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Antiviral drugs
- 1. INHIBITION OF VIRAL NUCLEIC ACID SYNTHESIS BY : ANDREA TITUS
- 2. DRUG ROA USE SIDE EFFECTS Acyclovir Oral Topical IV Herpes Encephalitis Genital Herpes Orolabial Herpes Varicella Zoster Nephrotoxicity , Renal or CNS toxicity NUCLEOSIDE INHIBITORS CONTD Famciclovir Oral Orolabial Herpes, Zoster,Genital Herpes,EBV,HBV Headache, nausea, or diarrhea
- 3. CONTD DRUG ROA USE Side Effects Ganciclovir IV Oral Intraocular implant CMV retinitis treatment CMV prophylaxis CMV retinitis treatment CMV retinitis treatment Leukopenia & thrombocytopenia as a result of Myelosuppression Cidofovir Intravenous CMV retinitis treatment Fanconi’s syndrome
- 4. DRUG ROA USE SIDE EFFECTS Valacyclovir(no IV) Oral Herpes Encephalitis,Genital Herpes Gastrointestinal intolerance as well as thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome Valganciclovir Oral Oral CMV retinitis CMV prophylaxis Leukopenia, thrombocytopenia, Myelosuppression CONTD
- 5. DRUG ROA USE SIDE EFFECTS Entecavir Oral Chronic hepatitis B Headache, fatigue, dizziness, and nausea Telbivudine Oral Chronic hepatitis B Nausea and vomiting ,myalgia myopathy ,neuropathy Ribavirin Oral Influenza A and B, parainfluenza, paramyxoviruses, HCV, and HIV-1 Anemia, end-stage renal failure, ischemic vascular disease,
- 6. NON NUCLEOSIDE INHIBITORS DRUG ROA USE Side Effects Foscarnet IV CMV retinitis Hypo- or hypercalcemia and phosphotemia
- 8. AGENT ROA USE SIDE EFFECTS Oseltamivir Oral influenza A and influenza B viruses Nausea and abdominal pain (gastric irritation) Headache, weakness, sadness, diarrhea, cough, and insomnia Skin reactions Zanamivir Intranasal influenza A and influenza B viruses Bronchospasm in asthmatic patients NEURAMINIDASE INHIBITORS
- 9. AGENT ROA USE SIDE EFFECTS AMANTADINE & RIMANTADINE Oral Influenza A Gastrointestinal (nausea, anorexia) and central nervous system (nervousness, difficulty in concentrating, insomnia, light-headedness) Other Anti-Influenza Agents
- 10. CLASS OF AGENT DRUG 1) Nucleoside reverse transcriptase inhibitors (NRTIs) Zidovudine(Retrovir, ZDV, AZT), Stavudine (Zerit, Zerit XR, d4T), Abacavir (Ziagen, ABC) , Didanosine (Videx, Videx EC, ddI), Emtricitabine (Emtriva, FTC) , Lamivudine (Epivir, 3TC) Nucleotide reverse transcriptase inhibitors (NTRTIs) Tenofovir (TFV) 2) Non-nucleoside reverse transcriptase inhibitors (NNRTIs) Efavirenz (Sustiva, EFV) , Nevirapine (Viramune, NVP) ANTIRETROVIRAL DRUGS
- 11. 3)Protease inhibitors Lopinavir+Ritonavir 4) Entry (Fusion) inhibitor Enfuvirtide (Fuzeon, T-20) 5) CCR5 receptor inhibitor Maraviroc (Selzentry, MVC) 6)Integrase inhibitor Raltegravir(Isentress, RAL)
- 12. Zidovudine +Lamivudine (AZT +3TC) Tablet 150 mg/300 mg Tenofovir/Emtricitabine/Efavi renz (TDF+ FTC + EFV ) Tablet 300/200/600 mg Antiretroviral Combination Therapy
- 13. REFERENCES • Katzung - Basic and Clinical Pharmacology 12th Edition (2012) • https://aidsinfo.nih.gov/ • http://emedicine.medscape.com/
Editor's Notes
- Acyclovir- no activity against CMV * In first episodes of genital herpes, oral acyclovir shortens the duration of symptoms by approximately 2 days, the time to lesion healing by 4 days, and the duration of viral shedding by 7 days. *prophylaxis in AIDS
- Ganciclovir-The risk of Kaposi’s sarcoma is reduced in AIDS patients receiving long-term ganciclovir Cidofovir- also treatment of HPV infec and pox virus
- Valacyclovir- It is rapidly converted to acyclovir after oral administration via firstpass enzymatic hydrolysis in the liver and intestine, resulting in serum levels that are three to five times greater than those achieved with oral acyclovir and approximate those achieved with intravenous acyclovir.
- Entecavir- it should be taken in an empty stomach to approach 100% bioavailability Ribavarin-rb is effective orallly and should avoid antacids *no benefit on RSV treatment
- Foscarnet-The combination of ganciclovir and foscarnet is synergistic in vitro against CMV
- Oseltamivir is approved by the Food and Drug Administration (FDA) for patients 1 year and older, whereas zanamivir is approved in patients 7 years or older. zanamivir not given to patients underlying airway disease
- rimantadine 4-10 times more active than amantadine
- Zidovudine was the first antiretroviral agent to be approved and has been well studied *it is available in combination with lamivudine