Non-HIV and Non-Hepatitis

Question 1

Receptor -> Virus?
ICAM-1

Answer 1

polio

Question 2

Receptor -> Virus?
CD4

Answer 2

HIV

Question 3

Receptor -> Virus?
acetylcholine

Answer 3

rabies

Question 4

Receptor -> Virus?
EGF

Answer 4

vaccinia

Question 5

Receptor -> Virus?
CR2/CD21

Answer 5

Epstein-Barr

Question 6

Receptor -> Virus?
HVEM

Answer 6

herpes

Question 7

Receptor -> Virus?
sialic acid

Answer 7

influenza, reo, corona

Question 8

Receptor -> Virus?
ACE2

Answer 8

SARS, COVID-19

Question 9

Many antivirals are prodrugs and need to be _________ in order to become active

Answer 9

phosphorylated

Question 10

Drugs for Herpes Viruses
ORAL

Answer 10

• acyclovir
• valacyclovir
• famiciclovir

Question 11

Drugs for Herpes Viruses
TOPICAL

Answer 11

• acyclovir
• docosanol
• penicyclovir

Question 12

Drugs for Herpes Viruses
OPHTHALMIC

Answer 12

trifluridine

Question 13

acyclovir MOA

Answer 13

• inhibition of viral synthesis of DNA
• Virus-specific thymidine kinase (TK) phosphorylates to acyclovir monophosphate; cellular enzymes convert to acyclovir triphosphate
• lacks 3’-hydroxyl group & results in chain termination; inactivates the viral DNA polymerase-guanosine analog

Question 14

Acyclovir formulations and SOA

Answer 14

• topical, oral, intravenous
• herpes simplex 1 & 2, varicella-zoster virus, possibly Epstein-Barr Virus

Question 15

Valacyclovir formulations and SOA

Answer 15

• oral only
• similar to acyclovir

Question 16

L-valyl ester prodrug of acyclovir

Answer 16

Valacyclovir MOA

Question 16

acyclovir resistance mechanisms

Answer 16

• reduced or absent thymidine kinase
• altered TK substrate specificity
• alteration in DNA polymerase

–cross resistance to famciclovir and valacyclovir

Question 17

Famciclovir formulations and SOA

Answer 17

• oral only
• HSV 1 & 2, VZV, to a lesser extent EBV

Question 18

Famciclovir

Answer 18

• cyclic analog
• converted to penciclovir in the liver and intestines

Question 19

Famciclovir resistance

Answer 19

mutations in VIRAL TK

Question 20

Ganciclovir MOA

Answer 20

• inhibit DNA polymerase
• viral-coded phosphotransferase converts to ganciclovir triphosphate, therefore more effective than acyclovir

Question 20

ANTI-CMV AGENTS

Answer 20

Ganciclovir
Valganciclovir
Foscarnet
Cidofovir

Question 21

Ganciclovir formulations and SOA

Answer 21

• oral, intravenous, intraocular
• CMV, EBV, HSV/VZV
  —-very effective in treating CMV retinitis in AIDS patients

Question 22

Vanganciclovir MOA

Answer 22

inhibition of viral synthesis of DNA

Question 23

Vanganciclovir formulations and SOA

Answer 23

- oral only (quickly hydrolyzed after absorption) - similar to ganciclovir

Question 24

Foscarnet MOA

Answer 24

- inhibition of viral synthesis of DNA - does not require thymidine kinase - selective inhibition at the pyrophosphate binding site on virus-specific DNA polymerase - noncompetitive inhibitor; doesn't affect cellular DNA polymerase

Question 25

Foscarnet formulations and SOA

Answer 25

- IV only (controlled infusions) - CMV (including ganciclovir resistant strains; acyclovir resistant HSV or VZV, EBV

Question 26

Cidofovir MOA

Answer 26

- inhibition of viral synthesis of DNA

Question 27

Cidofovir formulations and SOA

Answer 27

- IV only - CMV including acyclovir and foscarnet resistant, HSV 1 & 2, VZV, EBV

Question 28

caveats for Cidofovir

Answer 28

- must be avoided in preexisting renal impairment - AE: nephrotoxicity )dose-limiting), neutropenia, metabolic acidosis

Question 29

Cidofovir resistance

Answer 29

Foscarnet activity not affected by cidofovir resistance

Question 30

Shingles (Herpes Zoster)

Answer 30

- caused by reactivation of Varicella zoster virus (VZV) initial infection causes chickenpox - effective vaccine available

Question 31

Shingles therapy

Answer 31

- acyclovir - famciclovir - valacyclovir

Question 32

Human Papilloma Virus (HPV)

Answer 32

non-enveloped dbl-strand virus

Question 33

Imiquimod MOA

Answer 33

IMMUNOMODULATOR - activates immune cells (monocytes, macrophages, NK cells) - produces antiviral cytokines

Question 33

HPV Treatment

Answer 33

- imiquimod (Aldara) - Trichloroacetic Acid

Question 34

Podofilox (Condylox)

Answer 34

PODOPHYLLOTOXIN - main ingredient in podophyllin - MOA unknown

Question 35

Lopinavir

Answer 35

experimental for HPV but approved for HIV as protease inhibitor

Question 36

Vaccines against HPV

Answer 36

Gardasil - types 6, 11, 16, 18 Cervarix - types 16 and 18 Gardisil9 - types 6, 11, 16, 18, 31, 33, 45, 52 and 58

Question 37

Influenza Viruses

Answer 37

neuraminidase and hemagglutinin - undergoes antigenic shift and drift

Question 38

influenza A causes...

Answer 38

worldwide epidemics (pandemics)

Question 39

Influenza B causes...

Answer 39

major outbreaks of influenza

Question 40

Influenza Agents

Answer 40

oseltamivir zanamivir amantadine rimantadine

Question 41

Oseltamivir (Tamiflu) formualtion & MOA

Answer 41

ORAL-neuraminidase inhibitor - cleaves terminal SIALIC ACID

Question 41

Zanamivir (Relenza) formualtion & MOA

Answer 41

INHALATION- neuraminidase inhibitor

Question 42

Amantadine (Symmetrel) Rmantadine (Flumadine) MOA

Answer 42

prevents the release of viral nucleic acid into host cell

Question 43

drugs for COVID-19

Answer 43

Rotinavir-Boosted Nirmatrelvir - metabolized by 3A4 - CYP450 3A4 inhibitor

Question 43

Monkey Pox Sx

Answer 43

- invasion period (lasts 0-5 days): fever, chills, HA, backache - skin eruption ( begins 1-3 days) : development of rash including lesions and pustules, during this time, the patient is the most --lasts 2-4 wks

Question 44

Smallpox vaccines

Answer 44

ACAM2000 JYNNEOS

Question 44

Monkeypox Tx

Answer 44

Tecovirmat (TPOXX or ST-246) - not FDA approved - limited to patients who are at risk of severe disease like immunocompromised conditions or children younger than 8