Unit 3: K49.Antivirals

Question 1

Most used antiherpes drug

Answer 1

Acyclovir

Question 2

Acyclovir has a ____half life

Answer 2

Short —> must be dosed frequently

Question 3

How is valacyclovir related to acyclovir?

Answer 3

Adjusted medication to extend half life; can be taken less frequently

Question 4

Brand name for docosanol; what is it used to treat?

Answer 4

Abreva; cold sores

Question 5

What is CMV?

Answer 5

Cytomegalovirus; it is a mono-like illness

Question 6

What can be used to treat CMV?

Answer 6

Ganciclovir

Question 7

5 Anti-HIV Classes

Answer 7

1. NRTIs = nucleoside reverse transcriptase inhibitors
2. NNRTIs = nonnucleoside reverse transcriptase inhibitors
3. Protease inhibitors
4. Entry and Fusion Inhibitors
5. Integrase Strand Transfer Inhibitors (INSTs)

Question 8

Viruses have RNA or DNA?

Answer 8

RNA

Question 9

MOA:

NRTIs = nucleoside reverse transcriptase inhibitors

NNRTIs = nonnucleoside reverse transcriptase inhibitors

Answer 9

Block reverse transcription of viral RNA into DNA

Question 10

MOA: Protease inhibitors

Answer 10

Block viron assembly and virus from leaving cell (stop virus from finishing maturation process)

Question 11

MOA: Entry and Fusion Inhibitors

Answer 11

Block entry of virus into cell or fusion with cell

Question 12

MOA: Integrase Strand Transfer Inhibitors (INSTs)

Answer 12

Block integration of viral DNA with host DNA nucleus; block hijacking of nucleus

Question 13

HAART stands for…

Answer 13

Highly active antiretroviral therapy

*** must use multiple medications for HIV

Question 14

Why can’t we get rid of HIV?

Answer 14

Virus is very successful at hiding out in some of our cells

Question 15

What is genotype testing for a virus?

Answer 15

Basically a Culture and Sensitivity for a virus

Question 16

Adverse effects: NRTIs

Symptoms?

Answer 16

Can cause lactic acidosis
Sx: muscle aches or changes in liver enzymes
Check: liver functions, lactic acid levels

Question 17

NNRTI Sustiva (efavirenz) can cause what?

Answer 17

Bizarre dreams

Question 18

Adverse effects: NNRTIs

Answer 18

Rash

Raise cholesterol

Question 19

NNRTI Nevirapine can cause what?

Answer 19

Stevens Johnson Syndrome

Question 20

Adverse effects: protease inhibitors

Answer 20

Strange fat distribution: Buffalo hump, gynecomastia, truncal obesity

Facial and peripheral lipodystrophy (fat wasting/gaunt looking)

Question 21

Adverse effects of Maraviroc (entry and fusion inhibitor)

Answer 21

Cough, diarrhea, muscle and joint pain, increases in hepatic transaminases

Question 22

Two once daily pill recommendations for new HIV treatment

Answer 22

Biktarvy (Bictegravir/TenofovirAF/Emtrictabine)

Triumeq (Abacavir/Lamivudine/Dolutegra)

Question 23

Two categories of people at highest risk for HIV

Answer 23

MSM (men who have sex with men)

PWID (people who inject drugs)

Question 24

What is PrEP?

Answer 24

Medication regimen for those who are at high risk of contracting HIV

Question 25

Two meds on the PrEP regimen

Answer 25

Truvada | Descovy

Question 26

What is required for patients on PrEP?

Answer 26

See every three months Screen for HIV (stop PrEP, start HAART of positive) Check BMP (kidney function)

Question 27

Chronic hepatitis B typically comes from ...

Answer 27

Asia, transmitted from mother to child

Question 28

Acute hepatitis B typically comes from...

Answer 28

Sexual transmission | OR blood/body fluids

Question 29

Why is hepatitis B uncommon in the US?

Answer 29

We vaccinate against it

Question 30

Two classes of anti-influenza agents

Answer 30

Neuraminidase inhibitors | Adamantanes

Question 31

Why are adamantanes no longer used for flu?

Answer 31

High level of resistance | Only effective against flu A

Question 32

Why does Tamiflu (oseltamivir) work best if initiated within 24-48h of flu onset?

Answer 32

It interferes with viral replication

Question 33

What is the benefit of Tamiflu? What is the cost?

Answer 33

Can decrease duration of flu by half a day or so. | Out of pocket cost ~ $100

Question 34

What is Synagis (palivizumab) used for? How is it dosed?

Answer 34

Young children to help prevent/fight RSV Once monthly IM injections (15mg/kg) for 5 months during RSV season

Question 35

Palivizumab is a -mab, so to what class does it belong?

Answer 35

Monoclonal antibodies

Question 36

What is Aldara (imiquimod cream) used for?

Answer 36

Treatment of genital and perinatal warts, as well as plantars warts

Question 37

List NRTIs [8]

Answer 37

``` Abacavir Didanosine Emtricitabine Lamivudine (3TC) Stavudine (d4T) Tenofovir Zalcitabine (ddC) Zidovudine ```

Question 38

List NNRTIs [5]

Answer 38

``` Delavirdine Efavirenz Etravirine Nevirapine Rilpivirine ```

Question 39

List Protease Inhibitors [9]

Answer 39

``` Atazanavir Darunavir Fosamprenavir Indinavir Lopinavir/ritonavir Nelfinavir Ritonavir Saquinavir Tipranavir ```

Question 40

List Entry and Fusion Inhibitors [2]

Answer 40

Maraviroc | Enfuvirtide

Question 41

List Integrase Strand Transfer Inhibitors (INSTs) [3]

Answer 41

Raltegravir Dolutegravir Elvitegravir

Question 42

3 neuraminidase inhibitors

Answer 42

oral oseltamivir inhaled zanamivir IV peramivir

Question 43

2 adamantanes

Answer 43

amantadine | rimantadine