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Who is the author of the book 'Antiviral Agents'? Elizabeth R. Reyes-Telado, MD.
What is virus replication? The process by which a virus makes copies of itself within a host cell.
What are some commonly used antiviral drugs? Acyclovir, Valacyclovir, Ganciclovir, and HIV protease inhibitors.
Which viruses are commonly targeted by antiviral drugs? Herpes, VZV, CMV, and HIV.
What is the classification of COVID-19? COVID-19 is caused by the virus SARS-CoV-2, which is a member of the coronavirus
family.
What is the mechanism of action of antiviral drugs? Antiviral drugs target specific stages of the virus replication cycle, such as viral entry,
replication, or release.
What are pharmacokinetic properties of antiviral drugs? Pharmacokinetic properties include absorption, distribution, metabolism, and excretion of
the drug within the body.
What are the components of an enveloped virus? Lipoproteins, core proteins (capsid), RNA or DNA core, surface proteins.
What is the function of lipoproteins in an enveloped They form the envelope of the virus.
virus?
What is contained in the core of an enveloped virus? RNA or DNA core and core proteins (capsid).
What are the surface proteins of an enveloped virus They are responsible for interacting with host cells.
responsible for?
What is the first step in the viral life cycle? Receptor binding.
What is the process of viral RNA being converted into Reverse transcription.
DNA?
What is the term for the integration of viral DNA into the Integration.
host cell's genome?
What is the final step in the viral life cycle before the Maturation.
release of new viral particles?
What is the term for the process of assembling new viral Assembly.
particles within the host cell?
What is the term for the process of viral RNA being Translation.
translated into viral proteins?
What is the term for the stage where the viral DNA is Provirus.
integrated but not actively producing new viral particles?
What are some examples of herpesviruses? Herpes simplex type 1, Varicella zoster virus, Human herpesvirus 6.
Which viruses are associated with respiratory infections? Respiratory syncytial virus, Influenza virus, Parainfluenza virus.
What are some sexually transmitted viruses? Herpes simplex virus, Human papillomavirus, HIV, Cytomegalovirus.
Which viruses are associated with gastrointestinal Adenovirus, Rotavirus, Norovirus, Astrovirus, Coronavirus.
infections?
What are the common inhibitory actions of antiviral drugs Targeting nucleic acid polymerases, proteases, integrases, and neuraminidases.
targeting viral function?
Which viral functions do antiviral drugs targeting nucleic DNA-dependent and RNA-dependent functions.
acid polymerases affect?
What are the cellular functions that antiviral drugs DNA-dependent RNA polymerase.
targeting virus needs affect?
What is the function of maraviroc in HIV treatment? Blocking viral attachment and entry.
Which antiviral drugs block viral protein synthesis in Amantadine and rimantadine.
influenza?
Which antiviral drugs block nucleic acid synthesis in HSV Nucleoside/nucleotide analogs.
and HBV?
What are the three classifications of antiviral therapy I. Anti-herpesvirus agents, II. Antiretroviral agents, III. Other antiviral agents.
based on the spectrum of activity?
What are some commonly used antiviral drugs for Acyclovir, Valacyclovir, Famciclovir, Penciclovir, Anciclovir, Cidofovir, Foscarnet,
herpesviruses? Trifluridine, Idoxuridine, Vidarabine.
What is the mechanism of action of Acyclovir? Acyclovir structurally resembles the nucleoside deoxyguanosine and is converted by
virus-infected cells into a fake nucleotide, which is then incorporated into DNA by DNA
polymerase.
How does Acyclovir affect cells infected by a virus? Acyclovir, resembling the nucleoside deoxyguanosine, is converted into a fake nucleotide
by virus-infected cells, which is then incorporated into DNA by DNA polymerase.
What effect does Acyclovir have on cells not infected by Acyclovir has no effect on cells not infected by a virus.
a virus?
What is the role of DNA polymerase in the mechanism of DNA polymerase incorporates the fake nucleotide created by Acyclovir into DNA.
action of Acyclovir?
