Term
| For the following anti-viral, name its drug class, viruses for which it is indicated, and what it has its activity on: acyclovir? |
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Definition
| Nucleoside analogue. Indicated for HSV, and VZV, active against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, viruses for which it is indicated, and what its activity is against: valacyclovir? |
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Definition
| Nucleoside analogue. Indicated for HSV, and VZV. Active against polymerase 13-2 |
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Term
| For the following anti-viral, name its drug class,, viruses for which it is indicated, and what its activity is against: famciclovir? |
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Definition
| Nucleoside analogue. Indicated for HSV, and VZV. Active against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against : penciclovir? |
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Definition
| Nucleoside analogue. Indicated for HSV. Activity against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: trifluorothymidine? |
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Definition
| Nucleoside analogue. Indicated for HSV. Activity against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: gancyclovir? |
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Definition
| Nucleoside analogue. Indicated for CMV. Activity against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: valganciclovir? |
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Definition
| Nucleoside analogue. Indicated for CMV. Activity against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: cidofovir? |
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Definition
| Nucleoside analogue. Indicated for resistant CMV. Activity against polymerase. 13-2 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: foscarnet? |
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Definition
| Polymerase inhibitor. Indicated for nucleoside analogue resistant HSV and CMV. Activity against polymerase. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: fomivirsen? |
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Definition
| Anti-sense mRNA. Indicated for CMV-retinitis. Activity against translation. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: amantidine? |
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Definition
| Ion channel blocker (HA). Indicated for Influenza A. Activity against uncoating. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against:rimantidine? |
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Definition
| Ion channel blocker (HA). Indicated for Influenza A. Activity against uncoating. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: oseltamivir? |
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Definition
| Sialic acid analogue (NA). Indicated for Influenza A and B. Activity against virus release. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: zanamivir? |
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Definition
| Sialic acid homologue (NA). Indicated for Influenza A and B. Activity against virus release. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: peramivir? |
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Definition
| Sialic acid homologue (NA). Indicated for Influenza A and B. Activity against virus release. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: ribavirin? |
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Definition
| Nucleotide analogue. Indicated for RSV, HCV, and Lassa. Inhibits viral mRNA. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: palivizumab? |
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Definition
| Monoclonal antibody. Indicated for RSV. Activity against virus entry. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: interferon alpha? |
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Definition
| Immunomodulator. Indicated for HCV, HBC, and HPV. Activity is against host factors. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: imiquimod? |
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Definition
| Cytokine inducer. Indicated for HPV. Activity is against host factors. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: lamivudine? |
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Definition
| Nucleoside analogue. Indicated for HBV, and HIV. Activity against polymerase. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: adefovir? |
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Definition
| Nucleoside analogue. Indicated for HBV. Activity against polymerase. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against:entacavir? |
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Definition
| Nucleoside analogue. indicated for HBV. Activity against polymerase. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: telbivudine? |
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Definition
| Nucleoside analogue. Indicated for HBV. Activity against polymerase. 13-3 |
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Term
| For the following anti-viral, name its drug class, and viruses for which it is indicated and what its activity is against: pleconaril? |
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Definition
| Class??? Indicated for enterovirus. Activity?????. 13-3 |
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Term
| Name eight organisms for which the vaccines are attenuated virus and may not be safe for immunocompromised patients. |
|
Definition
Measles, mumps, rubella, yellow fever, smallpox, polio (OPV), influenza (flumist).
Note IM influenza and IPV polio are dead virus.
13-4 |
|
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Term
| Name eight organisms for which the vaccines are inactivated (dead) viruses. |
|
Definition
HAV, HBV, (HEV coming soon), Influenza (not mist), HPV, Polio (IPV), Rabies, and rotavirus.
13-3 |
|
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Term
| Name 6 viruses for which passive immunization is available. |
|
Definition
HAV, HBV, VZV, Rabies, CMV, and RSV.
13-5 |
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Term
| Name the 4 anti-viral actions of cytokine (interferon) and cytokine inducer (imiquimod). |
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Definition
Induce viral mRNA degradation
Inhibit viral protein synthesis
Enhance CTL activity
Enhance NK cell activity
13-5 |
|
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Term
| Name the four principles of antiviral drugs and their use. |
|
Definition
They should target virus specific proteins, and not host.
They only act on actively replicating viruses
They must be used very early in infection to be effective
Drug resistance develops rapidly
13-5 |
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Term
| What is the target for the nucleoside analogue class of anti-virals? |
|
Definition
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|
Term
| For the anti-viral drugs ending in "-clovir", what must happen in the cell for them to be active? |
|
Definition
| They must gain an initial phosphate from the viral enzyme thymidine kinase, and two additional phosphates from host enzymes. 13-6 |
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Term
| What are two mechanisms of resistance that happen against the anti-virals acyclovir and penciclovir? |
|
Definition
| Reduced or absent viral thymidine kinase Decreased viral polymerase affinity for ACV-TP/PCV-TP. 13-7 |
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Term
| What drug should be used in viruses with induced acyclovir resistance (who would otherwise be susceptible)? |
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Definition
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|
Term
| T/F. Genital herpes is transmissible if the affected patient is undergoing viral suppressive therapy. |
|
Definition
True. Suppressive therapy only reduces sexual transmission by 50%.
