Antiviral Drugs

Antiviral

Oseltamivir,
Zanamivir

Analogs of
Activation

Acyclovir, Famiclovir,
Valacyclovir
Guanosine analog
Monophosphate by HSV/VZV
thymidine kinase
Not activated in healthy cell

Better oral
bioavailabili
ty
Mechanism

Clinical use

Triphosphate via cellular

enzymes
Valacyclovir (prodrug)
Inhibit
influenza
neuraminidase
: release of
progeny virus
Treatment and
prevention of
Influenza A &
B

Ganciclovir

Foscarnet

Guanosine analog
5monophosphate
formed by CMV viral
kinase

Pyrofosphate analog

Cidofovir

Triphosphate via
cellular kinases
Valganciclovir
(prodrug)

Inhibit viral DNA polymerase

Inhibits Viral DNA and

RNA Pol

Inhibit viral
DNA pol

Inhibit HIV RT
HSV mucocutaneous, genital
lesions, and encephalitis.
Prophylaxis in
immunocompromised

CMV
(esp Immunocomp)

CMV retinitis
Acyclovir-resist HSV

VZV & recurrent VZV

(famciclovir)
Does not
treat
Adverse
effects

Weak activity for EBV

No activity against CMV and
latent HSV and VZV
Obstructive crystalline
nephropathy
Acute renal failure if not
adequately hydrated

Mechanism
of
resistance

Mutated viral thymidine

kinase

Renal Toxicity

Nephrotoxic

Bone marrow
suppression
(leukopenia,
neutropenia,
thrombocytopenia)

Electrolyte
abnormalitiesHypo/hypercalcemia,
hypo/hyperphosphate
hypokalemia,
hypomagnesium

More toxic than

acyclovir
Mutated viral kinase

Mutated DNA pol

Nephrotoxic
(probenecid
and IV saline
toxicity)
Long Half
Life