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Antiviral D.
Drugs
| Drug | Information |
|---|---|
| Acyclovir | against HSV1, HSV2, VZV --> drug of choice for CNS, visceral, disseminated infections |
| Acyclovir | Best data use in children, pregnancy --> can reduce risk of transmission if mom w/ genital herpes |
| Acyclovir | MOA: 3 steps 1) converted to acyclovir monophosphate with TK 2) 2 more P added to form active drug acyclovir triphosphate 3) Acyclovir triphosphate competes with deoxyguanosine triphosphate as substrate for viral DNA polymerase (prevents further elongat.) |
| Acyclovir | 5 times a da, poor availability |
| Acyclovir | AE: IV: phlebitis and renal dysfunction; PO: GI disturbance and headache |
| Famciclovir | PO only |
| Famciclovir | Against HSV1, HSV2, VZV |
| Famciclovir | Metabolized to penciclovir in the body --> 1st past metabolism |
| Famciclovir | Improved bioavailability, 3/days |
| Valacyclovir | PO only |
| Valacyclovir | Metabolized to acyclovir |
| Valacyclovir | Valine ester prodrug of acyclovir |
| Valacyclovir | AE: TTP/HUS |
| Zovirax | Prescription only |
| Denavir | Prescription only |
| Abreva | Over-the-counter |
| Abreva | inhibits fusion between HSV and plasma membrane |
| Trifluridine | nucleoside analog, active against acyclovir resistant strains of HSV |
| Trifluridine | Irreversible inhibition of thymidylate synthetase |
| Ganciclovir | Against systemic CMV, CMV retinitis |
| Ganciclovir | Initially phosphorylated by UL97 |
| Ganciclovir | Poor availability |
| Ganciclovir | AE: Teratogenir, carcinogenic, myelosuppression, liver + kidney dysfn |
| Valganciclovir | PO only |
| Valganciclovir | Oral prodrug of ganciclovir |
| Valganciclovir | Improved bioavailability |
| Valganciclovir | Prevention of CMV in transplant and Tx of systemic CMV --> not FDA approved |
| Foscavir | IV only --> slow infusion and large fluid volume |
| Foscavir | against CMV |
| Foscavir | Pyrophosphate analog --> doesn't require activation by TK nor phosphorylation |
| Foscavir | Inhibits DNA, RNA polymerase |
| Foscavir | Can deposit in bone |
| Foscavir | Poor bioavailability and GI intolerance --> no PO |
| Foscavir | AE: Nephrotoxicity, Electrolyte disturbance, GI side effect, bone marrow suppression |
| Cidofovir | Cytosine nucleoside analog |
| Cidofovir | IV only |
| Cidofovir | Used primarily for CMV, resistant HSV/VZV, rare viruses |
| Cidofovir | 2 Phosphorylations --> monophosphate kinase and pyruvate kinase NOT TK |
| Cidofovir | Not available commercially, but coumpounded as topical cream for genital warts |
| Cidofovir | AE: metabolic acidosis, netropenia, nephrotoxicity (give with NS and probenecid) |
| Fomivirisen | Unique MOA --> binds to mRNA; last hope tx for CMV retinitis |
| Amantadine and Rimantadine | Prevention and tx of influenza A |
| Amantadine and Rimantadine | Blocks M2 which impairs viral uncoating |
| Rimantadine | Hepatically metabolized before excretion |
| Amantadine and Rimantadine | AE: GI and CNS effects |
| Oseltamivir and Zanamivir | Prevention and tx of influenza A & B; decrease risk of complication |
| Zanamivir | Inhalation, rare resistance, not FDA approved for inluenza prevention, AE: bronchoplasm |
| Oseltamivir and Zanamivir | Neuraminidase inhibitor --> can't release new virus and becomes noninfectious |
| Interferons | Hepatitis antiviral and immunomodulary (RNA & prot), given SC or IM, with ribavirin if tx of HCV |
| Interferons | AE: Flu-like symptoms or injection site rxn, depression, more muscle spasticity |
| Ribavirin | Never as monotherapy for HCV, pregnancy category X, hemolytic anemia |
| Imiquimod | cream for human papillomavirus |
| Palivizumab | monoclonal antibody, for prevention of repiratory syncytial virus (RSV) |
| HAART | Treatment of HIV infection --> monitor CD4 cell count and HIV RNA levels |
| Enfuvirtide aka T20 | Fusion inhibitor --> binds to gp4; AE: hypersensitivity |
| NRTI (nucleoside reverse transcriptase inhibitors) --> stauvudine, didanosine, zidovudine | AE: mitochondrial toxicity, lipoatrophy except with abacavir |
| Didanosine | Only NRTIs taken with regards to meals |
| NNRTIs (delavirdine, efavirenz, nevirapine) | Rash, EFV: CNS effect, NVP: hepatotoxicity; more drug interactions |
| Protease inhibitors | AE: increased serum glucose and cholesterol, lipodystrophy (fat dep. in back), hepatotoxicity, highest drug interaction among HIV meds |
| Zidovudine + NRTIs and PI or nevirapine | Prevention of perinatal transmission |
Created by:
gladho
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