56.下列何種抗病毒藥物不需經細胞酵素活化即可作用?
(A)acyclovir
(B)ritonavir
(C)cidofovir
(D)zidovudine
統計: A(345), B(615), C(438), D(687), E(0) #2626051
詳解 (共 3 筆)
補充,這題問得很細
(A) Acyclovir:guanosine (鳥糞嘌呤)的類似物,用來治療HSV和VZV感染,需要病毒的thymidine kinase活化產生 acyclovir-monophosphate (ACV-P),再由細胞內的nucelotide monophosphate (NMP)-kinase活化產生acyclovir-diphosphate (ACV-PP)、 nucelotide diphosphate (NDP)-kinase活化產生acyclovir-triphosphate (ACV-PPP),而ACV-PPP才有干擾病毒的DNA polymerase活性;
(B) Ritonavir:HIV的protease inhibitor,抑制病毒對合成的polyprotein剪切、修飾,進而導致合成出的病毒顆粒中的蛋白質沒有功能;
(C) Cidofovir:Cytidine monophosphate (CMP)的類似物,用來治療CMV的感染,需要細胞內的NMP-kinase和 NDP-kinase活化產生可以抑制CMV的DNA polymerase的cidofovir diphosphate (CDV-PP);
(108年第一次第70題問的是「不需要病毒的酵素活化」所以Cidofovir是正確解答,但這裡問的是「不需要細胞的酵素活化」所以不能選)
(D)Azidothymidine (AZT/Zidovudine):2',3'-dideoxythymidine (ddT)的類似物,用來治療HIV的感染,需要細胞內的2'-deoxythymidine (dThD) kinase、2'-deoxythymidine monophosphate (dTMP) kinase和 NDP-kinase活化產生可以抑制HIV的reverse transcriptase的ddTTP。
參考資料
Bacon TH, Levin MJ, Leary JJ, Sarisky RT, Sutton D. Herpes simplex virus resistance to acyclovir and penciclovir after two decades of antiviral therapy. Clinical Microbiology Reviews. 2003 Jan;16(1):114-128. DOI: 10.1128/cmr.16.1.114-128.2003. PMID: 12525428; PMCID: PMC145299.
Talha B, Dhamoon AS. Ritonavir. [Updated 2022 May 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544312/
Lurain, N. S., & Chou, S. (2010). Antiviral drug resistance of human cytomegalovirus. Clinical microbiology reviews, 23(4), 689–712. https://doi.org/10.1128/CMR.00009-10
Clercq, E & Neyts, Johan. (2009). Antiviral agents acting as DNA or RNA chain terminators. Handbook of experimental pharmacology. 189. 53-84. 10.1007/978-3-540-79086-0_3.