Podcast
Questions and Answers
Which nucleoside analog therapy has the highest risk of nephrotoxicity?
Which nucleoside analog therapy has the highest risk of nephrotoxicity?
Which nucleoside analog therapy requires renal dosage adjustments?
Which nucleoside analog therapy requires renal dosage adjustments?
Which nucleoside analog therapy has the highest risk of lactic acidosis?
Which nucleoside analog therapy has the highest risk of lactic acidosis?
Which of the following drugs is a CYP3A4 substrate?
Which of the following drugs is a CYP3A4 substrate?
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Which of the following drugs is a NS5A Replication Complex Inhibitor?
Which of the following drugs is a NS5A Replication Complex Inhibitor?
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Which of the following drugs is NOT recommended for use in patients with CrCl < 30?
Which of the following drugs is NOT recommended for use in patients with CrCl < 30?
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Which of the following drugs inhibits BCRP and PGP transporters?
Which of the following drugs inhibits BCRP and PGP transporters?
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Which of the following is NOT a risk factor for severe respiratory syncytial virus (RSV) infection?
Which of the following is NOT a risk factor for severe respiratory syncytial virus (RSV) infection?
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Which of the following is the MOA of palivizumab?
Which of the following is the MOA of palivizumab?
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Which of the following is NOT a potential adverse effect of ribavirin?
Which of the following is NOT a potential adverse effect of ribavirin?
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Which of the following is the correct statement about herpes simplex virus (HSV) encephalitis?
Which of the following is the correct statement about herpes simplex virus (HSV) encephalitis?
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Which drug is a prodrug of tenofovir used for the treatment of hepatitis B?
Which drug is a prodrug of tenofovir used for the treatment of hepatitis B?
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Which drug can overcome lamivudine resistance in the treatment of hepatitis B?
Which drug can overcome lamivudine resistance in the treatment of hepatitis B?
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Which drug is a once-daily oral drug with no renal dose adjustment and is a substrate and inhibitor of PgP and OATP1B1/1B3?
Which drug is a once-daily oral drug with no renal dose adjustment and is a substrate and inhibitor of PgP and OATP1B1/1B3?
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Which therapy is used in combination with ribavirin for the treatment of hepatitis C?
Which therapy is used in combination with ribavirin for the treatment of hepatitis C?
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Which drug is effective against HSV, HHV-6, VZV, EBV, and CMV?
Which drug is effective against HSV, HHV-6, VZV, EBV, and CMV?
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Which drug is a nucleotide analogue of cytosine and effective against resistant forms of HSV, CMV, HHV6, BKV, Adenovirus, Ebola, and anthrax?
Which drug is a nucleotide analogue of cytosine and effective against resistant forms of HSV, CMV, HHV6, BKV, Adenovirus, Ebola, and anthrax?
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Which virus is the most common viral infection in infants born in the US?
Which virus is the most common viral infection in infants born in the US?
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Which drug is 10 times more active against CMV than acyclovir?
Which drug is 10 times more active against CMV than acyclovir?
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Study Notes
Antiviral Drugs for CMV, Adenovirus, BK Virus, Hepatitis A and B
- Foscarnet is a non-nucleoside pyrophosphate analog that inhibits viral DNA polymerase and reverse transcriptase. It is effective against HSV, HHV-6, VZV, EBV, and CMV.
- Cidofovir is a nucleotide analogue of cytosine that inhibits viral DNA synthesis. It is effective against resistant forms of HSV, CMV, HHV6, BKV, Adenovirus, Ebola, and anthrax.
- Cytomegalovirus (CMV) is the most common viral infection in infants born in the US. It can cause permanent disabilities and is often transmitted from pregnant women to their infants.
- Ganicyclovir is a guanosine analogue that is 10 times more active against CMV than acyclovir. It is used for prophylaxis and treatment of CMV in organ transplant patients.
- Letermovir inhibits CMV DNA terminase and is effective only against CMV. It has high bioavailability and can be given orally or intravenously.
- Maribavir inhibits UL97 kinase and has a multimodal effect on CMV DNA replication. It is available only orally and is metabolized by CYP3A4.
- CMV drug resistance can occur due to mutations in UL97 or UL54 genes. Active drugs against resistant CMV strains include cidofovir, foscarnet, letermovir, and maribavir.
- Adenovirus infections are often seen in solid organ transplant and hematopoietic stem cell transplant patients. Cidofovir is the drug of choice for treatment, administered with probenecid to decrease nephrotoxicity.
- BK virus can cause hemorrhagic cystitis/nephropathy in immunocompromised patients. Treatment involves reducing immunosuppression and using intravenous cidofovir or intravesicular cidofovir.
- Hepatitis A is an RNA virus transmitted fecally, orally, or sexually. It causes mild jaundice and self-resolves without treatment. Prevention is possible with the HepA vaccine.
- Hepatitis B is a chronic infection that can lead to liver damage. Antiviral treatment options include tenofovir, entecavir, and lamivudine, with varying efficacy, resistance barriers, and safety profiles.
- Tenofovir has potent activity against HBV but may cause renal and bone complications. Entecavir is highly effective but has a high cost. Lamivudine has a lower resistance barrier but is relatively safe.
- Interferon-alpha has an unacceptable safety profile for long-term treatment of HBV.
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Description
Test your knowledge on antiviral drugs for CMV, adenovirus, BK virus, hepatitis A, and hepatitis B. Learn about the different drugs used to treat these viral infections and their mechanisms of action.