In which body tissues does Acyclovir distribute, including All body tissues, including CNS.
CNS?
What are the common side effects of Ganciclovir? Nausea, vomiting, diarrhea, nephrotoxicity, crystalluria, haematuria, renal insufficiency,
myelosuppression (neutropenia and thrombocytopenia).
What is the recommended oral dosage of Acyclovir for 20mg/kg/dose, 4 times a day for 5 days.
children with chicken pox?
What is the recommended oral dosage of Acyclovir for 800 mg/dose, 5 times a day for 7 days.
adults with chicken pox?
What effects can be observed if treatment with Acyclovir Reduction in duration of fever, new lesion formation, and time of crusting for 2 days in
is begun within 24 hours? adults, and reduction in the number of lesions by 50%.
What are some anti-herpes agents? Famciclovir, Valacyclovir, Foscarnet, Ganciclovir, Docosanol, Penciclovir, Trifluridine.
For which conditions are these anti-herpes agents used? Genital herpes (first/recurrent), Orolabial herpes (first/recurrent), Herpes zoster.
When is Acyclovir-resistant HSV and VZV infection Keratitis, Recurrent herpes labialis, Herpes genitalis.
treated with these agents?
What is the dosing frequency for Famciclovir? Every 3 hours while awake.
What is the dosing frequency for Valacyclovir? Every 2 hours while awake.
What are the two antiviral drugs mentioned in the text? Acyclovir and Penciclovir.
What is the mechanism of action of Acyclovir and They are phosphorylated by cellular kinases to their active triphosphate form, which
Penciclovir in the body? inhibits HSV DNA polymerase.
What is the resistance mechanism for HSV against Absent/reduced thymidine kinase (HSV) or altered viral DNA polymerase.
Acyclovir?
What is the resistance mechanism for VZV against Altered thymidine kinase.
Acyclovir?
What is the resistance mechanism for HSV and VZV Altered viral DNA polymerase.
against Penciclovir?
How is Vidarabine converted to inhibit viral DNA It is converted to its triphosphate analog.
polymerase?
For what condition is the use of Vidarabine limited to? HSV keratitis only.
Question Answer
For what condition is the use of Trifluridine limited to? Ocular HSV Keratitis.
For what condition is Cidofovir approved for treatment? CMV retinitis in immunocompromised patients.
How does Cidofovir act on viral DNA synthesis? It inhibits viral DNA synthesis.
In what forms is Cidofovir available for administration? IV, Intravitreal injection, topical.
How does Foscarnet inhibit viral DNA and RNA It directly inhibits them.
polymerase?
Which viruses does Foscarnet target? HSV-1, HSV-2, VZV, CMV, and HIV.
Where does Foscarnet distribute in the body? To all tissues including CNS.
What are the common effects of chelation of the drug Hypocalcemia and hypomagnesemia.
with divalent cations?
What are the neurotoxic effects associated with the Headache, hallucinations, seizures.
drug?
What nephrotoxic effects can the drug cause? Acute tubular nephrosis, interstitial nephritis.
What are NRTIs, NNRTIs, PI, Fusion Inhibitors, CCR5, They are all types of antiretroviral agents.
and INSTIs?
What do NRTIs, NNRTIs, PI, Fusion Inhibitors, CCR5, They inhibit the replication of retroviruses.
and INSTIs inhibit?
What is the mechanism of action of reverse transcriptase They block the activity of the enzyme reverse transcriptase, preventing the production of
inhibitors (RTIs)? new viral DNA.
What are the types of reverse transcriptase inhibitors NUcleoslde RTIs (NRTIs), Nonnucleoside RTIs (NNRTIs), NUcleotide RTis (NTRTIs).
(RTIs)?
Can you provide examples of reverse transcriptase Abacavir (Ziagen), Delavirdine (Rescriptor), Didanosine (Videx), Lamivudine (Epivir),
inhibitors (RTIs)? Stavudine (Zerit), Tenofovir (Viread).
