Pharm Test 3: Viruses & Antiviral Drugs

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Pharm Test 3: Viruses & Antiviral Drugs
2012-12-06 17:54:49
Viruses Antiviral Drugs

Viruses & Antiviral Drugs
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  1. 4 Drugs that block viral entry and attachment
    Enfuvirtide (HIV), Maraviroc (HIV), Docosanol (HSV), Palivizumab (RSV)
  2. Herpesviruses (HSV, VZV, CMV) have what type of genetic material?
  3. Retroviruses (HIV) have what type of genetic material?
  4. Orthomyxoviruses (Influenza A, B) have what type of genetic material?
  5. Hepadnaviruses (HBV, HCV) have what type of genetic material?
    HBV, HCV (Hep B & C)
  6. Includes watery blisters in the skin or mucous membranes of the mouth, lips, or genitals
    HSV-1 and HSV-2
  7. Acyclovir is most effective against
    HSV (Herpes Simplex Virus)
  8. Why is CMV resistant to Acyclovir?
    It lacks a thymidine kinase or is the virally encoded thymidine phosphate is unable to phosphorylate acyclovir.
  9. Name 3 prodrugs
    Valacyclovir, Penciclovir, Famciclovir
  10. Acylovir molecules entering the cell are converted to?  By?
    • Acyclovir monophosphate
    • By virus-induced thymidine kinase

    (Host cell enzymes add 2 more phosphates.  Acyclovir triphosphate is them transported to the nucleus)
  11. Acyclovir monophosphate takes the place of _______ in the viral DNA.  It stops chain elongation because it lacks _____
    • 2'-deoxyguanosine monophosphate
    • 3'-OH group
  12. Major adverse drug rxn of Acyclovir
    • Reversible renal toxicity
    • Neurologic effects (tremors, delirium, seizures)
  13. Acyclovir resistant mutants are sensitive to _____ because they do not require viral ______ for activation.
    • Foscarnet
    • Thymidine kinase
  14. Ganciclovir is much more effective against ____ than acyclovir
  15. Adverse drug rxn w/ Ganciclovir
    • CNS toxicity (can cause myelosuppression)
    • Hepatotoxicity
  16. What drug can cause myelosuppression (particularly after IV adminstration)
  17. Myelosuppression of Ganciclovir (CMV) may be additive in patients receiving concurrent ?
    • Ziovudine
    • Azathioprine
    • Mycophenolate mofetil
  18. Primary drugs for Influenza A?  How do they work?
    • Amantadine
    • Rimantadine

    Prevent RNA uncoating and thus release of genetic material
  19. Which two drugs are used to treat Influenza A & B?
    • Zanamivir
    • Oseltamavir
  20. Which drug inhibits RNA polymerase of the influenza virus?
  21. Analogs of sialic acid
    Oseltamivir, Zanamivir
  22. Tricyclic amines of adamantane
    • Amantadine
    • Rimantadine
  23. GI and CNS are more likely to occur in? (Rimantadine or Amantadine)
  24. Which drug is not recommended for patients with underlying airway disease?
  25. Resistance to oseltamivir may be associated w/ point mutations in the viral ____ or ____ genes.
    Hemagglutinin, neuraminidase
  26. Viral point mutations in hemagglutinin or neuramindiase and provide resistance to
  27. In contrast, to the tx of patients w/ chonric HBV infection, the primary goal of tx in patients with HCV infection is _____
  28. Goal of HBV therapy
    Sustain suppression (prevent complications, slow progression of hepatic disease, reduce the need for liver transplantation)
  29. Major mechanism of action of IFN-a
    Inhibition of translation
  30. What is the most powerful tx against HBV and C?
    IFN-a (antiviral properties)
  31. What drug should not be administered w/ didanosine?  Why?
    IFN-a, because of risk of hepatic failure
  32. IFN-a potential drug-drug interactions
    Theophylline and methadone levels may be increased
  33. Two drugs used in combination with IFN-a
    • Lamivudine (HBV)- also used to treat HIV
    • Ribavirin (HCV)
  34. Lamivudine w/ coinfection w/ HIV increase the risk of
  35. Name 2 Entry Inhibitors
    • Enfuvirtide (T-20)
    • Maraviroc
  36. Binds specifically and slectively to host protein CCR5.  Treats HIV-1 infection in those who are experiencing virological failure due to resistance to other antiretroviral
  37. Maraviroc binds to ___ and treats____
    CCR5, HIV-1 infxn that exhivits resistance to other antiretrovirals
  38. Resitance to what drug is associated w/ one or more mutations in the V3 loop of gp120?
  39. Maraviroc is contraindicated in pts. w/ ?
    • Severe or end-stage renal impairment who are taking concurrent CYP3A inhibitors or inducers
    • Pts. w/ increased cardiovascular risk (has been known to cause myocardial ischemia/infarction)
  40. 1st drug to be approved, well absorbed and distributed to most tissues (including CSF)
    Zidovine (Nucleoside and Nucleotide Reverse Transcriptase Inhibitor)
  41. Nucleoside and Nucleotide Reverse Transcriptase Inhibitor
  42. Non-Nucleoside and Nucleotide Reverse Transcriptase Inhibitors
    Delavirdine, Etravirine, and Nevirapine
  43. Delavirdine, Etravirine and Nevirapine treat?  How?
    Treat HiV-1 by binding directly to HIV-1 reverse transcriptase and result in allosteric inhibition of RNA- and DNA- dependent DNA polymerase activity
  44. Drug that binds directely to HIV-1 reverse transcriptase and is contraindicated in pregnancy
  45. Drug that binds directely to HIV-1 reverse transcriptase and can also cause an elevation in serum cholesterol, tiglyceride, and glucose?

    Which drug has a minimal effect on serum lipids?

  46. Which Non-Nucleoside and Nucleotide Reverse Transcriptase Inhibitors are extensively metabolized by the CYP3A and CYP2D6 enzymes.  It also inhibits CYP3A4 and 2C9
  47. Which Non-Nucleoside and Nucleotide Reverse Transcriptase Inhibitors is a substrate as well as an inducer of CYP3A4 and an inhibitor of CYP2C9 and CYP2C19?
  48. Results in decreased levels of methadone and indinavir
  49. Inhibits viral integrase enzyme that is essential for replication of HIV-1, -2
  50. In combination w/ rifampin, a strong inducer of ____________, the dose of ________ should be increased from 400 to 800 mg twice daily.
    • UDP-glucuronosyl transferase 1A1 (UGT1A1)
    • Raltegravir
  51. Protease inhibitor