More Related Content Similar to Antiviral drugs Similar to Antiviral drugs (20) Antiviral drugs4. CLASSIFICATION
DNA virus
Hepatitis B
Herpes virus
HSV-1,HSV-2
VZV
EBV
CMV
Poxvirus(Molluscum)
Parvovirus(Erythema
infectiosum)
Papilloma virus(Warts)
RNA Virus
Influenza
Hepatitis A,C,D,E
Enterovirus
Mumps
Measles
14. PK
BA – 10-30%
Wide distribution, crosses BBB
Half life – 2-3hrs
Renal excretion-dose reduction
ACYCLOVIR &VALACYCLOVIR
15. SPECTRUM AND USE
HSV-1: Herpes labialis, esophagitis, keratitis ,encephalitis,
Ocular herpes
HSV-2: Genital herpes,VZV
EBV,CMV: Weak action HSV-1>HSV-2>CMV>EBV
17. ADR
I.V- rash, sweating, emesis, hypotension, CNS effects, renal
insufficiency, phlebitis on extravasation
Topical-stinging, burning
Oral-head ache, nausea, malaise
18. VALACYCLOVIR
L-valyl ester prodrug of acyclovir
BA more than acyclovir
Less frequent dosing
No IV preparation
Use:
VZV, Recurrent genital herpes
Dose:1g BD/TDS 7 days
20. GANCICLOVIR AND VALGANCICLOVIR
Selective action to CMV Infections
Accumulate in vitreous humor
CMV retinitis
Poor oral Bioavailability
ROA:
IV
Oral
Intraocular implant
23. CIDOFOVIR
Poor oral bioavailability
Topical, IV
Phosphorylated by cellular but not viral enzymes
Acyclovir resistant cases
Use:CMV Retinitis,HSV mucocutaneous lesion
AE:Nephrotoxicity,Uveitis
24. MOA:No phosphorylation required to inhibit DNAP
Thymidine kinase mutation not a threat
Use:Mucocutaneous HSV ,CMV retinitis
ROA:IV
Dose:
Induction:90mg/kg IV Q12h
Maintenance:90 mg/kg/day
FOSCARNET
28. InterferonsDefence against viral infections:
Immunomodulator
Inhibit viral replication at multiple steps:
1 Penetration
2 Uncoating
3 mRNA synthesis
4 Assembly
5 Release
DNA and RNA viruses are sensitive to interferons
2) INHIBITION OF REPLICATION BY
INTERFERONS
29. Uses:
Interferon alpha2a:
Chronic hepatitis B,Kaposi’s sarcoma,Chronic Hepatitis C
Interferon alpha2b
HepatitisC,Chronic hepatitis B,Condyloma acuminata
Adverse effects:
Myalgia.fever,rash
Alopecia,Bone marrow suppression(long term)
INTERFERONS
31. 1) ATTACHMENT AND ENTRY
Palivuzumab
Humanized monoclonal antibody
Use: RSV
AE: Fever,Rhinitis,Diarrhoea
33. AMANTADINE ,RIMANTADINE
Rimantadinealpha methyl ester of amantadine
Amantadine is excreted in urine ,Rimantidineliver
ROA:Oral,100mg BD
Rapidly absorbed from GIT
Use: Treatment of Influenza
Additional use of Amnatidine:Parkinson’s Disease
InfluenzaA >Influenza B
37. Oseltamivir Zanamivir
MOA Neuraminidase inhibitor Neuraminidase inhibitor
ROA Oral Intranasal
ROE Renal Renal
AE Gastrointestinal Bronchospasm
Dose 75 mg BD for treatment
75mg OD fror prophylaxis
10mg BD inhalation
40. HSV-1 Herpes Labialis
Ocular Herpes ,
Herpes encephalitis
HSV-2
Genital herpes
VZV
Chickenpox
Shingles
AGENTS TO TREAT-HSV,VZV INFECTIONS
41. Drug ROA USE
Acyclovir
Valacyclovir (No IV)
Oral
Topical
IV
Genital herpes
Orolabial herpes
Herpes Encephalitis
Varicella
Zoster
Famciclovir Oral Genital herpes
Orolabial herpes
Zoster
Foscarnet IV Acyclovir resistant HSV,VZV
Docosanol Topical Recurrent herpes labialis
Penciclovir Topical Herpes labialis
Herpes Genitalis
Trifluridine Topical Acyclovir resistant HSV
43. Agent Route Use
Ganciclovir Oral
IV
Intraocular implant
CMV retinitis
Treatment and prophylaxis
Valganciclovir Oral CMV Retinitis
Treatment and prophylaxis
Foscarnet IV CMV retinitis treatment
Cidofovir IV CMV retinitis treatment
45. Agent Indication Route
Lamivudine Chronic hepatitis B Oral
Adefovir
Chronic hepatitis B
Oral
Entecavir Chronic hepatitis B Oral
Tenofovir Chronic hepatitis B Oral
Telbivudine Chronic hepatitis B Oral
Interferon alpha Chronic Hepatitis B S/C
Interferon alpha +Ribavirin Chronic hepatitis C S/C
46. Agent Indication Route
Lamivudine Chronic hepatitis B Oral
Adefovir
Chronic hepatitis B
Oral
Entecavir Chronic hepatitis B Oral
Tenofovir Chronic hepatitis B Oral
Telbivudine Chronic hepatitis B Oral
Interferon alpha Chronic Hepatitis B S/C
Interferon alpha +Ribavirin Chronic hepatitis C S/C
48. Agent Route Mechanism Use
Oseltamivir Oral Neuraminidase inhibitor Influenza A ,B
Zanamivir Inhalation Neuraminidase inhibitor Influenza A,B
Peramivir IV Neuraminidase inhibitor H1N1
Amantadine Oral Inhibtor of penetration Influenza A>B
Rimantidine oral Inhibitor of penetration Influenza A>B
Ribavirin Oral
IV
Aerosol
mRNA inhibitor Influenza A,B
RSV