13-7 |
|
|
Term
| Which virus requires the higher dose of acyclovier: HSV, or VZV? |
|
Definition
VZV requires the larger dose.
13-7 |
|
|
Term
| T/F. Acyclovir therapy is indicated to reduce the symptoms of VZV causes shingles. |
|
Definition
False. No anti-viral therapy is indicated for shingles.
13-7 |
|
|
Term
| What is the window to treat chicken pox with anti-virals and which should you use? |
|
Definition
<3 days in adults. Use acyclovir/valacyclovir.
13-7 |
|
|
Term
| What is different between acyclovir and valacyclovir? |
|
Definition
Bioavailibility. Valacyclovir is 3 to 5 times greater, but it is also more expensive.
13-8 |
|
|
Term
| What viral enzyme is ganciclovir phosphorylated by? |
|
Definition
|
|
Term
| What is the unique toxicity of ganciclovir (compared to other similar anti-viral nucleoside analogues)? |
|
Definition
Bone marrow suppression.
The other anti-virals may cause nephrotoxicity, but not bone marrow suppression.
13-8 |
|
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Term
| What is the main drawback to fascarnet anti-viral therapy? When is it indicated? |
|
Definition
It is directly toxic to renal tubules.
Causes renal insufficiency.
Used in viruses resistant to acyclovir and ganciclovir.
13-8 |
|
|
Term
| Name the 2 ion channel blockers. |
|
Definition
Amantidine and rimantadine.
13-8 |
|
|
Term
| Name the 3 sialic acid analogues. |
|
Definition
Zanamivir, Oseltamivir, and Peramivir.
13-9 |
|
|
Term
| Which of the following acquisitions of HBV infection is more likely to produce a chronic carrier state: perinatal transmission from mother to newborn, or adult acquisition via sex or body fluid? |
|
Definition
Perinatal transmission causes chronic active hepatitis in majority of cases (80%). Adult infection is mainly self limited (80%)
13-10 |
|
|
Term
| What treatment is indicated in HCV infection? |
|
Definition
Pegylated interferon and ribavirin for 6-12 months.
13-10 |
|
|
Term
| What is the mechanism of action of ribavirin? |
|
Definition
It decreases the nucleotide pool and inhibits viral mRNA. It is active against many RNA viruses, and available as PO, IV and inhaled.
13-11 |
|
|
Term
| Name the 5 nucleotide analogues that are used for chronic HCV infection. |
|
Definition
| Lamivudine Adefovir Entecavir Telbivudine Tenofovir 13-12 |
|
|
Term
| What is the name of the monoclonal antibody specific for RSV? |
|
Definition
|
|
Term
|
Definition
It is a monoclonal antibody specific for RSV and available only IV. It is used prophylactically for infants at risk (immunocompromised).
13-13 |
|
|
Term
| Name the two second line nucleoside analogue antiviral drugs. |
|
Definition
|
|
Term
| Ribavirin is used for HCV infections, but not HBV. What is a likely reason for this? |
|
Definition
Ribavirin is active against RNA viruses (HCV) by inhibiting viral mRNA.
HBV is a DNA virus so would not be susceptible.
13-11 |
|
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Term
| If a an antiviral ends in -ivir, what is its indication, drug class, and activity? |
|
Definition
indication: Influenza A and B
Drug class: Sialic acid analogue
Activity on: Virus release |
|
|
Term
| What is the only antiviral with activity on polymerase that is NOT of the drug class nuceloside inhibitor? |
|
Definition
| Foscarnet (drug class: polymerase inhibitor) |
|
|
Term
| If an antiviral ends in -ovir, what drug class is it and what is its activity on? |
|
Definition
| It's a nuceloside analogue w/ activity against polymerase. |
|
|
Term
| Which are the antiviral drug class: nuceloside analogues that don't end in -ovir? What is their activity against? |
|
Definition
Trifluorothymidine
Lamivudine
Entecavir
Telbivudine
Activity against polymerase (just like all nucleoside analogues) |
|
|
Term
| What causes Kaposi sarcoma? |
|
Definition
| Human Herpes Virus 8 (HHV-8) or KSHV |
|
|
Term
|
Definition
| Fever blisters, genital herpes, encephalitis |
|
|
Term
|
Definition
| Retinitis, colitis, pneumonia |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
RSV is respiratory synctial virus
bronchitis, pneumonia |
|
|
Term
| Manifestations of Enterovirus? |
|
Definition
|
|
Term
| What is unique about antiviral Ribavirin? |
|
Definition
| Only one that's indicated for Lassa virus (also indicated for HCV and RSV). Only one that's a nucleotide analogue for its drug class. Only one that acts as an inhibitor of viral mRNA |
|
|
Term
| Which 3 viruses were described as "immediately lethal?" |
|
Definition
| Ebola, Hanta, Yellow Fever |
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