What is the first step in the HIV replication cycle? Receptor binding.
Question Answer
Name two receptors involved in the HIV replication cycle. tCR5 and CXCR4.
What is the term for the process of viral RNA being Reverse transcription.
converted into DNA in the HIV replication cycle?
What does PIC stand for in the context of HIV Pre-integration complex.
replication?
What is the term for the process of viral DNA being Integration.
integrated into the host cell's DNA in the HIV replication
cycle?
What is the term for the process of translating viral RNA Translation.
into viral proteins?
What is the mechanism of action of Protease inhibitors They inhibit the protease retroviral enzyme, preventing viral replication.
(PIs)?
Can you name some examples of Protease inhibitors amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir),
(PIs)? saquinavir (Invirase).
What do Protease inhibitors (PIs) prevent in viral They prevent individual and subunit maturation of viral particles.
particles?
What is the term for an immature viral particle? Immature viral particle.
What is the function of the Mti-protein molecule in virus It is involved in virus replication.
replication?
What is the role of the Protease enzyme in virus It is involved in the maturation of viral particles.
replication?
What does the inhibition of Veal RNA prevent in virus It prevents the maturation of viral particles.
replication?
What is the mechanism of action of fusion inhibitors? They inhibit viral fusion, preventing viral replication.
What is the goal of using combinations of multiple To find the regimen that will best control the infection with a tolerable adverse effect
antiretroviral medications? profile.
How do adverse effects vary with each antiretroviral They may be severe and vary with each drug.
drug?
What should be monitored for in patients taking Dose limiting toxicities and signs of opportunistic diseases.
antiretroviral medications?
Question Answer
How does Zidovudine inhibit reverse transcriptase? It acts as a DNA chain terminator.
What is the therapeutic use of Zidovudine? Initial treatment of choice when CD4<500/mm3.
What is the mechanism of action of Didanosine? It is a purine analog recognized by HIV reverse transcriptase in place of either dATP or
dGTP, acting as a DNA chain terminator.
What is the therapeutic use of Didanosine? It is used in advanced HIV (adults/infants) intolerant/deteriorating with AZT, after more
than 4 months of AZT use.
What is the potency of Didanosine against AZR resistant 10-100 times more potent.
strain?
What are the side effects of Didanosine? Diarrhea, skin rash, headache, insomnia, seizures, retinal depigmentation.
What are the dose-limiting toxicities of Didanosine? Pancreatitis and sensory peripheral neuropathy.
What are the side effects of Stavudine? Painful sensory neuropathy, pancreatitis, anemia, arthralgia, fever, rash, chromosomal
abnormalities.
What is the mechanism of action of Zalcitabine? It inhibits HIV reverse transcriptase as a DNA chain terminator.
What is the therapeutic use of Zalcitabine? It is used in combination with AZT for advanced HIV, for CD4 <300/mm3, and for those
intolerant of AZT therapy.
What is the mechanism of action of Lamivudine? It inhibits the HIV reverse transcriptase.
What are the common side effects of Lamivudine? Neutropenia, mild and transient episodes of diarrhea, headache, fatigue, nausea, and
abdominal pain.
What is the most effective treatment for HIV? Triple therapy with two reverse transcriptase inhibitors and one protease inhibitor.
What are the recommended Nucleoside/nucleotide Abacavir, emtricitabine, lamivudine, tenofovir disoproxil fumarate, zidovudine.
reverse transcriptase inhibitors (NRTIs) for use in
pregnancy?
What are the alternate agents for use in pregnancy? Integrase inhibitors (Raltegravir, Rilpivirine), Lopinavir/ritonavir.
What are miscellaneous antiviral agents? Antiviral drugs that do not fit into specific categories and are used to treat a variety of viral
infections.
How are miscellaneous antiviral agents used? To treat a variety of viral infections.
What distinguishes miscellaneous antiviral agents from They do not fit into specific categories.
other antiviral drugs?
