Pharm- Antiviral Non-Hiv

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Amantadine and Ramantadine

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Inhibit fusion of influenza with sialic acid by blocking acidification via Ion channels. Prophylaxis against influenza A. Amantadine causes CNS stimulation in the elderly and can get confusion, hallucination, seizures.

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Neuraminidase

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Removes sialic acid from membrane so the virus doesn't clump together.

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Zanamivir

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Inhaled neuraminidase inhibitor. Active against A and B types. resistance is developiong.

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Oseltamivir

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Oral neuraminidase inhibitor. There have been child suicides and other destructive behaviors. Resistance is developing.

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Ribavirin

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Guanosine analog. Blocks viral RNA polymerase. Used for influenza, RSV, hanta virus, Hepatitis C in combo with interferon a-2b

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Deoxynucleosides and tide difference.

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Nucleotide has triphosphate group.

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Acyclovir

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Prototype for most nucleoside analog antiviral. Looks a lot like deoxyguanasine. Viral enzyme thymidine kinase phosphorylates it than two more phosphorylations are done by the human cell. Get acyclo-GTP. Only gets activated in virus infected cells. Mutation of TK(-) results in resistance. It is now a competitive inhibitor of viral DNA polymerase by looking like G but there is no 3' OH.

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Acyclovir virus targets

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HSV 1,3, Varicella, CMV. Not curative but it helps.

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Famciclovir

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Prodrug of penciclovir. Same mechanism as acyclovir. No chain termination.

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Ganciclovir.

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Activated by cellular enzymes in CMV. No chain termination. Prodrug for valganciclovir. Used for CMV. Cytopenias are common.

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Cidofovir

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CMV resistnat to ganciclovir.

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Trifluridine

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Too toxic for systemic use. DNA strand breaks when incorporated. Herpes keratoconjunctivitis.

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Foscarnet

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non-nucleoside antiviral. Binds to phosphate binding site of polymerases. Treat resistant CMV, HSV and VZV.