Sweatman: Viral Pneumonia therapy

Question 1

Markers suggestive of Viral Pneumonia

Answer 1

younger than five
ongoing viral epidemic
slow onset
rhinitis, wheezing

Question 2

chest radiograph findings for intersititial

Answer 2

sole interstitial infiltrates bilaterally

Question 3

blood markers for viral pneumonia

Answer 3

few white cells
little CRP
little pro-calcitonin in serum

Question 4

tx of Influenza A and B

Answer 4

Oseltamvir, Zanamivir

Question 5

prevention of Influenza A and B

Answer 5

vaccine, oseltamvir, zanamivir

Question 6

Influenza A virus tx

Answer 6

amantadine PO, rimantidine PO

Question 7

Hnumber refer to

Answer 7

hemagluttinin type

Question 8

N# refers to

Answer 8

neuraminidase strain

Question 9

Hemagluttinins allow for

Answer 9

binding of virus to sialic acid receptors and fusion with cell membrane to permit entry

Question 10

neuraminidase function

Answer 10

bind the cell to the inner part of membrane and functions in release of the newly formed virion to infect other eukaryotic cells

Question 11

Tx for RSV

Answer 11

ribavarin

Question 12

prevention of RSV

Answer 12

palavizumab

Question 13

palavizumab MOA

Answer 13

MAB that binds up F protein in RSV and prevents entry/attachment into host cell

Question 14

indications for Palivizumab

Answer 14

neonates, infants with congenital heart defects, chronic lung disease and/or prematurity

Question 15

tx of rhinovirus

Answer 15

none

Question 16

prevention of rhinovirus

Answer 16

Alfa intereron

ribavarin (off label use)

Question 17

tx for enteroviruses

Answer 17

none

Question 18

preventions of enteroviruses

Answer 18

none

Question 19

tx of metopneumovirus

Answer 19

ribavirin

Question 20

prevention of metpneumovirus

Answer 20

none

Question 21

tx of hantavirus

Answer 21

ribavirin

Question 22

prvention of hanta virus

Answer 22

none

Question 23

tx of varicella-zoster

Answer 23

acyclovir

valacyclovir

Question 24

prevention of vericella-zoster

Answer 24

vaccine

Question 25

MOA for oseltamvir

Answer 25

Oseltamivir is a neuraminidase inhibitor, serving as a competitive inhibitor of neuraminidase (NA) enzyme upon sialic acid, -->prevents new viral particles from being released through the cleaving of terminal sialic acid on glycosylated hemagglutinin and thus fail to facilitate virus release

Question 26

MOA for zanamivir

Answer 26

Zanamivir works by binding to the active site of the neuraminidase protein, rendering the influenza virus unable to escape its host cell and infect others

Question 27

MOA for amantidine

Answer 27

inhibits entry/uncoating--> involves interference with the viral protein, M2, a proton channel

Question 28

will amantidine work on influenza B

Answer 28

no because the M protein channel has a deifferent configuraiton..amantidine has no specificity for this

Question 29

Rimantidine MOA

Answer 29

M2 proton channel inhibitor

Question 30

tx of adeno virus

Answer 30

cidofovir

Question 31

prevention of adenovirus

Answer 31

vaccine for type 4 and 7

Question 32

MOA for valacyclovir and acyclovir

Answer 32

becomes GTP, incorporates into DNA polymerase--> chain termination VALACYLOVIR=prodrug for acyclovir

Question 33

MOA or ribavirin

Answer 33

"inhibits viral nucleic acid synthesis" DNA viruses--> ihibit IMP-dehydrogenase...cell runs out of GMP/GTP RNA--> incorporates into chain...terminations

Question 34

MOA for cidofovir

Answer 34

inhibits viral DNA polymerase

Question 35

review metabolism of antivirals

Answer 35

fag

Question 36

contraindicated in narrow angle glaucoma and breast feeding

Answer 36

amantadine

Question 37

black box warning for renal impairment/toxicity

Answer 37

cidofovir

Question 38

adverse neuropysche effects

Answer 38

oseltamvir | *ALSO SERIOUS SKIN EFFECTS REPORTED

Question 39

blck box warning for hemolytic anemia and M/F teratogenicity

Answer 39

ribavarin

Question 40

minimal adverse effects

Answer 40

rimantidine, oseltamvir

Question 41

acyclovir/ valacyclovir side effects

Answer 41

elevate hepatic enzymes, use caution with other reno-toxic drugs, maintain hydration, rhinnitis, nasopharyngitis,

Question 42

side effects of zanamivir

Answer 42

FATAL broncho spasm--> NOT TO BE USED WITH UNDERLYING PULMONARY DISEASE throat/tonsil pain,

Question 43

metabolism of acyclovir

Answer 43

viral cells metab. to triphosphate form | --> syst. elim unchanged by gfilt and sec.

Question 44

metabolism of amantadine

Answer 44

--> syst. elim unchanged by gfilt and sec.

Question 45

metabolism of cidofovir

Answer 45

metabolized by pyrimidine nucleoside monophosphate kinase to mono--> dipho analogs, then to the monophosphate-choline -->--> syst. elim unchanged by gfilt and sec.

Question 46

Metabolism of oseltamvir

Answer 46

hepatically metab to the carboxyllate form | --> syst. elim unchanged by gfilt and sec.

Question 47

metabiolism of ribavirin

Answer 47

non-cyp mediated metabolism in Multi-N-Giant cells with systemic elimination in the urine

Question 48

metablism of ramantidine

Answer 48

extensively first pass metabolized by cyps in liver | --> renal elimination

Question 49

metabolism of valacyclovir

Answer 49

first pass metab to acyclovir, | --> syst. elim as acyclovir, unchanged by gfilt and sec.

Question 50

metabolism of zanamivir

Answer 50

renally eliminated unchanged