Drug-summary-table-antiviral.docx

DRUG SUMMARY TABLE: ANTIVIRALS and ANTIRETROVIRALS

DRUG CLASSIFICATION Antiherpes drug Acyclovir Valacyclovir Penciclovir Famciclovir

MECHANISM of ACTION

CLINICAL APPLICATION

TOXICITIES

Activated by viral thymidine kinase to forms that inhibit viral DNA polymerase

Treatment and prophylaxis for HSV-1, HSV-2 and VZV None of the drugs active against TK strains

Oral: nausea, diarrhea and headache IV: renal and CNS toxicities

Viral activation of ganciclovir to form inhibiting DNA polymerase

Treatment of CMV infections in immunosuppression and organ transplantation

Bone marrow suppression, hepatic and neurologic dysfunction

Antihepatitis drugs Interferon-alpha Adefovir-dipivoxil Lamivudine Rivabirin Tenofovir

Degrades viral RNA via activation of host cell RNAase; inhibition of HBV polymerase

Suppressive treatment of HBV (all drugs except rivabirin) + treatment of HCV (Rivabirin + INF)

Interferon: flu like symtoms Adefovir: lactic acidosis Rivabirin: Anemia, teratogen

Antiinfluenza drugs Amantadine Rimantadine Oseltamivir Zanamivir

Blocks M2 channel and inhibition of neuraminidase

Prophylaxis for current flu strains and shorten symptoms

GI symptoms Bronchospasms in asthmatics

Drug for CMV Ganciclovir Valganciclovir Cidofovir Foscarnet

Antiretroviral drugs Nucleoside reverse transcriptse inhibitors (NRTI) AbacavirDidanosine Emtricitabine Lamivudine StavudineTenofovir ZalcitabineZidovudine Antiretroviral drugs Nonnucleoside reverse transcriptase inhibitors(NNRTI) Delavirdine Efavirenz Etravirine Nevirapine Antiretroviral drugs Protease inhibitors Atazanavir Darunavir Fosamprenavir Indinavir Nelfinavir Ritonavir Saquinavir Tipranavir Entry inhibitors Enfuvirtide Maraviroc

Inhibit reverse transcriptase after phosphorylation by cellular enzymes

Treatment of HIV

Zidovudine: Bone marrow depression Abacavir: Hypersensitivity Didanosine: Pancreatitis Stavudine: Peripheral neuropathy

Inhibit HIV reverse transcriptase with no phosphorylation required

Treatment of HIV

Delavirdine,nevirapine: rash Efavirenz: Teratogenicity

Inhibit viral protein processing; cross resistance between PI is common

Treatment of HIV

GI distress, diarrhea Atazanavir: neuropathy Indinavir: Hyperbilirubinemia and nephrolithiasis

Block fusion between viral and cellular membrane; CCR5 inhibitor (Maraviroc)

Treatment of HIV

Hypersensitivity, joint pains, diarrhea and increase liver enzymes