USMLE Pharmacology Antivirals
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- Drug of choice for cytomegalic retinitis in immunocompromised patients?
- Ganciclovir
- Why is CMV resistant to Acyclovir?
- CMV is deficient in thymidine kinase, therefore forms triphosphate by another route
- Describe the action of thymidine kinase (viral) on acyclovir?
- It phosphorylates acyclovir to monophosphorylated) thus allowing further phosphorylations by host enzymes
- How does acyclovir inactivate viral DNA polymerase?
- by being incorporated into the growing viral DNA chain it terminates elongation and binds irreversibly to viral DNA polymerase thus leading to inactivation.
- The drug of choice for herpes infected cells that divide is?
- acyclovir
- Drug similar to ganciclovir but used to treat herpes zoster infections?
- famciclovir-a prodrug that must be metabolized to penciclovir.
- This drug is used to treat ganciclovir resistant CMV in patient with HIV?
- Foscarnet (not a purine or pyrimidine analog. It inhibits viral DNA and RNA polymerases.
- This drug is a pyrophosphate analog that binds to the pyrophosphate binding site of viral RNA and DNA polymerase leading to inactivation
- Foscarnet
- Inhibits influenza neuraminidase
- Zanamivir and Oseltamivir
- Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
- Ribavirin
- Drug of choice for RSV and chronic hepatitis?
- Ribavirin
- Blocks viral penetration/uncoating
- Amantadine
- This antiviral causes release of dopamine thus having an addition benefit?
- Amantadine
- This antiviral causes ataxia, dizziness, and slurred speech? What is an alternative?
- Amantadine thus use Rimantidine which has less CNS complications
- This antiviral inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase
- Acyclovir