A 75-year-old man with chronic obstructive pulmonary disease is diagnosed with suspected influenza based on his complaints of flu-like symptoms that began 24 hours ago. Which of the following agents is most appropriate to initiate for the treatment of influenza?

A 24-year-old female is diagnosed with genital herpes simplex virus infection. Which of the following agents is indicated for use in this diagnosis?

A female patient who is being treated for chronic hepatitis B develops nephrotoxicity while on treatment. Which is the most likely medication she is taking for HBV treatment?

Which statement about the mechanisms of action of antiviral drugs is accurate?

A 30-year-old male patient who is HIV- positive and symptomatic has a CD4 count of 250/μL and a viral RNA load of 15,000 copies/mL. His treatment involves a 3-drug antiviral regimen consisting of zidovudine, didanosine, and ritonavir. The patient is taking acyclovir for a herpes infection and ketoconazole for oral candidiasis. He now complains of anorexia, nausea and vomiting, and abdominal pain. His abdomen is tender in the epigastric area. Laboratory results reveal an amylase activity of 220 U/L, and a preliminary diagnosis is made of acute pancreatitis. If this patient has acute pancreatitis, the drug most likely to be responsible is

A 30-year-old male patient who is HIV- positive and symptomatic has a CD4 count of 250/μL and a viral RNA load of 15,000 copies/mL. His treatment involves a 3-drug antiviral regimen consisting of zidovudine, didanosine, and ritonavir. The patient is taking acyclovir for a herpes infection and ketoconazole for oral candidiasis. He now complains of anorexia, nausea and vomiting, and abdominal pain. His abdomen is tender in the epigastric area. Laboratory results reveal an amylase activity of 220 U/L, and a preliminary diagnosis is made of acute pancreatitis. In the further treatment of this patient, the drug causing the pancreatitis should be withdrawn and replaced by

In an accidental needlestick, an unknown quantity of blood from an AIDS patient is injected into a resident physician. The most recent laboratory report on the AIDS patient shows a CD4 count of 20/μL and a viral RNA load of greater than 107 copies/mL. The most appropriate course of action regarding treatment of the resident is to

A patient with AIDS has a CD4 count of 45/μL. He is being maintained on a 3-drug regimen of indinavir, didanosine, and zidovudine. For prophylaxis against opportunistic infections, he is also receiving cidofovir, fluconazole, rifabutin, and trimethoprim-sulfamethoxazole. The drug most likely to suppress herpetic infections and provide prophylaxis against CMV retinitis in this patient is

A patient with AIDS has a CD4 count of

45/μL. He is being maintained on a 3-drug regimen of indinavir, didanosine, and zidovudine. For prophylaxis against opportunistic infections, he is also receiving cidofovir, fluconazole, rifabutin, and trimethoprim-sulfamethoxazole. The dose of indinavir in this patient may need to be increased above normal. This is because

A 27-year-old nursing mother is diagnosed as suffering from genital herpes. She has a history of this viral infection. Previously, she responded to a drug used topically. Apart from her current problem, she is in good health. Which drug to be used orally is most likely to be prescribed at this time?

Oral formulations of this drug should not be used in a pregnant AIDS patient because they contain propylene glycol. One of the characteristic adverse effects of the drug is hyperpigmentation on the palms of the hands and soles of the feet, especially in African-American patients.

Which of the following statements about interferon-α is false?

More than 90% of this drug is excreted in the urine in intact form. Because its urinary solubility is low, patients should be well hydrated to prevent nephrotoxicity. Which drug is described?

A man with HIV infection is taking an agent that pre- vents viral maturation. Which adverse effect is typically associated with this type of drug?

A patient with shingles receives a drug that is converted to penciclovir in the body. Which antiviral action is exerted by this agent?

A woman with an upper respiratory infection is treated with an agent that is administered by nasal inhalation. Which step in viral replication is prevented by this drug?

A man with immunodeficiency syndrome being treated for a severe herpesvirus infection develops acute renal insufficiency and tachycardia. Which drug is he most likely receiving?

A 78-year-old man presents for evaluation of a painful rash. He reports a sharp, burning pain radiating from his midback to his left side. He noticed a “rash” that spread “like a line” in the same area where he had pain. The rash has a dermatomal distribution from his spine around the left flank to the midline of the abdomen. It has erythematous patches with clusters of vesicles. He reports a history of chickenpox as a child. Among the following, which would be the most appropriate agent to prescribe?

A 25-year-old man was recently diagnosed with genital herpes and was prescribed acyclovir. Although acyclovir is well distributed into most cells throughout the body, it is more active in herpesvirus (HSV)–infected cells. Which of the following mechanisms best accounts for the selective action of acyclovir in HSV-infected cells as compared with uninfected cells?

Which of the following drugs is indicated for the treatment of either influenza A or influenza B?

A patient is being treated for hepatitis C. Which drug combination would be the preferred treatment to eradicate the viral infection?

Which nucleoside analogue that was used previously to treat HIV is now used to treat resistant forms of hepatitis B?

An HIV-positive patient has been treated with FTC-TDF and efavirenz for the past 3 years, and plasma HIV RNA levels have been undetectable. However, recent plasma RT-PCR reveals that her HIV RNA levels are greater than 20,000 copies/mL. A new regimen was proposed that included abacavir, lamivudine, and raltegravir. One year later, the patient's HIV RNA level is again found to be elevated with 50,000 copies/mL. Which of the following most likely describes the reason for the failure of this second regimen?

A 25-year-old man was recently diagnosed with HIV infection and presents to you for treatment. He has also had diabetes mellitus since childhood and has renal insufficiency as a result, with a glomerular filtration rate of only 20 mL/min. Which drug should be avoided in this patient?

Which of the following drugs is indicated for the treatment of either HIV or hepatitis B?

Which of the following drugs does not need to be administered with a boosting agent?

Treatment of HIV typically involves the use of three active agents and a “boosting” agent such as cobicistat. The efficacy of the booster is due to its ability to inhibit