Influenza Antiviral Agents Flashcards
(36 cards)
Neuraminidase Inhibitors
“Mivirs”
1) Oseltamivir
2) Peramivir
3) Zanamivir
Oseltamivir (A)DME
Oral prodrug
Oseltamivir A(D)ME
Low Plasma Protein Binding
Oseltamivir AD(M)E
Esterase hydrolysis to active carboxylate
Oseltamivir ADM(E)
Renal, tubular secretion of parent & active metabolite
Oseltamivir Half life
6-10 hrs (active metabolites)
Dose adjustment for renal issues
Zanamivir (A)DME
Intranasal (4-25% systemic absorption)
Zanamivir A(D)ME
Low Plasma Protein Binding
Zanamivir AD(M)E
Minimal
Zanamivir ADM(E)
Urine, unchanged (less than 8% of dose)
Zanamivir Half life
~ 2 hrs
Peramivir (A)DME
IV single dose
Peramivir A(D)ME
Low Plasma Protein Binding
Peramivir AD(M)E
Minimal
Peramivir ADM(E)
Renal, unchanged
Peramivir Half life
20 hrs; dose adjustment for renal issues
Neuraminidase Inhibitors: MOA
Binds to Neuraminidase causing conformational change preventing budding of viral progeny from cellular envelope attachment point just prior to release
Oseltamivir Clinical Uses
Treatment of any age
Chemoprophylaxis in children > 3 months & adults
Zanamivir Clinical Uses
Treatment in children > 7 years & adults
Chemoprophylaxis in children > 5 years & adults
Not for patients with underlying respiratory disease
Peramivir Clinical Uses
Treatment in children > 2 years old & adults
Not used for chemoprophylaxis
Neuraminidase inhibitor use in pregnancy
Recommended treatment or prophylaxis for influenza
Oseltamivir adverse effects
Nausea
Vomiting
Skin rxn
Neuropsychiatric events
Zanamivir adverse effects
Sinusitis Dizziness Ear, nose, throat infections Bronchospasm Oropharyngeal / facial edema
Peramivir adverse effects
Diarrhea
Skin rxn
Neuropsychiatric events
