Pharm: Antivirals Flashcards
Valacyclovir after hepatic pass turns into acyclovir. While fanciclovir turns into?
Penciclovir
What antiviral inhibits fusion of the HSV envelope and plasma membranes?
Docosanol
What is the treatment and prophylaxis for CMV retinitis and other CMV infections in the ICC?
Ganciclovir
In viral strains resistant to acyclovir which among these can be used instead? Valacyclovir Ganciclovir Foscarnet Penciclovir Cidofovir
Cidofovir
And foscarnet
What drug is injected intravitreally for CMV retinitis?
Fomivirisen
What component of emtricitabine make it contraindicated for pregnant patients?
Propylene glycol
T/F Lamivudine is exclusively eliminated in the kidney.
True
Besides lactic acidosis what is the other most important AE of NRTI especially in the obese?
Severe hepatomegaly and steatosis
What is the dosing for efavirenz?
Once a day because of its long half life.
Which among the protease inhibitors has the most pronounced inhibitory effect on CYP3A4?
Ritonavir
At high doses what is the adverse effect of Atazanavir?
Prolonged QT
To avoid nephrolithiasis in indinavir what does one do?
Hydrate!
Which drug is given with other PI’s so that they may be given at a lower dose?
Ritonavir
Pyrimidine derivative that binds integrase
Raltegavir
This antiviral is an adenine analog active against HSV, VZV, and CMV; used topically for herpes keratitis
Vidarabine
Which NRTI causes pancreatitis especially in alcoholic patients and with those with hypertriglyceridemia?
Didanosine
Which 2 NRTIs cause peripheral neuropathy?
Which protease inhibitor causes peripheral neuropathy?
Stavudine and Zalcitabine (NRTIs)
Atazanavir (PI)
2 NRTIs in AIDS also used in Hepatitis B infection:
Lamivudine
Tenofovir
The primary toxicity of the prototype NRTI is:
Bone marrow suppression
Zidovudine
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?
Nevirapine.
Rash occurs in 15-20% of patients, especially female.
Of the protease inhibitors, this has the most pronounced inhibitory effect on CYP enzymes.
Ritonavir
Which 2 antivirals have propylene glycol and are therefore contraindicated in pregnancy?
Emtricitabine and efavirenz
Of the protease inhibitors, this has the most favorable safety profile.
Nelfinavir
Which PI is associated with hyperbilirubinemia and neprolithiasis?
Indinavir
All PI cause hyperlipidemia, hyperglycemia and insulin resistance with the possible exception of this drug.
Fosamprenavir
Atazanavir
Which is teratogenic among NNRTI?
Efavirenz
Delavirdine
Which is given as prophylactic agents for needle prick injuries involving HIV-+ patients?
Zidovudine
Lamivudine
PI
Which anti-HIV drug binds to the gp41 subunit of the virus to prevent fusion?
Enfuvirtide
Which anti-HIV drug is a CCR5 antagonist?
Maraviroc
Amantadine must be given within ___ hours in influenza A infection? Oseltamivir?
Amantadine given within 48 hours of contact. Oseltamivir to be given within 24 h after onset of symptoms.
Contraindications to IFN-a treatment in Hep C
Autoimmune disease
Pregnancy
History of cardiac arrhythmias
Ribavirin inhibits replication of which viruses:
Influenza A and B Parainfluenza RSV HCV HIV
Systemic use of ribavirin results in dose-dependent _____
Hemolytic anemia
HSV strains resistant to acyclovir lack this enzyme which is involved in the viral-specific phosphorylation of acyclovir.
Thymidine kinase
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?
Cidofovir
Nephroticity
Foscarnet is associated with which metabolic derangement
Hypocalcemia
MOA of Ribavirin
Precise antiviral mechanism unknown but it does:
- Inhibit GTP formation
- Prevent capping of viral mRNA
- Block RNA-dependent RNA pol
Acyclovir is an analogue of?
Guanosine
