Usmle - Pharmacology - Antivirals

Front 1

Amantidine

Back 1

Blocks viral membrane protein M2 (H+ ion channel); prevents viral endocytosis and uncoating

Hint 1

Effective against influenza A only

Front 2

Oseltamivir

Back 2

Sialic acid analog that inhibits neuraminidase

Hint 2

Effective against both influenza A and influenza B

Front 3

Ribavirin

Back 3

Guanosine analog; prevents viral mRNA capping and inhibits RNA-dependent RNA-polymerases

Hint 3

Indicated for children with RSV; Hepatitis C, concurrent with IFN-α treatment

Front 4

Rimantadine

Back 4

Blocks viral membrane protein M2 (H+ ion channel); prevents viral endocytosis and uncoating

Hint 4

Effective against influenza A only

Front 5

Zanamivir

Back 5

Sialic acid analog that inhibits neuraminidase

Hint 5

Effective against both influenza A and influenza B

Front 6

Entecavir

Back 6

Guanosine analog; inhibits HBV DNA polymerase

Hint 6

Lamivudine-resistant HBV

Front 7

Interferon

Back 7

Induction of host cell enzymes that inhibit viral RNA translation

Hint 7

IFNα: Chronic hepatitis B and C, CML, HHV-8; IFNβ: relapsing-remitting MS; IFNγ: chronic granulomatous disease

Front 8

Lamivudine

Back 8

Cytosine analog
Inhibits DNA polymerase in HepB and reverse transcriptase in HIV
Must be phosphorylated by intracellular enzymes

Hint 8

Hepatitis B; HIV

Front 9

Telbivudine

Back 9

Thymidine analog
Either directly inhibits viral DNA polymerase or is incorporated into growing DNA, terminating elongation

Hint 9

HBV

Front 10

Acyclovir

Back 10

Guanosine analog
Intravenous administration
Monophosphorylated inside cell by viral-encoded thymidine kinase
Di- and tri-phosphorylation via host cell enzymes
Incorporated into viral DNA, leading to chain termination
Can also bind directly to thymidine kinase and irreversibly inhibit enzyme

Hint 10

HSV infections, given prophylactically in immunocompromised or pre-transplant patients; also EBV, VZV

Front 11

Cidofovir

Back 11

Cytosine nucleotide analog

Hint 11

CMV-induced retinits in AIDS patients

Front 12

Famciclovir

Back 12

Acyclic guanosine analog
Similar mechanism as ganciclovir
Prodrug that is converted to penciclovir

Hint 12

PO treatment of herpes zoster

Front 13

Fomivirsen

Back 13

Antisense oligonucleotide directed against CMV mRNA

Hint 13

Refractory CMV retinitis

Front 14

Foscarnet

Back 14

Phosphonoformate (pyrophosphate derivative)
Reversibly inhibits viral RNA and DNA polymerases

Hint 14

HSV, VZV, CMV that doesn't respond to other treatments

Front 15

Ganciclovir

Back 15

Administered IV
Acyclovir analog with relatively specific activity against CMV in a thymidine kinase-independent manner
Incorporated into growing DNA strand, inhibiting elongation

Hint 15

CMV infection, retiniits

Front 16

Penciclovir

Back 16

Topical administration
Acyclic guanosine analog with similar mechanism as acyclivor

Hint 16

Topical treatment of HSV-1, HSV-2, VZV

Front 17

Valacyclovir

Back 17

Guanosine analog
Oral administration
Monophosphorylated inside cell by viral-encoded thymidine kinase
Di- and tri-phosphorylation via host cell enzymes
Incorporated into viral DNA, leading to chain termination
Can also bind directly to thymidine kinase and irreversibly inhibit enzyme

Hint 17

HSV infections, given prophylactically in immunocompromised or pre-transplant patients; also EBV, VZV

Front 18

Valganciclovir

Back 18

Administered PO
Acyclovir analog with relatively specific activity against CMV in a thymidine kinase-independent manner
Incorporated into growing DNA strand, inhibiting elongation

Hint 18

CMV infection, retiniits

Front 19

Vidarabine

Back 19

Adenosine analog, converted to ara-ATP analog, which inhibits viral DNA synthesis

Hint 19

Immunocompromised patients with herpetic and vaccinial keratitis & HSV keratoconjunctivitis

Front 20

Adefovir

Back 20

Nucleotide analog that is incorporated into viral DNA and subsequent termination

Front 21

Abacavir

Back 21

NRTI

Front 22

Didanosine

Back 22

NRTI

Front 23

Emtricitabine

Back 23

NRTI

Front 24

Lamivudine

Back 24

NRTI

Front 25

Stavudine

Back 25

NRTI

Front 26

Tenofovir

Back 26

NRTI

Front 27

Zidovudine

Back 27

NRTI

Front 28

Delavirdine

Back 28

NNRTI

Front 29

Efavirenz

Back 29

NNRTI

Front 30

Nevirapine

Back 30

NNRTI

Front 31

Etravirine

Back 31

NNRTI

Front 32

Atazanavir

Back 32

HIV Protease Inhibitor

Front 33

Darunavir

Back 33

HIV Protease Inhibitor

Front 34

Fosamprenovir

Back 34

HIV Protease Inhibitor

Front 35

Indinavir

Back 35

HIV Protease Inhibitor

Front 36

Lopinavir

Back 36

HIV Protease Inhibitor

Front 37

Nelfinavir

Back 37

HIV Protease Inhibitor

Front 38

Ritonavir

Back 38

HIV Protease Inhibitor

Front 39

Saquinavir

Back 39

HIV Protease Inhibitor

Front 40

Tipranavir

Back 40

HIV Protease Inhibitor

Front 41

Darunavir

Back 41

Blocks gp41; inhibits viral entry

Front 42

Enfuvirtide

Back 42

Blocks gp41; inhibits viral entry

Front 43

Maraviroc

Back 43

Blocks gp41; inhibits viral entry

Front 44

Raltegravir

Back 44

HIV Integrase inhibitor