Viral Pneumonia Rx

Question 1

Tx for Influenza A virus

Answer 1

1. Oseltamivir (PO)
2. Zanamivir (Inhalation)
3. Amantadine (PO)
4. Rimantadine (PO)

Question 2

Tx for Respiratory Syncytial Virus

Answer 2

Ribavirin (Inhalation, IV)

Question 3

Tx for Adenovirus

Answer 3

Cidofovir (IV)

Question 4

Tx for Human Metapneumovirus

Answer 4

Ribavirin (IV)

Question 5

Tx for Varicella-Zooster virus

Answer 5

1. Acyclovir (IV)

2. Valacyclovir (PO)

Question 6

Acyclovir

1. MOA
2. Metabolism
3. Toxicity

Answer 6

1. Inhibition of viral DNA polymerase (DNA synthesis)
2. Activated into its triphosphate form by viral cells; Renal
3. Neurotox (confusion, seizures); Dose adjust in renal impairment.

Question 7

Cidofovir

1. MOA
2. Metabolism
3. Toxicity

Answer 7

1. Inhibition of viral DNA polymerase (DNA synthesis)
2. Via pyrimidine nucleoside monophosphate kinase into it’s mono, then diphosphate analogs; Renal
3. BBW neuro, hematologic, and tubular damage

Question 8

Amantadine

1. MOA
2. Metabolism
3. Toxicity

Answer 8

1. Inhibition of viral entry or uncoating
2. Renal
3. Neuro, nausea, and orthostatic hypotension

Question 9

Rimantadine

1. MOA
2. Metabolism
3. Toxicity

Answer 9

1. Inhibition of viral entry or uncoating
2. Hepatic with renal elimination of drug and metabs.
3. minimal

Question 10

Valacyclovir

1. MOA
2. Metabolism
3. Toxicity

Answer 10

1. Inhibition of viral DNA polymerase (DNA synthesis)
2. Converted to acyclovir by 1st pass metab
3. Same as acyclovir (Neurotox (confusion, seizures); Dose adjust in renal impairment) PLUS thrombocytopenia

Question 11

Oseltamavir

1. MOA
2. Metabolism
3. Toxicity

Answer 11

1. inhibition of release of influenza virus from infected cell
2. Hepatically activated into carboxylate form; Renal elim.
3. Minimal; potential fatal neurophyc. adverse effects in flu pts; serious skin rxn rarely

Question 12

Zanamivir

1. MOA
2. Metabolism
3. Toxicity

Answer 12

1. inhibition of release of influenza virus from infected cell
2. Renal elimination, unchanged
3. Contraindicated w/ pulmonary disease (fatal bronchospasm)

Question 13

Ribavirin

1. MOA
2. Metabolism
3. Toxicity

Answer 13

1. Inhibition of viral nucleic acid synthesis
2. non-CYP metab in nucleated cells with renal elim
3. BBW: Hemolytic anemia and M/F teratogenicity

Question 14

Tx for influenza B virus

Answer 14

1. Oseltamivir (PO)

2. Zanamivir (Inhalation)