Antivirals Flashcards
Inhibitors of Viral Attachment, Uncoating or Release (list)
Pleconaril Docosanol Amantadine Rimantadine Osteltamivir Zanamivir
Name 2 inhibitors of viral attachment (inhibit viral uncoating)
Amantadine
Rimantadine
What are Amantadine and Rimantadine used for?
Used for treatment and prophylaxis of *influenza type A, no effect on type B-lack M2
Amantadine also used in Parkinson’s disease
Name 2 Neuraminidase Inhibitors
Oseltamivir and Zanamivir
What are Oseltamivir and Zanamivir used for?
Treatment of influenza A and B, duration 5 days. Also effective for prophylaxis.
Name one precaution for Zanamivir
inhalation of dry powder
May produce bronchospasms, careful in patients with asthma or COPD
What 2 drugs inhibit attachment?
Pleconaril
Docosanol (Abreva)
Pleconaril
Prevents attachment of the virus to the human cell
Prevents viral uncoating within the cell
Effective against picornavirus (common cold)
Not FDA approved—not used here, used in other countries
Docosanol (Abreva)
Prevents attachment of the virus to the human cell
OTC cream : recurrent oral/genital herpes
Begin treatment within 12 hours of prodromal symptoms or lesion onset
Drugs that Block DNA Synthesis from Viral DNA: Guanosine analogs
Acyclovir Valacyclovir Penciclovir Famiciclovir Ganciclovir
Drugs that Block DNA Synthesis from Viral DNA: adenosine analog
Vidarabine
Drugs that Block DNA Synthesis from Viral DNA: Cytosine analog
Cidfovir (used in CMV in HIV/AIDS patients)
Acyclovir and Valacyclovir
Treatment and Prophylaxis of:
Herpes simplex (type I and II) and zoster
Drug of choice for treatment of HSV infections
Acyclovir used prophylactically to prevent mucocutaneous HSV infection in seropositive patients undergoing immunosuppressive therapy
Genital herpes: Decrease viral shedding, systemic symptoms, and time to resolution
Varicella zoster- treatment
Used within 24hours of rash onset decreases symptoms by ~ 1 day- use in high risk patients
Penciclovir and Famciclovir (oral prodrug of Penciclovir)
Both used to treat Herpes Zoster, Herpes simplex type II, topical treatment of oral/labial herpes simplex virus
Which 2 antivirals are Category B in pregnancy?
Acyclovir and Penciclovir
Ganciclovir and Valganciclovir (Oral prodrug)
Phosphorylated by viral protein kinase in cytomegalovirus and by viral thymidine kinase in herpes simplex virus then further phosphorylated by host enzymes
Active against all herpes viruses
Treatment of CMV in immunocompromised patients
Neutropenia, thrombocytopenia, teratogenic –Cat C
Vitasert- an intraocular sustained release implant for CMV retinitis
Which 2 antiviral are category C in pregnancy?
Ganciclovir and Valganciclovir (Oral prodrug)
Vidarabine
Phosphorylated by host enzymes
Treatment of viral thymidine kinase resistance
Broad spectrum antiviral activity- herpes, pox viruses, rhabdoviruses, hepadenaviruses, some RNA tumor viruses
Primarily used for keratitis, keratoconjunctivitis due to HSV, life threatening herpes simplex virus, varicella zoster infections
N/V, bone marrow suppression, neurotoxicity, peripheral neuropathy
Cidofovir
Phosphorylated by host enzymes- so useful when viral thymidine kinase resistance has developed
Broad spectrum antiviral activity; herpes and pox viruses, adenoviruses, papilloma viruses, and hepadenavirus
Primary use for treatment of cytomegalovirus in AIDS patients who are intolerant, relapsed, or nonresponsive to ganciclovir or foscarnet
Acyclovir resistant mucocutaneous HSV infection
Neutropenia and nephrotoxicity
Thymidine analog
Idoxuridine- Topical- for HSV types 1 and 2 keratoconjunctivitis and recurrent epithelial keratitis
Nucleotide analog
Adefovir- does not require phophorylation
FDA approved for treatment of chronic active infections HepB
Foscarnet (method of action)
an inorganic phosphate analog
Directly inhibits DNA and RNA polymerases and reverse transcriptases- 100 x greater effect on viral vs human DNA polymerase.
Does not require phosphorylation- broad spectrum
Foscarnet (uses)
Active against all herpes viruses, influenza, and HIV
Primary uses: CMV infections, acyclovir resistant herpes simplex or varicella zoster
Ribavirin
purine nucleoside analog
Phosphorylated intracellularly by host cell enzymes
Ribavirin aerosol- treatment of RSV
Ribavirin plus peginterferon – for Hepatitis C
