Pharmacology Fungals and Virals

Question 1

yeasts

Answer 1

single-cell, round

Question 2

Molds

Answer 2

Multicellular, filamentous

Question 3

Which people have an increased risk of developoing fungal infections

Answer 3

• Immunocompromised patients
  
  • (not immunocompetent)
• drug-treated patients
• prostheses
• surgical and ICU

Question 4

3 Common Pathogenic Fungi

Answer 4

• candida albicans
• cryptococcus neoformans
• asperigillus fumigatus

Question 5

Candida albicans

Answer 5

• yeast
  
  • dimorphic: round and pseudohyphae
• nonpathological
• can be pathological candidiasis

Question 6

Cryptococcus neoformans

Answer 6

• encapsulated yeast
• found in bird soil
• pathological
  
  • lung disease
  • meningitis

Question 7

Asperigillus fumigatus

Answer 7

• mold
  
  • multicellular and filamentous
• found in soil and decaying organic matter
• can colonize in a healed lung scar

Question 8

Diagnosis of fungal infection

Answer 8

fungal culture (slow)

or

Western blot or PCR (rapid)

Question 9

Antifungal Targets

Answer 9

• Fungal cell membrane
  
  • azoles, terbinafine, amphotericin B, nystatin
• Fungal cell wall
  
  • caspofungin
• Fungal DNA synthesis
  
  • flucytosine

Question 10

Answer 10

• Azoles
  
  • Ketoconazole
  • Itraconazole
  • Fluconazole
  • Voriconazole
  • Psoaconazole
• Echinocandins
  
  • Caspofungin

Question 11

Azoles

Answer 11

Broad-spectrum anti-fungal agents

inhibits the 14a-sterol demethylase (CYP450) involved in ergosterol biosynthesis

Question 12

Azole Drug list

Answer 12

Ketoconazole (Extina)

Fluconazole (Diflucan)

Itraconazole (Sporanox)

Voriconazole (VFEND)

Posaconazole (Noxafil)

Question 13

Ketoconazole

(extina)

Answer 13

oral and topical

interferes with human demethylase function

does not penetrate the CNS

Question 14

Fluconazole

(diflucan)

Answer 14

oral and parenteral

CNS penetration

Question 15

Itraconazole

(sporanox)

Answer 15

oral and partenteral

does not penetrate CNS

exacerbation of congestive heart failure

Question 16

Voriconazole

(VFEND)

Answer 16

oral and parenteral

drug of choice for invasive aspergilliosis

Question 17

Posaconazole

(Noxafil)

Answer 17

liquid oral

brodest spectrum of all azoles

prophylaxis in high risk patients

Question 18

Terbinafine

(Lamisil)

Answer 18

inhibits squalene epoxidase enzyme

oral and topical

used in onchomycosis, tinea pedia, and tinea capitis

Question 19

Amphotericin B

Answer 19

broad spectrum antifungal

binds to erogsterols and disrupts membrane by forming pores

(Fungizone, AmBisome, Amphtec, Abelcet)

Question 20

Nystatin

Answer 20

oral and topical

used in cadida sp

named for the New York State PHD

Question 21

Which antifungals target the cell membrane?

Answer 21

azoles, terbinafine, amphotericin B, nystatin

Question 22

Caspofungin

(cancidas)

Answer 22

inhibits B-glucan synthase

(Echinocandin class)

• enhances effect of azoles
  *

Question 23

Flucytosine

(Ancobon)

Answer 23

competes with Uracil for incorporation into DNA

• enters fungal cell via cytosine permease
• converted to 5-FU by cytosine deaminase

Question 24

HSV

Answer 24

herpes simplex

Question 25

ZVZ

Answer 25

Varicella Zoster Virus

Question 26

CMV

Answer 26

Cytomegalovirus

Question 27

DNA Viruses

Answer 27

viruses that contain DNA as genetic material

examples: HSV, VZV, CMV, HBV

Question 28

RNA Viruses

Answer 28

viruses contain RNA as genetic material

Examples: HCV, influenza A, HIV

Question 29

Question 30

Which drug blocks viral fusion with the host cell?

Answer 30

Enfuvirtide

Question 31

Which drug blocks viral “uncoating” within the host cell

Answer 31

Amantadine

Question 32

Which drugs block viral nucleic acid synthesis

Answer 32

Valacyclovir, Zidovudine, and Raltegravir

Question 33

Which drug blocks viral processing inside the host cell?

Answer 33

Saquinavir

Question 34

Which drug blocks viral exit from the host cell?

Answer 34

Zanamivir

Question 35

Enfuvirtide

(Fuzeon)

Answer 35

inhibits HIV-1 viral fusion

biinds to the gp41 subunit of the viral envelope glycoprotein

• 36 a.a. peptide
• ‘salvage therapy”

Question 36

Amantadine

(Symmetrel)

Answer 36

antiviral

influenza type A

inhibits uncoating by inhibiting M2 proton pump

Question 37

Which type A influenza viruses are not ssceptible to Amantadine?

Answer 37

H1N1 and H3N2

Question 38

Valacyclovir

(Valtrex)

Answer 38

treats HSV and VZVZ

(cyclovirs)

• converted to acyclovir (ACV)
  
  • inhibits viral DNA synthesis

Question 39

Zidovudine

Answer 39

antiretroviral

• used in combination for HIV
• thymidine nuceloside analog

Question 40

Zidovudine triphosphate

Answer 40

reverse transcriptase inhibitor

inhibits the formation of vDNA from vRINA

Question 41

Question 42

Raltegravir

(Isentress)

Answer 42

HIV integrase inhibitors

Question 43

Saquinavir

(Invirase)

Answer 43

competitive HIV protease inhibitor

Question 44

Zanamivir

(Relenza)

Answer 44

neuraminidase inhibitor

• treatment and prophylaxis of influenza type A and B

Question 45

Neuroamidase

Answer 45

cleaves the bond between host cell sialic acid and viral hemagglutanin

Question 46

Interferon alpha

Answer 46

endogenous antiviral immunomodulatory proteins used to treat HBV and HCV

• produces anti-viral proteins and inhibits numerous stages of the viral life cycle