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Antivirals
 
 
 
 
Antivirals
Antiviral agents are used to treat a variety of viral infections including herpesviruses, influenza and human immunodeficiency virus. This section outlines their mechanism of action, indications and potential adverse effects.
 

Nucleoside Analogues

 
 
  •  
    Oral / IV
    Aciclovir
    Herpex, zovirex 
     
    20% bioavailability; mainly used for HSV and VZV
  •  
    Oral
    Valaciclovir
    Prodrug of aciclovir, with 55% bioavailability
  •  
    Oral
    Famciclovir
    77% bioavailability
  •  
    IV, intravitreal
    Ganciclovir

  •  
    Oral
    Valganciclovir

Overview

    • Mechanism of Action

    • Analogues of nucleosides that are incorporated into viral DNA by viral DNA polymerase, resulting in premature DNA termination.
    • Microbiology

    • Effective against Herpes simplex virus (HSV), varicella zoster virus (VZV) and cytomegalovirus (CMV).

Clinical Use

    • Indications

    • Genital herpes
    • Cold sores
    • Herpes simplex encephalitis
    • Chickenpox (in adults)
    • Shingles
    • Ophthalmic herpes zoster
    • Treatment / prophylaxis for CMV infection in immunocompromised patients (ganciclovir)
    • Adverse Effects

    • Nausea / vomiting, headache.
Last updated on August 10th, 2018
 
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The information in this section has been adapted in part from the Australian Therapeutic Goods Association website's repository of product information documents, which are available at https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI.
 Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrobial Agents and Chemotherapy. 1995 Jul 1;39(7):1546-53. Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. The Lancet. 2015 May 2;385(9979):1729-37. Gnann JW, Barton NH, Whitley RJ. Acyclovir: mechanism of action, pharmacokinetics, safety and clinical applications. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 1983 Sep 10;3(5):275-83. Jefferson T, Jones MA, Doshi P, Del Mar CB, Hama R, Thompson M, Spencer EA, Onakpoya I, Mahtani KR, Nunan DN, Howick J. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Sao Paulo Medical Journal. 2014;132(4):256-7. Muthuri SG, Venkatesan S, Myles PR, Leonardi-Bee J, Al Khuwaitir TS, Al Mamun A, Anovadiya AP, Azziz-Baumgartner E, Báez C, Bassetti M, Beovic B. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data. The lancet Respiratory medicine. 2014 May 1;2(5):395-404. Rivas P, Morello J, Garrido C, Rodriguez-Novoa S, Soriano V. Role of atazanavir in the treatment of HIV infection. Ther Clin Risk Manag. 2009 Feb;5(1):99-116. Verjans GM, Boucher CA. Aciclovir for dual infection with HIV and HSV. The Lancet Infectious Diseases. 2012 Jun, 12(6): Pages 424-425.
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