Antivirals Flashcards
(39 cards)
Anti-herpes virus agents
Action against HSV, VZV, CMV
Aciclovir Valaciclovir Penciclovir Famciclovir Trifluridine
Aciclovir
Anti-herpesvirus agent
-HSV and VZV
IV route SE: phlebitis, nephrotoxic if given too fast
Valaciclovir
Anti-herpes virus agent
- HSV and VZV
Penciclovir
Anti-herpes virus agent
-Herpes labialis
(Poor bioavailibility, topical use only)
Famciclovir
Anti-herpes virus agent
-HSV and VZV
Trifluridine
Anti-herpes virus agent
-HSV keratitis
Topical use (eye drops / cream)
Aciclovir mechanism of action
- synthetic nucleoside analogue
- leads to irreversible inactivation of viral DNA polymerase
Ganciclovir
100x stronger than acyclovir
-active against CMV
SE: myelosuppression (neutropenia)
Indicated: prevent CMV in transplant recipients, Rx of sight or life threatening CMV infxn in immunocompromized (CMV retinitis / CMV pneumonitis)
Valganciclovir
Against CMV
Cidofovir
Use in CMV, HSV, VZV
-for acyclovir resistant infections
SE: nephrotoxic
Foscarnet
- used for CMV, HSV, VZV
- for acyclovir resistant infections
SE: nephrotoxic
Ganciclovir mechanism of action
- nucleoside analogue
- leads to irreversible inactivation of viral DNA polymerase
Amantadine
M2-ion channel inhibitor
-prevents viral uncoating
Against influenza A only
(Not recommended - increasing resistance)
Rimantadine
M2-ion channel inhibitor
-prevents viral uncoating
Against influenza A only
(Not recommended - increasing resistance)
Zanamivir
Neuraminidase inhibitor (enzyme responsible for virion release) -prevents release of newly formed viruses from cell surface
- against influenza A and B
- give within first 48h of Sx
Oseltamivir
Neuraminidase inhibitor (enzyme responsible for virion release) -prevents release of newly formed viruses from cell surface
- against influenza A and B
- give within first 48h of Sx
Peramivir
Neuraminidase inhibitor (enzyme responsible for virion release) -prevents release of newly formed viruses from cell surface
- against influenza A and B
- give within first 48h of Sx
Indications for influenza antiviral therapy
-at higher risk of complications (<2y, >65y)
- complicated or severe illness
1. Requiring hospital admission
2. LRTI
3. CNS involvement
4. Significant exacerbation of underlying medical condition
5. Other cond. requiring admission eg bacterial pneumonia
Ribavirin
Hep C virus (combine with pegylated interferon)
Respiratory syncytial virus (only immunosuppressed with severe infection)
Certain viral hemorrhagic fevers
-Crimean-Congo hemorrhagic fever
Hep C Rx
-achieve sustained virological response (regarded as ‘cure’)
Peginterferon + ribavirin for 24-48w
Pegylated interferon SE
Influenza-like Sx
Neuropsychiatric effects
Hematologic abnormalities
Induction of autoimmune disorder
Ribavirin SE
Hemolytic anemia
Teratogen
Interferon alpha
In Hep B - in high viral load
-not in decompensated state
Entecavir
- in resistant HBV
- patients with HBV and kidney problems
-possible anti-HIV activity
