Anti-Viral Drugs

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Valacyclovir, Acyclovir

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Prodrug of Acyclovir(adenine analog)

[greater bioavailability if given in prodrug form]

MOA: triphosphate is active form-

(1) inhibits DNA polymerase and

(2) chain termination.

Converted to viral thymidine kinase so drug only--> infected cells

Uses: herpes simplex, genital and oral, EBV

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Docosanol

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Alcohol

MOA: Inhibits entry ~inhibits fusion of viral envelope to host cell membrane

Uses: Recurrent oral herpes

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Famciclovir, Penciclovir

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Fam is prodrug of Pen (guanosine analog)

MOA: competitive inhibition of viral DNA polymerase only

Requires triphosphorylation~ lower affinity than acyclovir; but achieves greater intracellular

NO chain termination

Uses: Oral herpes

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Trifluridine

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Opthalmic - only used in eye*

Pyrimidine uridine analog

*DONT use systemically!!!

MOA: mono-P form inhibits thymidylate synthase; tri-P form competes with thymidine kinase

Uses: HSV 1, HSV2, CMV

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Valganciclovir, Ganciclovir

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guanosine analog- prodrug for Ganciclovir; require triphosphorylation done by viral phosphotransferase UL97 in CMV and viral thymidine kinase in HSV.

MOA: chain termination

EYE USE

** AIDS patients to decrease Kaposi sarcoma

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Foscarnet

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pyrophosphate analog

MOA: (1)inhibits viral DNA polymerase; (2) inhibits RNA polymerase and (3) inhibits HIV reverse transcriptase

**blocks pyrophosphate binding site and inhibit cleavage of pyrophosphate from nucleotide tri-phosphates ***

Anti- CMV

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Cidofavir

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IV; cytosine analog

MOA: chain termination

Cidofavir must be used with Probenacid (uric acid inhibition)

Anti CMV

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Amantidine

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Anti-influenza

Treats Parkinson's

MOA: blocks M2 protein of channel of virus particle

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Rimantidine

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alpha derivative of amantidine; same MOA as amantidine;

influenza A inhibition

NOT Used in Parkinson's

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Oseltamivir

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sialic acid analog

MOA: competitively inhibits viral neuraminidase, thereby blocking release of progeny flu into host cells; thus halting spread in respiratory tract.

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Zanamavir

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sialic acid analog; same MOA as oseltamavir

inhibits viral neuraminidase, thereby blocking release of progeny flu into host cells; thus halting spread in respiratory tract.

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Interferons

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Anti-hepatitis

Interferons are good anti-viral agents b/c they induce JAK-STAT pathway; contributes to antiviral effect. induces several genes that contributes to viral resistance. Interfere with viral entry; inhibit transcription, translation, viral maturation, viral release.

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Adefovair

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di-p-ylation needed

MOA: inhibits HBV RT —> chain termination

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Entecavir

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guanosine analog- triphosphate form is active form- inhibit HBV RT

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Lamivudine

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against HBV (all you need to know)

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Telbivudine

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thymidine analog- inhibits HBV RT

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Tenofavir

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against HBV - RT inhibitors

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Ribavarin

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Anti HCV

purine nucleoside analog- triphosphate active.

Moa: inhibits synthesis of GTP; inhibits GTP capping of viral RNA

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Boceprivir

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MOA: protease inhibitor ***inhibits HVC/NS3/4a protease (Enzyme that cleaves virus into mature form) //so now you can’t make mature virus (no p-ylation needed because not a nucleotide analog **)

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Sofosbuvir

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Anti HCV

Uridine analog- prodrug.

MOA: Inhibits RNA dependent polymerase

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Palvizumab

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monoclonal antibody-

antiviral against RSV respiratory syncytial virus

MOA: binds to the RSV's fusion protein and prevents viral entry into the cell

Give to premature, high risk infants

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Imiquimod

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increased interferon release// acts on TLR.. agonist-->stimulates peripheral mononuclear cells to release interferon alpha —> eventually suppresses viral replication.