Antiviral Drugs
CMV/HSV/VZV
Hepatitis
HSV
HBV (DNA)
HCV (RNA)
Clovirs (Guanine Analogs)
Topical
Thymidine Analogs (inhibit DNA Pol)
Fusion Inhibitor
Docosanol (Abreva)
Idoxuridine
Trifluridine
Indication
Acyclovir-Resistant HSV
CMV (also HSV, VZV, and EBV)
Ganciclovir
Valganciclovir (Guanosine Analog)
MOA
Prodrug of Ganciclovir
Activated by Phosp. of Viral UL97
Triphosphate inhibits DNA Pol.
Indications
CMV Prophylaxis (transplant)
Indications
CMV Retinitis (IV)
CMV Prophylaxis (Oral)
CMV Treatment (oral)
Adverse:
Resistance
Crystalline Nephropahty
Mutation/deletion of Viral Thymidine Kinase
DNA Polymerase Mutation
Drugs against Resistance
Foscarnet
MOA
Inhibits DNA Pol
Inhibits RNA Pol
Inhibits HIV Reverse Transcriptase
Resistance
Viral Mutation in CMV UL54 Gene (DNA Pol)
Drugs
Acyclovir
Valacyclovir (prodrug of Acyclovir)
Famciclovir
Penclovir (Metablized from Famciclovir)
MOA
First line
Indications
Acyclovir Resistant HSV/VZV
CMV Retinitis Alternative
Adverse
Renal Impairment
Hypokalemia
Hypocalcemia
Hypomagnesemia
Nucleotide Analogues
Interferons 🚩
Protease Inhibitors (always Co-administered with Ribavirn) 🚩
Interferons 🚩
MOA
Upregulate JAK-STAT Upregulate Antiviral Proteins
MOA
Upregulate JAK-STAT Upregulate Antiviral Proteins
Adverse
Flu-like symptoms
Depression
Thyroiditis
Adverse
Flu-Like Symptoms
Depression
Thyroiditis
Combinations
INF-a + Ribavirin
Combinations
INF-a + Ribavirn
Ribavirin 🚩
Lamivudine 🚩
Adefovir 🚩
Entecavir
Entecavir
Telbivudine
Tenofovir
MOA 🚩
MOA (Guanosine alonog)
Combination 🚩
Ribavirin + INF-a
Inhibits RNA-dependent DNA polymerase
Indications
Influenza-a + b
Parainfluenza
RSV
Paramyxovirus
HCV
HIV
Adverse 🚩
Hemolytic Anemia
MOA
Inhibits DNA Pol.
Inhibits Reverse Transcriptase (HIV) 🚩
Adverse
Rapid Resistance
MOA
Adenine Analog
Inhibits DNA Pol.
Indications
Lamivudine-Resistant HBV 🚩
HIV
HSV
Adverse
Toxic
Expensive
MOA
Guanosine Analog
Inhibits HBV pol
100% Bioavailability
Sofosbuvir
MOA
Inhibits RNA NS5B Pol.
Combinations
Sofosbuvir + Peginterferon alfa + Ribavirin
Adverse
Suicidal Ideation
Sofosbuvir + Ledipasvir
Contraditions
Pregnancy
Resistance
Absence of Thymidine Kinase
CMV
EBV
MOA
Ganciclovir monophos --> Ganciclovir Triphos by (UL-97)
Ganciclovir Triphosphate Inhibits DNA-Dependent-DNA Pol.
Inhibits Inosine Monophosphate Dehydrogenase (IMP)
