First-Aid For Step 1 - Anti-Virals

Front 1

What is the mechanism of action of amantadine? (2)

Back 1

1) Blocks viral penetration and uncoating (M2 protein)
2) Causes release of dopamine from intact nerve terminals

Front 2

Current (1) and former (1) use for amantadine

Back 2

Current: Parkinson's
Former: Influenza A

Front 3

Toxicity of Amantidine (4)

Back 3

Ataxia, dizziness, slurred speech, anti-cholinergic

Front 4

Mechanism of viral resistance to amantadine

Back 4

Mutated M2 protein

Front 5

Mechanism of zanamavir, oseltamavir

Back 5

- inhibit influenza neuraminidase, decreasing release of progeny virus

Front 6

Zanamavir & Oseltamavir are used for?

Back 6

Influenza A & B

Front 7

Mechanism of Ribavarin?

Back 7

Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase

Front 8

Clinical use of Ribavarin (2)

Back 8

1) RSV in ADULTS ONLY
2) Chronic hepatitis C

Front 9

Toxicity of Ribavarin (2)

Back 9

1) Hemolytic anemia
2) Severe teratogen

Front 10

Mechanism of action of acyclovir/valacyclovir/famcyclovir

Back 10

Monophosphorylated by HSV/VZV thymidine kinase, guanosine analog- chain termination

Front 11

Clinical use for Acyclovir/Valacyclovir/Famcyclovir

Back 11

HSV, VZV, EBV. Notice that CMV is NOT included.

Front 12

Ganciclovir- MOA?

Back 12

Guanosine analog (like Acyclovir); can be phosphorylated by HSV/VZV OR CMV; inhibits viral DNA polymerase

Front 13

Ganciclovir- uses? (1)

Back 13

CMV, especially in immunocompromised patients

Front 14

Ganciclovir toxicity (2)

Back 14

Pancytopenia (leuko, neutro, thrombo)
Renal toxicity

Front 15

Foscarnet- MOA?

Back 15

Viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme- does NOT require viral kinase to phosphorylate anything

Front 16

Use for Foscarnet? (2)

Back 16

In CMV when Ganciclovir fails (immunocompromised patient)
In acyclovir-resistant HSV

Front 17

Toxicity of Foscarnet?

Back 17

Nephrotoxic