Antiviral Pharm

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Author:
Tarapie
ID:
97198
Filename:
Antiviral Pharm
Updated:
2011-08-16 08:30:32
Tags:
USMLE step
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Description:
antiviral drugs
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  1. Amantadine
    • Mech: Blocks viral penetration/uncoating (M2 prot); causes release of DA from intact nerve terminals
    • uses: Prophylaxis/tx for influenza A ; parkinsons
    • Tox: atazia, dizziness, slurred speech
  2. Zanamivir/oseltamivir
    • Mech: Inhibits influenza neuraminidase, decreases release of progeny virus
    • uses: influenza A and B
  3. Ribavirin
    • Mech: Inhibits guanine nucleotide synthesis (inhib IMP DH)
    • Uses: RSV, chronic Hep C
  4. Ganciclovir
    • Mech: 5'MP (guanosine analog) formed by viral kinase. Inhibits viral DNA polymerase
    • uses: CMV retinitis (esp in IC)
    • tox: renal, blood stuff
  5. Foscarnet
    • *does not require activation by viral kinase (unlike acyc and gancic)*
    • Mech: Viral DNA polymerase inhibitor (binds to pyrophosphate binding site of enzyme) - pyrophosphate analog
    • uses: CMV retinitis in IC in pt refractory to ganciclovir
    • tox: nephrotox!!!
  6. Protease inhibitors
    • saquiNAVIR, ritoNAVIR, indiNAVIR, nelfiNAVIR, ampreNAVIR (-NAVIR)
    • Mech: Block protease in progeny virus
    • tox: GI intolerance, hyperclycemia, lipodystrophy - fat redistribution
    • "NAVIR tease a protease"
  7. Reverse transcriptase inhibitors: NUCLEOSIDES (NRTI)
    • Zidovudine: BM supression - megaloblastic anemia (used in PREGNANCY to reduce transmission to fetus)
    • didanosine: Pancreatitis
    • zalcitabine: peripheral neuropathy
    • lamivudine, abacavir
  8. Reverse transcriptase inhibitors: NON-NUCLEOSIDES (NNRTI)
    • Nevirapine: Cyp450 inducer
    • Efavirenz: CNS - delusions, nightmares
    • Delavirdine
    • Never Ever Deliver Nucleosides
  9. RTI's (NNRTI, NRTI)
    • Mech: inhibit RT of HIV. Prevent incorporation of viral DNA into host DNA.
    • tox: BM suppression, etc - Can avoid with GM-CSF
    • uses: HAART therapy
  10. Fusion inhibitors
    • Enfuvirtide
    • mech: bind viral gp41 subunit, inhibit fusion, block entry and replication
    • tox: HS reactions, incr risk of bacterial pneumo

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