Viral diseases

Question 1

What is acyclovir indicated to treat?

Answer 1

varicella zoster; varicella chicken pox

Question 2

What is cidofovir indicated to treat?

Answer 2

pox virus; HHV-6; HHV-7;

Question 3

What is drug is metabolized to the active product, penciclovir?

Answer 3

famciclovir

Question 4

What is famciclovir used to treat?

Answer 4

varicella zoster

Question 5

What is forscarnet indicated to treat?

Answer 5

HHV-6

Question 6

Indication for ganciclovir?

Answer 6

HHV-6; HHV-8;

Question 7

Which are viral prodrugs?

Answer 7

valacyclovir; valganciclovir

Question 8

Indications for valacyclovir?

Answer 8

varicella zoster; varicella chicken pox;

Question 9

indications for valganciclovir?

Answer 9

HHV-6; HHV-8

Question 10

How does acyclovir prevent further viral chain elongation?

Answer 10

insertion of acyclovir monophos into viral DNA so viral polymerase cannot remove the acyclovir moiety

Question 11

Why is ganciclovir not block further viral DNA synthesis?

Answer 11

it has a 3’ OH group

Question 12

What is the MOA of foscarnet?

Answer 12

pyrophosphate binding site of viral DNA polymerase and prevents cleavage of pyrophosphate to stall primer template extension

Question 13

Which drugs have the MOA of competitively inhibits viral DNA polymerase; competes with deoxyguanosine-TP for incorporation into viral DNA?

Answer 13

acyclovir; famciclovir; ganciclovir; valacyclovir; valganciclovir

Question 14

How does the MOA of cidofovir differ from the other “virs”?

Answer 14

competes with deoxyCYTOSINE-TP for viral DNA incorpation

Question 15

What is significant when considering dose adjustment in the antivirals?

Answer 15

renal elimination so dose adjustment necessary in renal dysfxn => if not renal failure may occur

Question 16

What is a toxicity of acyclovir and valacyclovir?

Answer 16

neurotoxicity including seizures

Question 17

What is the toxicity of cidofovir?

Answer 17

Nephrotoxicity and probenecid hypersensitivity

Question 18

What is important to monitor during the administration of cidofovir?

Answer 18

to prevent nephrotoxicity monitoring creatinine and urinary protein is necessary

Question 19

What antiviral is not associated with toxicity?

Answer 19

famciclovir

Question 20

What is the toxicity of forscarnet?

Answer 20

electrolyte imbalance => chelates Ca ions

Question 21

What are the toxicities of ganciclovir and valganciclovir?

Answer 21

anemia; leukopenia; neutropenia; pancytopenia; thrombocytopenia; teratogen

Question 22

How is renal toxicity minimized in patients receiveing cidofovir?

Answer 22

oral probenecid and hydration with normal saline concurrently to effectively reduce concentration and lower magnitude of clearance

Question 23

The dose-limiting adverse reaction of intravenous cidofovir is what?

Answer 23

dose-dependent renal tubular necrosis (proximal tubule cell injury) beginning as soon as the first one or two doses