Viral Pathophysiology and Pharmacology

Question 1

DNA virus examples

Answer 1

smallpox, chickenpox, herpes, HEp B, CMV, HPV

Question 2

RNA non-retroviral examples

Answer 2

rabies, polio, influenza, colds, MMR, hep A, Hep C

Question 3

RNA retroviral examples

Answer 3

HIV, Human T-cell leukemia

Question 4

Acyclic Guanosine Analogs

Answer 4

Acyclovir and Valacyclovir

Question 5

Acyclic Guanosine Analog spectrum

Answer 5

good activity against HSV-1(oral) and HSV-2(genital)

Question 6

Acyclic Guanosine Analog ADME

Answer 6

renally excreted (dose adjust if decreased renal function)

Question 7

Acyclic Guanosine Analog Tox

Answer 7

Topical - local irritation
Oral - N/V/D, rash, some hepatotoxicity
high doses- myelosuppression, nephrotoxicity, neurotoxicity

Question 8

Cidofovir MOA

Answer 8

cytodine phosphate analog (bypasses viral thymidine kinase)

Question 9

Cidofovir Spectrum

Answer 9

DNA viruses

Question 10

Cidofovir ADME

Answer 10

Give IV, low oral bioavailability
metabolites form depot (t1/2 = 87 hrs)
mostly excreted via kidney

Question 11

Cidofovir TOX

Answer 11

nephrotoxicity, bone marrow suppression

Question 12

Foscarnet MOA

Answer 12

inorganic pyrophosphate analog, viral polymerase is unable to cleave pyrophosphate from dNTP as it elongates DNA

Question 13

Foscarnet Spectrum

Answer 13

HSV I, HSV II, VZV, CMV

Question 14

Foascarnet ADME

Answer 14

Low oral bioavailability (give IV), excreted renally

Question 15

Foscarnet TOX

Answer 15

Nephrotoxicity, hypocalcemia, neurotox

Question 16

Fomivirsen MOA

Answer 16

oligonucleotide complimentary to CMV mRNA

Question 17

Amantadine & Rimantadine Spectrum

Answer 17

Influenze (except H1N1)

Question 18

Amantadine & Rimantadine MOA

Answer 18

inhibit viral uncoating, inhibit assembly of surface glycoproteins

Question 19

Amantadine & Rimantadine AMDE

Answer 19

good oral absorption, amantadine (renal), rimantadine (liver + renal)

Question 20

Amantadine & Rimantadine Tox

Answer 20

N/V/D, nervousness, CNS effects

Question 21

Oseltamavir & Zanamivir MOA

Answer 21

analog of sialic acid; they inhibit neuramindase so the virus cannot release progeny viruses from infected host cells

Question 22

Oseltamavir & Zanamivir Spectrum

Answer 22

Influenze (including H1N1)

Question 23

Oseltamavir ADME

Answer 23

well absorbed PO, renally excreted

Question 24

Zanamivir ADME

Answer 24

Poor PO absorption, give intranasal or inhalation, renally excreted

Question 25

Antiviral agents to treat Hep B and C

Answer 25

1. Adefovir
2. Recombinant & Natural Interferons
3. Lamivudine & Telbivudine
4. Ribavirin

Question 26

Adefovir MOA

Answer 26

Acyclic AMP analog

Question 27

Adefovir Tox

Answer 27

generally well tolerated

Question 28

Recombinant and Natural Interferons MOA

Answer 28

activates JAK-STAT, inhibits viral transcription, translation, processing, maturation, and release.

Question 29

Recombinant and Natural Interferons ADME

Answer 29

give parentally, eliminated via tissue uptake, liver, and renal

Question 30

Recombinant and Natural Interferons Tox

Answer 30

flu like symptoms, myelosuppresion, inhibit cyp450, Do not use in autoimmune disorders

Question 31

Lamivudine and Telbivudine MOA

Answer 31

pyrimidine analogs

Question 32

Lamivudine and Telbivudine Tox

Answer 32

well tolerated, given orally

Question 33

Ribavirin MOA

Answer 33

Purine analog with modified base (true cyclic ribose is present), inhibits inosine-5’-phosphate dehydrogenase

Question 34

Ribaviron ADME

Answer 34

Can be used IV, but better PO; hepatic metabolised with renal excretion

Question 35

Ribavirin Tox

Answer 35

dose related myelosuppression