Pharm: Antivirals

Question 1

Valacyclovir after hepatic pass turns into acyclovir. While fanciclovir turns into?

Answer 1

Penciclovir

Question 2

What antiviral inhibits fusion of the HSV envelope and plasma membranes?

Answer 2

Docosanol

Question 3

What is the treatment and prophylaxis for CMV retinitis and other CMV infections in the ICC?

Answer 3

Ganciclovir

Question 4

In viral strains resistant to acyclovir which among these can be used instead? 
Valacyclovir 
Ganciclovir 
Foscarnet
Penciclovir 
Cidofovir

Answer 4

Cidofovir

And foscarnet

Question 5

What drug is injected intravitreally for CMV retinitis?

Answer 5

Fomivirisen

Question 6

What component of emtricitabine make it contraindicated for pregnant patients?

Answer 6

Propylene glycol

Question 7

T/F Lamivudine is exclusively eliminated in the kidney.

Answer 7

True

Question 8

Besides lactic acidosis what is the other most important AE of NRTI especially in the obese?

Answer 8

Severe hepatomegaly and steatosis

Question 9

What is the dosing for efavirenz?

Answer 9

Once a day because of its long half life.

Question 10

Which among the protease inhibitors has the most pronounced inhibitory effect on CYP3A4?

Answer 10

Ritonavir

Question 11

At high doses what is the adverse effect of Atazanavir?

Answer 11

Prolonged QT

Question 12

To avoid nephrolithiasis in indinavir what does one do?

Answer 12

Hydrate!

Question 13

Which drug is given with other PI’s so that they may be given at a lower dose?

Answer 13

Ritonavir

Question 14

Pyrimidine derivative that binds integrase

Answer 14

Raltegavir

Question 15

This antiviral is an adenine analog active against HSV, VZV, and CMV; used topically for herpes keratitis

Answer 15

Vidarabine

Question 16

Which NRTI causes pancreatitis especially in alcoholic patients and with those with hypertriglyceridemia?

Answer 16

Didanosine

Question 17

Which 2 NRTIs cause peripheral neuropathy?

Which protease inhibitor causes peripheral neuropathy?

Answer 17

Stavudine and Zalcitabine (NRTIs)

Atazanavir (PI)

Question 18

2 NRTIs in AIDS also used in Hepatitis B infection:

Answer 18

Lamivudine

Tenofovir

Question 19

The primary toxicity of the prototype NRTI is:

Answer 19

Bone marrow suppression

Zidovudine

Question 20

This NNRTI is effective in preventing HIV vertical transmission when given as single doses to mothers at the onset of labor and to the neonate. Common adverse effect?

Answer 20

Nevirapine.

Rash occurs in 15-20% of patients, especially female.

Question 21

Of the protease inhibitors, this has the most pronounced inhibitory effect on CYP enzymes.

Answer 21

Ritonavir

Question 22

Which 2 antivirals have propylene glycol and are therefore contraindicated in pregnancy?

Answer 22

Emtricitabine and efavirenz

Question 23

Of the protease inhibitors, this has the most favorable safety profile.

Answer 23

Nelfinavir

Question 24

Which PI is associated with hyperbilirubinemia and neprolithiasis?

Answer 24

Indinavir

Question 25

All PI cause hyperlipidemia, hyperglycemia and insulin resistance with the possible exception of this drug.

Answer 25

Fosamprenavir

Atazanavir

Question 26

Which is teratogenic among NNRTI?

Answer 26

Efavirenz

Delavirdine

Question 27

Which is given as prophylactic agents for needle prick injuries involving HIV-+ patients?

Answer 27

Zidovudine
Lamivudine
PI

Question 28

Which anti-HIV drug binds to the gp41 subunit of the virus to prevent fusion?

Answer 28

Enfuvirtide

Question 29

Which anti-HIV drug is a CCR5 antagonist?

Answer 29

Maraviroc

Question 30

Amantadine must be given within ___ hours in influenza A infection? Oseltamivir?

Answer 30

Amantadine given within 48 hours of contact. Oseltamivir to be given within 24 h after onset of symptoms.

Question 31

Contraindications to IFN-a treatment in Hep C

Answer 31

Autoimmune disease
Pregnancy
History of cardiac arrhythmias

Question 32

Ribavirin inhibits replication of which viruses:

Answer 32

Influenza A and B
Parainfluenza
RSV
HCV
HIV

Question 33

Systemic use of ribavirin results in dose-dependent _____

Answer 33

Hemolytic anemia

Question 34

HSV strains resistant to acyclovir lack this enzyme which is involved in the viral-specific phosphorylation of acyclovir.

Answer 34

Thymidine kinase

Question 35

This antiviral is active against acyclovir and ganciclovir resistant strains of HSV and CMV because its phosphorylation does NOT require viral kinase. What is its major dose-limiting toxicity?

Answer 35

Cidofovir

Nephroticity

Question 36

Foscarnet is associated with which metabolic derangement

Answer 36

Hypocalcemia

Question 37

MOA of Ribavirin

Answer 37

Precise antiviral mechanism unknown but it does:

1. Inhibit GTP formation
2. Prevent capping of viral mRNA
3. Block RNA-dependent RNA pol

Question 38

Acyclovir is an analogue of?

Answer 38

Guanosine