What are the antiviral agents Amantadine and Tricyclic symmetric stable amines.
Rimantadine classified as?
What is the main action of Amantadine and Rimantadine Preventing the release of nucleic acid into cells.
in preventing viral infection?
What are the therapeutic uses of In the first 48 hours of Influenza A infection.
Amantadine/Rimantadine for Influenza A?
In what cases is chemoprophylaxis with Amantadine In cases of outbreak among household contacts to limit institutional spread of infection.
recommended?
How does Ribavirin inhibit virus replication? It interferes with guanosine monophosphate formation and nucleic acid synthesis, and
inhibits inosine monophosphate dehydrogenase, viral DNA, and RNA polymerase.
For which viruses is Ribavirin used? RSV (bronchiolitis/pneumonia), Herpes simplex, Influenza A and B, Lassa fever (IV prep).
What is interferon? A naturally occurring peptide that stimulates antiviral activity of the host.
How does interferon induce host cells to block viral By stimulating enzymes.
replication?
How does the anti-viral activity of interferon-y compare to It has less anti-viral activity compared to interferon-a and B.
interferon-a and B?
What enzymes are induced by interferon? 1. Protein kinase, 2. Oligo-adenylate synthase, 3. Phosphodiesterase.
What is the function of the protein kinase induced by Inhibits protein synthesis.
interferon?
What is the function of the oligo-adenylate synthase Leads to degradation of viral mRNA.
induced by interferon?
What viruses are included in the antiviral spectrum of HBV, HCV, and HPV.
Interferon a?
Which cancers may be inhibited by Interferon a? Kaposi sarcoma and hairy cell leukemia.
In which body tissues is Interferon distributed? In all body tissues, except CNS and eye.
What are the adverse effects of Interferon? Fever, fatigue, myalgia, weakness, anemia, gastrointestinal issues, and cytomegalovirus
(CMV).
What adverse effects can occur with high dose Interferon Marrows suppression and neurotoxicity.
therapy?
What can develop with extended use of Interferon? Development of neutralizing antibodies.
What are the therapeutic uses of interferons? Chronic hepatitis B and C, HZV infection in cancer patients, CMV infections in renal
transplant patients, condylomata acuminata, hairy cell leukemia, and AIDS-related
Kaposi's sarcoma.
What are some examples of viruses mentioned in the FLU, RSV, HSV, VZV, CMV, HIV, HBC, HCV
text?
What are some diseases caused by herpesviruses? Genital herpes, Keratitis, Conjunctivitis, Encephalitis, Neonatal HSV
What are some conditions where antiviral drugs are Immunocompromised, During pregnancy, AIDS, HIV antibody positive, With CD4 <
used? 500/mm3
Name some antiviral drugs mentioned in the text. Ribavirin (aerosol), Acyclovir, Trifluridine, Ganciclovir, ldoxuridine, Foscarnet, Vidarabine,
Zidovudine, Didanosine, Stavudine
Question Answer
What are SARS and MERS related to? Previously known diseases caused by different but related viruses.
How did SARS-CoV-2 originate? Through animal transmission and later human-to-human transmission.
What are some common symptoms of COVID-19? Fever, dry cough, shortness of breath.
What are some uncommon symptoms of COVID-19? Nasal congestion, sore throat, coughing up sputum.
What are some common symptoms of COVID-19? Fever, dry cough, shortness of breath.
What are some uncommon symptoms of COVID-19? Headache, nasal congestion, sore throat, coughing up sputum, pain in muscles or joints,
chills, nausea and/or vomiting, diarrhea.
What is a less common symptom of severe COVID-19 Decreased blood oxygen levels.
disease related to blood?
What is a less common symptom of severe COVID-19 Low white blood cell count.
disease related to the white blood cells?
What is the primary use of Lopinavir/Ritonavir? Primarily used for HIV infection.
