Lippincott Chapter 45: Antiviral Drugs

Question 1

45.1 A 30-year-old male patient with human immuno-
deficiency virus infection is being treated with a
HAART (highly active antiretroviral therapy) regimen.
Four weeks after initiating therapy, he presents to the
emergency department complaining of fever, rash, and
gastrointestinal upset. Which one of the following drugs
is most likely the cause of his symptoms?
A. Zidovudine.
B. Nelfinavir.
C. Abacavir.
D. Efavirenz.
E. Darunavir.

Answer 1

Correct answer = C. The abacavir hypersensitivity reaction
is characterized by fever, rash, and gastrointestinal upset.
The patient must stop therapy and not be rechallenged.

Question 2

45.2 A 75-year-old man with chronic obstructive pulmonary
disease is diagnosed with suspected influenza based
on his complaints of flu-like symptoms that began
24 hours ago. Which of the following agents is most
appropriate to initiate for the treatment of influenza?
A. Ribavirin.
B. Oseltamivir.
C. Zanamivir.
D. Rimantadine.
E. Amantadine.

Answer 2

Correct answer = B. Oseltamivir is the best choice since it
is administered orally and not associated with resistance.
Zanamivir is administered via inhalation and is not recom-
mended for patients with underlying COPD. High rates of
resistance have developed to adamantanes (amantadine,
rimantadine), and these drugs are infrequently indicated.
Ribavirin is not indicated for treatment of influenza.

Question 3

45.3 A 24-year-old female is diagnosed with genital herpes
simplex virus infection. Which of the following agents is
indicated for use in this diagnosis?
A. Valacyclovir.
B. Cidofovir.
C. Ganciclovir.
D. Zanamivir.
E. Lamivudine.

Answer 3

Correct answer = A. Valacyclovir, famciclovir, penciclovir,
and acyclovir are all indicated for herpes simplex virus
infection. Cidofovir and ganciclovir are used for CMV retini-
tis. Zanamivir is indicated for influenza. Lamivudine is indi-
cated for HIV and hepatitis B.

Question 4

45.4 A female patient who is being treated for chronic
hepatitis B develops nephrotoxicity while on treatment.
Which is the most likely medication she is taking for
HBV treatment?
A. Entecavir.
B. Telbivudine.
C. Lamivudine.
D. Adefovir.

Answer 4

Correct answer = D. Nephrotoxicity is the most commonly
seen with adefovir.