L11 Antiviral 1 P2

Q: What are the two inhibitors of viral uncoating mentioned in the slide?

A:

• Amantadine

• Rimantadine

Q: Are amantadine and rimantadine used for prevention, treatment, or both?

A: Both prevention and treatment of influenza.

Q: Do amantadine and rimantadine interfere with influenza vaccines?

A: No.

Q: How do amantadine and rimantadine work?

They block the viral M2 membrane protein, preventing viral uncoating.

“Block M2 → virus cannot open.”

What happens when viral uncoating is blocked?

A: The virus cannot continue replication inside the host cell.

Q: What causes resistance to amantadine and rimantadine?

A: Mutation of the1 amino acid of M2 protein.

Q: What is cross-resistance between amantadine and rimantadine?

A: If the virus becomes resistant to one drug, it is usually resistant to the other too.

Q: Which drug causes more CNS side effects: amantadine or rimantadine?

A: Amantadine

Common CNS side effects of amantadine

• Insomnia

• Dizziness

• Ataxia

• Hallucinations

• Seizures

Q: What risks are associated with amantadine and rimantadine(both)?

GI disturbance.

Embryotoxicity and teratogenicity (shown in animal studies).

Q: What type of drug is ribavirin?

A: A synthetic guanosine analog (prodrug.)

Q: Is ribavirin broad-spectrum or narrow-spectrum?

A: Broad-spectrum antiviral.

What is the treatments that ribavirin mainly used for in children?

Severe RSV infection in infants and young children.

Q: Is ribavirin commonly used for RSV infection in adults?

A: No.

Q: What hepatitis infection can ribavirin help treat?

Chronic hepatitis C (Combination with interferon –α).

Q: How does ribavirin work?

inhibits guanosine triphosphate formation, preventing viral mRNA capping and blocking RNA-dependent RNA polymerase.

Q: Why are rhinoviruses and enteroviruses resistant to ribavirin?

A: Because they already contain preformed mRNA.

Q: How can ribavirin be administered?

Oral (↑ absorption with fatty meal),

IV,

aerosol (RSV infection)

Q: How is ribavirin eliminated from the body?

A: Through urine.

Q: Is ribavirin teratogenic?

A: Yes.

Q: What is the major side effect of ribavirin?

dose-dependent transient anemia(blood-related)

elevated bilirubin(liver-related)

Q: How many major types of hepatitis viruses are listed in the slide?

A: Five types:

• Hepatitis A

• Hepatitis B(DNA virus)

• Hepatitis C(RNA virus)

• Hepatitis D

• Hepatitis E

Q: Which hepatitis viruses most commonly cause chronic hepatitis which can lead to cirrhosis and liver cancer?

A: Hepatitis B and Hepatitis C.

Q: Which hepatitis infection is common but usually not chronic?

A: Hepatitis A.

Q: What injectable therapies are used for chronic Hepatitis B?

A:

• Peginterferon-α-2a

• Interferon-α-2b

Q: What oral drugs are used for chronic Hepatitis B?

A:

• Lamivudine

• Adefovir

• Entecavir

• Tenofovir

• Telbivudine

Q: What combination is used for chronic Hepatitis C treatment?

A: Peginterferon + ribavirin.(Pegy form is better than conventional form)