Antivirals Listed Flashcards
ACYCLOVIR MOA Metabolism Viruses Treated Side Effects
MOA:
- Targets Nucleic Acid Synthesis by the herpes virus by a nulceoside analogue that MUST be METABOLICALLY activated
- Acts as a competitive inhibitor of dGTP
- Gets incorporated into growing chain
- Traps the polymerase on the ACV-terminated DNA chain when the next dNTP binds
Metabolism:
• Viral cells must activate it to triphosphate form
• Systemic Elimination - unchanged in Kidney (filtration and secretion)
Maintain hydration to prevent renal precipitationUse cautiously with other renal toxic drugs**
Viruses Treated: Herpes simplex (I and II), **Varicella Zoster**, Cytomegalovirus
Side Effects:
Neurotoxicity (confusion, siezures)
AMANTADINE MOA Metabolism Viruses Treated Side Effects
MOA:
• BLOCKS M2 CHANNEL NEEDED for H+ to enter the capsule of the virus so that RNP can be ejected into the host cell
Metabolism:
• Eliminated unchanged by kidney
Viruses Treated:
•Influenza A ONLY
Side Effects:
• NEUROLOGIC effects, Orthostatic Hypotension, LIVEDO RETICULARIS
Do NOT give to people with narrow angle glaucoma or who are breastfeeding
OSELTAMVIR MOA Metabolism Viruses Treated Side Effects
MOA:
Potent Sialic Acid Analogue of the active site of Flu A and B NEURAMINIDASES
Metabolism:
• Hepatically metabolized to the carboxylate active drug form
• Kidney eliminates (secretion and filtration)
Viruses Treated:
Flu
Side Effects:
mininal adverse effects; Fatal neuropsychiatric adverse effects in flu patients; Serious skin reactions
RIBAVARIN MOA Metabolism Viruses Treated Side Effects
MOA:
Converted to Triphosphate Form, Competitively Inhibits GTP-dependent 5’ capping of viral messenger RNA (specifically Flu virus transcriptase activity)
Metabolism:
• NON-CYP metabolism in nucleated cells with systemic elimination of drug and products in urine
Viruses Treated:
Hantavirus
Side Effects:
BBW HEMOLYTIC ANEMIA and M/F TERATOGENICITY
Rimantidine MOA Metabolism Viruses Treated Side Effects
MOA:
BLOCKS M2 CHANNEL NEEDED for H+ to enter the capsule of the virus so that RNP can be ejected into the host cell
Metabolism:
Extensive Hepatic metabolism with renal elimination of drug and metabolites
Viruses Treated:
Influenza
Side Effects:
Minimal
Valacyclovir MOA Metabolism Viruses Treated Side Effects
MOA:
- Targets Nucleic Acid Synthesis by the herpesevirus by a nuclceoside analogue that MUST be METABOLLICALLY activated
- Acts as a competitive inhibitor of dGTP
- Gets incorporated into growing chain
- Traps the polymerase on the ACV-terminated DNA chain when the next dNTP binds
Metabolism
- *Function as the Pro-drug of Acyclovir and has better ORAL BIOAVAILABILITY
- *May precipitate in kidney - use cautiously with other reno-toxic drugs**
Viruses Treated: Herpes simplex (I and II), Varicella Zoster, Cytomegalovirus
Side Effects:
Same as acyclovir [Neurotoxicity (confusion, siezures)] + THROMBOCYTOPENIA
ZANAMIVIR MOA Metabolism Viruses Treated Side Effects
MOA:
Potent Sialic Acid Analogue of the active site of Flu A and B NEURAMINIDASES
Metabolism:
Renally eliminated unchanged
Viruses Treated:
Flu
Side Effects:
FATAL BRONCHOSPASM - do not use with underlying pulmonary disease
CIDOFOVIR MOA Metabolism Viruses Treated Side Effects
MOA
• Inhibition of DNA polymerase
Metabolism:
Metabolized by pyrimidine nucleoside monophosphate kinase to mono- then diphosphate forms and finally to the monophosphate choline.
Eliminated by Kidney (filtration and secretion)
Viruses Treated
Adenovirus
Side Effects
RENAL TOXICITY BBW
Neurologic, Heatologic and Tubular Damage