Gartenberg - Anti-virals

Question 1

Which drugs are used to treat HSV and CMV?

Answer 1

Acyclovir and cidofovir (and topicals)

Foscarnet

Question 2

Acyclovir

Answer 2

Chain terminator that used to treat HSV and CMV

- has no phosphates and needs thymidine kinase to convert prodrug into regular drug.

Question 3

Thymidine kinase

Answer 3

Responsible for adding phosphates to acyclovir to make it whole.

Question 4

Cidofovir

Answer 4

Chain terminator used to treat HSV and CMV

• has 1 phosphate and needs 2 more.
• can cause nephrotoxicity
• probenecid blocks tubular transport of cidofovir, which minimizes nephrotoxicity.

Question 5

Probenecid

Answer 5

Usually given with cidofovir to reduce nephrotoxicity

Question 6

Fo scarlet

Answer 6

Used to treat CMV and HSV

- blocks viral DNA polymerase, RNA polymerase, and HIV RT directly.

Question 7

How do neurominidase inhibitors work

Answer 7

Basically hemagluttinins will stay bound to the cell and then neurominidase will come and cleave the sciatic acid receptor allowing the virus to go take over other cells. This is a sciatic acid analog that bind to neurominidase and doesn’t allow it to cut scialic acid receptors.

Question 8

What are the neurominidase inhibitors?

Answer 8

Osltamivir and Zanamivir (Peramivir)

Question 9

Amantadine and Rimantadine

Answer 9

Bind to M2 protein and block the unsheating process of the influenza virus.

Question 10

Which drugs treat influenza virus?

Answer 10

NI inhibitors and the “adamantanes” (the manta ray dining)

Question 11

Which drugs do we use for Hep C

Answer 11

Sofosbuvir, ribavarin, simeprevir, grazoprevir, ledipasvir, daclatasvir, elbasvir, Veikira Pak

Question 12

Sofosbuvir

Answer 12

Chain terminator of HCV RNA polymerase (HS5B)

• it is a uridine chain terminator.
• it is a prodrug
• substrate for p-glycoproteins efflux pump

Question 13

Ribavarin

Answer 13

chain terminator for Hep C

- Teratogenic

Question 14

Simeprevir and Grazoprevir

Answer 14

HCV protease inhibitor

Question 15

Ledipasvir

Answer 15

Inhibits NS5A, which has no known function but inhibiting it blocks viral RNA replication and packaging.
- combo of. Ledipasvir and sofosbuvir is called “Harvoni”

Question 16

Harvoni

Answer 16

Combination of ledipasvir and sofosbuvir for Hep C

Question 17

Daclatasvir and Elbasvir

Answer 17

NS5A inhibitors for Hep C

Question 18

Veikira Pak

Answer 18

Combination package that included Pariteprevir, ritonvir, ombitasvir, and dasabuvir for Hep C.

Question 19

Interferons

Answer 19

Activate Jak-Stat pathway. Has antiviral actions.

- very toxic though and awful side effects.

Question 20

Entecavir

Answer 20

Chain terminator for Hep B

- prodrug

Question 21

What drugs from the HIV lecture can be used for Hep B?

Answer 21

Truvada - Emtricitabine and Tenofovir

Question 22

Adefovir and Telbivudine

Answer 22

Hep B second line treatment

• A is similar to Tenofovir, a chain terminator.
• T is also a chain terminator.