Medical Pharmacology: Antiviral Drug Practice Questions
Click on the correct answer.
Doravirine (Pifeltro):
Classified as a nonnucleoside reverse transcriptase inhibitor (NNRTI) with antiviral efficacy against HIV-1.
Approved for use in the USA as both a single-agent or in combination with two other clinically effective HIV-1 antiretrovirals.
Both
Neither
Doravirine (Pifeltro): indications
Treatment of HIV-1 infection in both adults and pediatric patients.
Utilized in patients with typically no prior antiretroviral treatment (naïve patients).
Both
Neither
Doravirine is available in combination with lamivudine and tenofovir disoproxil fumarate (Delstrigo).
True
False
Doravirine (Pifeltro):
Antiviral effect mediated by noncompetitive HIV-1 reverse transcriptase inhibition.
Doravirine considered noninferior to efavirenz- and darunavir-based protocols, while exhibiting reduced frequency of adverse effects.
Both
Neither
Doravirine (Pifeltro):
Effective against HIV strains which exhibit resistance to earlier NNRTIs. Doravirine was recently approved by the FDA (2018), compared to other NNRTIs.
Doravirine resistance may develop with three particularly defined mutations in HIV reverse transcriptase.
Both
Neither
Doravirine pharmacokinetics:
May be administered without concern about food.
Metabolized by
the cytochrome P450 metabolizing isoform CYP3A.
Both
Neither
Doravirine pharmacokinetics: given that doravirine is metabolized by the cytochrome P450 CYP3A isoform, CYP3A inducers would be expected to:
Increase plasma doravirine levels
Decrease plasma doravirine levels
Doravirine side effects: reduced side effects associated with the central nervous system and lipid profile when compared to efavirenz and ritonavir-boosted darunavir protocols.
True
False
Doravirine metabolism:
Principally metabolized by CYP3A4
Limited renal clearance
Both
Neither
Relatively long elimination half-life (t1/2 12-21 hours) permits doravirine to be given by once-a-day dosing.
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Source Material:
Acosta EP Chapter 62 Antiviral Agents (Nonretroviral)
in Goodman & Gilman's: The Pharmcological
Basis of Therapeutics, 14e, (Brunton LL Knollmann BC eds) McGraw-Hill Education, 2023.
Safrin S Chapter 49 Antiviral Agents in
Basic & Clinical Pharmacology (Katzung BG, Editor;
Vanderah TW, Associate editor) 15e McGraw Hill 2021.
Li JZ Coen DM Chapter 38 Pharmacology of
Viral Infections in Principles of Pharmacology:
The Pathophysiologic Basis of Drug Therapy 4e (Golan DE
Armstong EJ Armstrong AW, eds) Wolters Kluwer 2017.
Waller DB Sampson AP Section 11
Chemotherapy in Medical Pharmacology & Therapeutics
Elsevier 2018.
Burchum JR Rosenthal LD Chapter 97
Antiviral Agents I: Drugs for Non-HIV Viral Infections
in Lehne's Pharmacology for Nursing Care Elsevier 2022.
Waller DB Sampson AP Section 11: Chapter
51
Chemotherapy of infections in Medical Pharmacology & Therapeutics
Elsevier 2018.
Benavides S Bahal O'Mara N Nahata MC
Chapter 79 Viral Infections in Applied Therapeutics:
The Clinical Use of Drugs (Zeind C, Carvalho MG Cheng JW
Zaiken K Lapointe T, eds) Wolters Kluwer, 2024.
Davanathan AS Symonds AE Adams JL
Cottrell ML Chapter 76 Pharmacotherapy of Human
Immunodeficiency Virus Infection
in Applied
Therapeutics: The Clinical Use of Drugs (Zeind C, Carvalho MG Cheng JW
Zaiken K Lapointe T, eds) Wolters Kluwer, 2024.
Flexner CW Chapter 64 Antiretroviral
Agents and Treatment of HIV Infection
in Goodman &
Gilman's: The Pharmcological
Basis of Therapeutics, 14e, (Brunton LL Knollmann BC eds) McGraw-Hill Education, 2023.
Burchum JR Rosenthal LD Chapter
98
Antiviral Agents II: Drugs for HIV Infection and Related
Opportunistic Infections
in Lehne's Pharmacology for Nursing Care Elsevier 2022.
Woster PM Chapter 30 Drugs Used to Treat
Viral Infections in Foye's Principles of Medicinal
Chemistry 8e (Roche VF Zito SW Lemke TL Williams DA, eds)
Wolters Kluwer 2020.
Talwani R Temesgen Z Doravirine: a
new non-nucleoside reverse transcriptase inhibitor for
the treatment of HIV infection Drugs Today (Barc).
56(2): 113-124 Feb 220.
https://pubmed.ncbi.nlm.nih.gov/32163527/