What activity against SARS-CoV was shown in vitro Activity against SARS-CoV.
when Lopinavir/Ritonavir was used with Ribavirin?
What are the adverse effects of Lopinavir/Ritonavir? Diarrhea, nausea, and asthenia.
Is Lopinavir/Ritonavir recommended for routine use? Not recommended for routine use.
In 2020 trials, in whom was the use of Pregnant individuals with documented COVID-19 infection.
Lopinavir/Ritonavir suggested for COVID-19 infection?
What viruses can Umifenovir (Arbidol) treat? Influenza A, B, Ebola, Human herpes virus 8, and Hepatitis C.
What is the mechanism of action of Umifenovir (Arbidol)? It blocks virus cell membrane fusion and virus endosome fusion through incorporation into
the cell membrane.
What is Remdesivir? An adenosine analogue prodrug and a strong inhibitor of viral RNA polymerase.
What are the side effects of Remdesivir? Increased liver function test, nausea, and vomiting.
What is the recommended dose of Remdesivir for 200 mg intravenous (IV) then 100 mg for 10 days.
COVID-19 treatment?
What is the clinical improvement rate with Remdesivir? 68% showed clinical improvement and 68% had reduced oxygen requirements.
What is the mechanism of action of Remdesivir? It is a strong inhibitor of viral RNA polymerase.
treatment?
What is the full name of the virus causing COVID-19? Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).
What does Remdesivir bind with to inhibit viral RNA Viral RNA Bind with Complex + ATP.
synthesis?
What is the full name of the virus known as Severe Acute Respiratory Syndrome Coronavirus 2.
SARS-CoV-2?
What is the function of RNA-dependent RNA polymerase It is responsible for replicating the RNA genome of the virus.
(RdRp) in SARS-CoV-2?
What is the role of the spike (S) protein in SARS-CoV-2? It helps the virus attach to and enter host cells.
What complex does RDT-TP form with ATP to inhibit viral RNA-dependent RNA polymerase (RdRp) complex.
RNA synthesis?
What is the mechanism of action of Favipiravir? It is an RNA polymerase inhibitor which blocks viral replication.
For which viruses does Favipiravir show favorable Influenzae, Ebola, and other RNA viruses.
effects?
When is Favipiravir recommended for COVID-19 For documented COVID-19 with severe pneumonia.
treatment?
What is the first cytokine produced during viral infection? Interferon (IFN-1).
What is the recommended dosage of IFN alpha for 5MU through inhalation 2x a day.
COVID-19 treatment?
What is the status of the study on IFN alpha for Still in progress.
COVID-19 treatment?
What is the mechanism of action of Chloroquine? Increase in endosomal pH needed for the virus/cell fusion.
How does Nitazoxanide interfere with virus replication? Interfere with host-regulated pathways of virus replication.
What is the mechanism of action of Ivermectin? Inhibition of importin ±/²1 heterodimer to inhibit the nuclear import of host and viral
proteins.
What is the mechanism of action of Protease inhibitors in They block the synthesis of viral proteins.
HIV treatment?
What is the mechanism of action of Oseltamivir and They block the release of influenza virus.
Zanamivir?
Name the antiviral agents used for HIV treatment that HIV Integrase Inhibitors.
are Non-nucleoside Reverse Transcriptase Inhibitors.
What is the mechanism of action of Nucleoside They inhibit nucleic acid synthesis.
analogues in treating HIV and HBV?
What type of antiviral agents are Amantidine and They are used for Influenza A treatment.
Rimantidine?
Where is the Dead Sea located? On the border between Israel and Jordan.
What is the lowest point on the Earth's surface? The Dead Sea shoreline.
What is the average level on which the Dead Sea is 396 meters (below sea level).
located?
How much saltier is the Dead Sea as compared with the 7 times.
oceans?
Why can the Dead Sea keep swimmers afloat? Due to high salt content.
Why is the Dead Sea called Dead? Because only simple organisms can live in it.
Why only simple organisms can live in the Dead Sea? Because of high salt content.