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Antiviral Agents, Antivirals by Disease - Coggle Diagram

- - - - Selectivity depends on interactino with 2 viral proteins
    - - Impaired production of viral thymidine kinase
      - Altered thymidine kinase
      - Altered viral DNA polymerase
    - - Oral Bioavailability 10-30%
      - T1/2 2.5 hours
      - Renal excretion
        Dose reduction in renal failure
      - Dosage 200mg - 400mg 4-5x day
    - - Genital / labial herpes simplex virus (HSV)
      - Varicella-zoster virus - Chickenpox
      - Herpes encephalitis and keratitis
      - HSV prophylaxis immunocompromised
    - - Nucleoside and other viral DNA polymerase inhibition
    - - Dizziness
      - Headache
      - Nausea
      - Skin rashes
      - Pruritis
      - Fever
      - Neurological
        
        Agitation
        
        Tremor
        
        Ataxia
        
        Dysarthria
        
        Pychotic symptoms
  - - - Pro-drug of Aciclovir
      - Converted via Hepatic valaciclovir hydrolase
    - - Bioavailability 3-5x greater than aciclovir
      - Dosage 500mg BD
      - Renal clearance
  - - - Acyclic Guanin nucleoside analogue
      - Requires phosphorylation
- - - - Are HHAPPPPy viruses
        Hepadna, Herpes, Adeno, Pox, Parvo,
        Papilloma, Polyoma.
  - - - Aciclovir
        
        Herpes
- - - - I went to a retro toga party, where I drank flavoured Corona and ate hippie California pickles
        Retrovirus, togavirus, flavivirus, coronavirus, hepevirus, calicivirus, picornavirus
  - - - Amantadine
      - Rimantadine
- - - - Influenza A viruses
    - - Rimantadine is a α-methyl derivative of amantidine
      - Interfere with virus M2 protein (ion channel)
    - - Dose related CNS and GIT symptoms
      - Delerium
      - Hallucinations
      - Seizures
      - Coma
    - - Amanda riminds me not to take off my Coat in the rain in case i get the Flu
- - - - Influenza A and B
      - Prevention of influenza post exposure
    - - Prodrug
      - Prevents release of virus from infected cells by inhibition of virus neuraminidases
    - - Bioavailability 80%
      - T1/2 10hrs
      - Active metabolite eliminated in urine
      - Dosing altered in renal dysfunction
      - Dosing
    - - Treatment
        
        30mg BD
      - Prevention
        
        30mg OD
    - - Nausea
      - Abdominal discomfort
      - Headaches
      - Nasopharyngitis
      - dizziness
      - Insomnia
      - Convulsions
      - Delerium
    - - The Wizard of Os never releases the monkeys in case they Flu
- - - - COVID-19
        
        Adult
        
        Not on O2
        
        Not at risk for progression to severe COVID-19
    - - Nirmatrelvir: Inhibitor of SARS-CoV-2 3C-like protease
        Inhibits viral replication
      - Ritonavir: Inhibits CYP-3A metabolism of nirmatrelvir - increases plasma conc
    - - 300mg Nirmatrelvir + 100mg ritonavir 12 hoursly x5 days
      - Avoid in pt eGFR <30ml/min
    - - Nausea
      - Vomiting
      - Diarrhoea
      - Abdominal pain
      - Headache
    - - Paxlovid's Pair Halt's COVID's lair