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Flashcards in Anti-Viral Drugs: Influenza Deck (5)
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Guidelines for prevention and control of Seasonal influenza

  • Annual Flu vaccine for everyone 6 months or older
    • no contraindications
  • CDC does not recommend chemoprophylaxis for 
    ​"healthy" after flu exposure 
    • only. high risk patients with suspected or confirmed exposure


Drugs for Influenza: Neuraminidase Inhibitors


-Clinical Use



-Side effects

Oseltamavir & Zanamavir

  • Clinical use:
    • tx/prophylaxis for influenza A and B
    • <48 hours post exposure
  • MOA:
    • interfere with release of progeny flu virus
      • competively and reversibly inhibits viral neuraminidase activity 
      • causes  virus particles to clump to cell membrane
      • NO BUDDING
  • PK:
    • Oseltamavir
      • Oral
      • prodrug
    • Zanamavir
      • inhalation
      • directly delivered to respiratory tract
  • Side effects:
    • Oseltamavir
      • headache
      • N & V (alleviated w/food)
      • Delirium
    • Zanamavir:
      • Bronchospasm
    • Pregnancy Category C


New drugs for influenza: 

-clinical use only

  • Baloxavir marboxi (Xofluza)
    • Tx of acute uncomplicated influenza
    • 12 and older 
    • symptomatic for less than 48 hours
  • Peramivir (Rapivab)
    • Treatment (not prophylaxis) for influenza A and B


Influenza: Antiviral options for:

-Hospitalize patients w/suspected or confirmed influenza

-Outpatients w/complications or progressive disease and suspected or confirmed influenza

-Outpatients w/suspected or confirmed uncomplicated influenza

  • Hospitalized patients with suspected or confirmed flu:
    • Oseltamivir ASAP
      • oral or enterically administered
  • Outpatients with complications or progressive disease and suspected or confirmed influenza:
    • Oral oseltamivir ASAP
  • Outpatients w/suspected or confirmed uncomplicated influenza:
    • oral oseltamivir
    • inhaled zanamivir
    • IV peramivir
    • oral baloxavir 


Drugs for Respirator Syncytial Virus:

-clinical Use




  • Clinical Use:
    • Tx of severe RSV infection in children 
    • Nebulizer=aerosol version
  • MOA:
    • nucleoside analog 
    • phosphorylated by host enzymes
    • interferes with synthesis of GTP to inhibit capping of viral mRNA and RNA-dependent polymerase



  • Clinical use:
    • prevention of RSV infeciton in high risk infants and children
      • premature
      • congenital heart disease
    • Administered: IM
  • MOA:
    • monoclonal antibody with potent fusion-inhibiting activity