T2 - L2 ANTIVIRALS

Question 1

what 3 things does a virus consist of?

Answer 1

Nucleic acid (DNA or RNA)

Protein (coat - structural, enzymes-non-structural)

+/- Lipid envelope
Obligate intracellular parasites

Question 2

list acute (RNA viruses)

Answer 2

Influenza, measles,

mumps, hepatitis A virus

Question 3

list Chronic, latent viruses (generally DNA viruses)

Answer 3

Herpes simplex, Cytomegalovirus

Question 4

when should you use antivirals for acute infections?

Answer 4

people with high risk e.g. elderly

Question 5

when should you use antivirals>

Answer 5

• acute infections in vulnerable/high risk patients
• chronic infections
• infections in immunocompromised

Question 6

besides an infection, when else may a patient receive antivirals?

Answer 6

if they’re immocompromised:

• post transplant
• patients receiving immunosuppressive therapies
• patients with primary immunodeficiencies.

Question 7

what antiviral would you give to treat HSV? (herpes simplex virus)

Answer 7

aciclovir

incl:

• encephalitis
• disseminated HSV
• Primary oral-labial or genital herpes
• chicken pox (adults) and shingles

Question 8

what antiviral do we treat chicken pox in adults with? Why don’t we treat children with it?

Answer 8

aciclovir

• adult = inc age = inc morality chance
• treat within first 48 hours or aciclovir doesn’t have an affect
• children tend to recover other own

Question 9

why don’t we treat immunocompetent people with antivirals?

Answer 9

won’t work as their immune response would’ve already started

Question 10

what antiviral would you give to treat influenza?

Answer 10

Neuraminidase inhibitors: oseltamivir (oral) and zanamavir (inhaled)

Question 11

when should you treat influenza with an antiviral?

Answer 11

high risk patients only

• chronic disease
• diabetes mellitus
• immunosuppressed
• over 65 years
• pregnant
• under six months of age
• morbidly obese

Question 12

what can chronic hepatitis C (HCV) lead to?

Answer 12

cirrhosis/liver damage

Question 13

what are the 8 steps in virus replication?

Answer 13

1. Virus attachment to cell (via receptor)
2. Cell Entry
3. Virus Uncoating
4. Early proteins produced – viral enzymes
5. Replication
6. Late transcription/translation – viral structural proteins
7. Virus assembly
8. Virus release and maturation

Question 14

what do antivirals target?

Answer 14

the unique proteins which are produced by the virus - which are vital for virus replication

Question 15

which drug inhibits HIV replication?

Answer 15

AZT (azidothymidine)

• not used anymore as it is toxic and can cause long term problems e.g. changes in fat deposition, mitochondrial toxicity

Question 16

what type of drug is AZT (azidothymidine)?

Answer 16

Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Question 17

what are the three NRTI drugs now used for the treatment of HIV?

Answer 17

HIV NRTIs:

Lamivudine (cytosine analogue)

Abacavir Tenofovir (purine analogues)

Question 18

what drug do you use to treat the hep B virus (HBV)?

Answer 18

Lamividine
Tenofovir
Aciclovir
Ganciclovir

Question 19

what drug do you use to treat the hep C virus (HCV)?

Answer 19

Sofosbuvir

Question 20

how do you know if the drug is a Nucleoside Reverse Transcriptase Inhibitors (NRTI)?

Answer 20

• inhibits reverse transcriptase

- all end in vir except Lamivudine

Question 21

how do you know if the drug is Non-Nucleotide Reverse Transcriptase inhibitors (NNRTIs)?

Answer 21

• “vir” in the middle of the drug name

Question 22

what are proteases?

Answer 22

enzymes that break proteins at particular sequences to make shorter molecules

Question 23

which protease inhibitors are used to treat HIV?

Answer 23

Atazanavir Darunavir Ritonavir*

Question 24

which protease inhibitors are used to treat HCV?

Answer 24

Paritaprevir Grazoprevir

Question 25

what fusion inhibitor can be given by IM injection to battle HIV?

Answer 25

Enfuviritide

Question 26

what chemokine receptor antagonist can be used to treat HIV?

Answer 26

Maraviroc

Question 27

what type of drug is Maraviroc?

Answer 27

Chemokine receptor antagonist (Co-receptor CCR-5) used to treat HIV

Question 28

what type of drug is Enfuviritide?

Answer 28

fusion inhibitor used to treat HIV

Question 29

what is HAART?

Answer 29

Highly Active Antiretroviral Therapy

Question 30

why do we use a combination of drugs to treat HIV instead of one single drug?

Answer 30

With a single drug, resistance comes quickly in days of treatment.
o A combination of drugs used to prevent resistance and to provide enough
efficacy to drop viral load.

Question 31

what integrase inhibitors can be used to treat HIV?

Answer 31

Raltegravir Dolutegravir

Question 32

what is the advantage of using intergrase inhibitors to treat HIV?

Answer 32

not toxic as they target the viruses

Question 33

what does HAART consist of?

Answer 33

2 NRTIs + NNRTI

or

2 NRTIs + boosted PI or integrase inhibitor