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Flashcards in Antivirals Deck (28):
1

Antiviral agents

acyclovir (Zovirax), valacyclovir (Valtrex), famciclovir (Famvir), Ganciclovir (Cytovene), valganciclovir (Valcyte), foscarnet (Foscavir), amantadine (Symmetrel),Oseltamivir (Tamiflu)

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Spectrum of activity of acyclovir

herpes simplex 1/2, varicela zoster, HSV1> HSV2> VZV

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ADRs of acyclovir

N/V, nephrotoxic, neurotoxic, lethargy confusion, disorientation, hallucination

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Kinetics of acyclovir

IV/PO, well distributed, renally eliminated

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Valacyclovir (Valtrex) MOA

prodrug of acyclovir

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Spectrum of activity of valacyclovir

herpes simplex 1/2, varicella zoster

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Kinetics of valacyclovir

Po only, rapidly converted in intestinal tract to acyclovir, 3-5x higher bioavailability than acyclovir

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ADRs of valacyclovir

N/V

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MOA of famiclovir (Famvir)

prodrug, converted to active form by liver, works by inhibition of viral replication

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Spectrum of activity of famciclovir

herpes simplex virus 1/2, varicella zoster virus

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Niche of famiclovir

best tolerated, but $$$

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Ganciclovir (Cytovene) MOA

inhibits viral DNA polymerase

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Spectrum of activity of ganciclovir

HSV-1/2, VZV, cytomegalovirus

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Kinetics of ganiclovir

IV/PO, penetrates well into aqueous humor of eye and subretinal fluid, and CSF

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ADRs of ganiclovir

Bone marrow suppression, neutropenia, thrombocytopenia, related to dose accumulation over time

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Valganciclovir MOA

prodrug of ganciclovir

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Spectrum of activity of valganciclovir

HSV 1/2, VZV, cytomegalovirus

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ADRs of valganciclovir

bone marrow suppression, neutropenia, thrombocytopenia

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Clinical use of valganciclovir

CMV retinitis in AIDs patients

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Vanciclovir niche

PO therapy better tolerated compared to ganciclovir

21

Foscarnet MOA

not a prodrug, directly inhibits viral DNA polymerase

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Spectrum of activity of foscarnet

HSV-1/2, VZV, CMV, spectrum includes any/all viruses that are resistant to acyclovir

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Foscarnet ADRs

nephrotoxic, CNS- HA, tremor, irritability, seizures, paresthesias, but pt already critically ill

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Amantadine (Symmetrel) MOA

blocks uncoating of viral RNA

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Amantadine spectrum of activity

influenza A

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ADRs of amantadine

CNS, HA, seizures, tremor, GI

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Oseltamivir (Tamiflu) Spectrum of activity

Influenza A and B

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Oseltamivir (Tamiflu) ADRs

none