Prepared By:-

Meraj Khan
Assistant Professor
Sop, ITMBU
 ANTIVIRAL DRUGS
Antiviral drugs can act at any step of viral replication.

Viral replication involves fusion of the virus to host

cell membrane and penetration inside the cell.
Then uncoating occurs and early proteins (like
DNA polymerase) are synthesized.
The nucleic acids (DNA or RNA) are then
synthesized and after that late proteins (final
functional proteins) are synthesized and processed.
After packaging and assembly, viral particles are
released (with the help of neuraminidase) and cause
infection of other cells.
Drugs can act at any of these steps to inhibit viral
replication.
 DRUGS FOR HERPESVIRUS INFECTIONS
All herpesviruses are DNA viruses.
The most common examples are herpes simplex virus (HSV), varicella-zoster
virus (VZV), and cytomegalovirus (CMV).

HSV frequently causes herpes genitalis (genital herpes infection), herpes

labialis (infection of the lips and mouth), or herpetic keratoconjunctivitis
(infection of the cornea and conjunctiva).

VZV is the cause of chickenpox (varicella) and shingles (herpes zoster).

CMV infections in immunocompetent individuals are usually asymptomatic.

Symptomatic CMV diseases, such as retinitis, esophagitis, and colitis, are seen
most often in immunocompromised patients, including those with HIV
infection or acquired immunodeficiency syndrome (AIDS).
Acyclovir and its Congeners
MOA
It is a guanosine analogue active against
herpes simplex virus (HSV-1 and 2) and
Acyclovir
varicella zoster virus (VZV).
Acyclovir is not active against CMV infections. Herpes virus specific thymidine kinase

Acyclovir is drug of choice for H. Simplex Acyclovir monophosphate

encephalitis
Cellular kinases
Famciclovir is a prodrug that gets converted
to penciclovir (also developed as a separate Acyclovir triphosphate
drug) and acts via similar mechanism.

Valacyclovir has a long half life Inhibits herpes virus DNA polymerase competitively
Gets incorporated in viral DNA and stops lengthening of
and gets converted to acyclovir byDNA strand.
hepatic metabolism. The terminated DNA inhibits DNA-polymerase
irreversibly
Uses of Acyclovir:-
Acyclovir is effective in patients with normal as well as deficient immune status.
Genital Herpes simplex
Mucocutaneous H. simplex
H. simplex encephalitis
H. simplex (type I) keratitis
Herpes zoster
Chickenpox

Ganciclovir:-
It is active against CMV and HSV and acts by inhibiting DNA polymerase.
Ganciclovir is used only intravenously whereas valganciclovir has good oral
absorption. Ganciclovir is the drug of choice for CMV infections including
retinitis.
 ANTI INFLUENZA DRUGS

These include amantadine, rimantadine, oseltamivir and zanamavir.

Amantadine and Rimantadine:-

These drugs prevent uncoating of influenza A virus (not influenza B).

These drugs decrease the duration of symptoms of influenza if used
prophylactically. Rimantadine is longer acting than amantadine.
Most common adverse effects of these drugs are gastrointestinal complaints
and minor CNS effects.
Amantadine is also effective for the treatment of Parkinsonism.
Oseltamivir and Zanamavir:-

These drugs act as neuraminidase inhibitors and prevent the virion

release by causing clumping of mature virions.
These drugs are effective against both influenza A and influenza B.
Oseltamivir is an oral prodrug (can cause nausea and vomiting) whereas
zanamivir is administered by inhalational route (bronchospasm is an
important adverse effect).
Neuropsychiatric disorders including suicidal tendancy have been
associated with oseltamivir and zanamivir.
These can be used prophylactically to prevent influenza during epidemics.
Oseltamivir is drug of choice for bird flu (currently strain causing pandemic is
H5N1) as well as swine flu (by H1N1).