mRNA synthesis

Question 18

2 drugs used to tx HSV & VZV

Answer 18

• acyclovir

- valacyclovir

Question 19

drug used for acyclovir resistance

Answer 19

foscarnet

Question 20

3 drugs used for CMV

Answer 20

• ganciclovir
• valganciclovir
• foacarnet

Question 21

antiviral acyclic nucleoside are analogs of what nucelotides in the cell?

Answer 21

guanosine

Question 22

HSV/VZV enzyme required for initial transformation of drugs into nucleotides

Answer 22

thymadine kinase

Question 23

CMV enzyme required for inital transformation of drugs into nucleotides

Answer 23

UL97 kinase

Question 24

MOA: anti-viral NTTPs

Answer 24

terminate viral DNA elongation d/t lack of 3’-OH

Question 25

mutations of thymadine kinase or UL97 kinase result in

Answer 25

inability of drugs to become mono-phosphorlyated

Question 26

nucleoside esters are pro-drugs with _____ oral bioavailability

Answer 26

high

Question 27

valacyclovir gets de-acylated into

Answer 27

acyclovir

Question 28

acyclovir distribution and elimination

Answer 28

- dist to CNS | - renal elminiation

Question 29

Acyclovir activity

Answer 29

HSV-1 >/= HSV-2 >> VZV ~ ABV

Question 30

acyclovir is NOT active against

Answer 30

CMV

Question 31

valacyclovir is NOT active against

Answer 31

EBV or CMV

Question 32

acyclovir + pro-drug indications

Answer 32

- HSV encephalitis | - prevention of HSV or VZV reactivation in immunocompromised patients

Question 33

AEs: acyclovir

Answer 33

- acute renal failure | - neurologic toxicity

Question 34

valganciclovir gets de-acylated into

Answer 34

ganciclovir

Question 35

ganciclovir dist and elim

Answer 35

- CNS dist | - renal elim

Question 36

ganciclovir is active against

Answer 36

CMV >> HSV-1,-2, and VZV

Question 37

ganciclovir indications

Answer 37

CMV retinitis and prophylaxis against CMV in immunocompromised pts

Question 38

AEs: ganciclovir (+ pro-drug)

Answer 38

- bone marrow suppression (leunopenia) | - hematologic and renal toxicity

Question 39

MOA: foscarnet

Answer 39

independent inhibition of viral DNA polymerase

Question 40

foscarnet indicaitons

Answer 40

- CMV retinitis | - acyclovir resistant HSV, VZV, and CMV infections

Question 41

AEs: Foscarnet

Answer 41

- nephrotoxicity | - hypoCa, hypoMg

Question 42

foscarnet can accumulate in the

Answer 42

bone matrix

Question 43

down side of foscarnet PK

Answer 43

short T1/2 - need frequent injections

Question 44

foscarnet elim

Answer 44

renal