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Amantadine
- Mech: Blocks viral penetration/uncoating (M2 prot); causes release of DA from intact nerve terminals
- uses: Prophylaxis/tx for influenza A ; parkinsons
- Tox: atazia, dizziness, slurred speech
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Zanamivir/oseltamivir
- Mech: Inhibits influenza neuraminidase, decreases release of progeny virus
- uses: influenza A and B
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Ribavirin
- Mech: Inhibits guanine nucleotide synthesis (inhib IMP DH)
- Uses: RSV, chronic Hep C
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Ganciclovir
- Mech: 5'MP (guanosine analog) formed by viral kinase. Inhibits viral DNA polymerase
- uses: CMV retinitis (esp in IC)
- tox: renal, blood stuff
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Foscarnet
- *does not require activation by viral kinase (unlike acyc and gancic)*
- Mech: Viral DNA polymerase inhibitor (binds to pyrophosphate binding site of enzyme) - pyrophosphate analog
- uses: CMV retinitis in IC in pt refractory to ganciclovir
- tox: nephrotox!!!
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Protease inhibitors
- saquiNAVIR, ritoNAVIR, indiNAVIR, nelfiNAVIR, ampreNAVIR (-NAVIR)
- Mech: Block protease in progeny virus
- tox: GI intolerance, hyperclycemia, lipodystrophy - fat redistribution"NAVIR tease a protease"
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Reverse transcriptase inhibitors: NUCLEOSIDES (NRTI)
- Zidovudine: BM supression - megaloblastic anemia (used in PREGNANCY to reduce transmission to fetus)
- didanosine: Pancreatitis
- zalcitabine: peripheral neuropathy
- lamivudine, abacavir
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Reverse transcriptase inhibitors: NON-NUCLEOSIDES (NNRTI)
- Nevirapine: Cyp450 inducer
- Efavirenz: CNS - delusions, nightmares
- Delavirdine
- Never Ever Deliver Nucleosides
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RTI's (NNRTI, NRTI)
- Mech: inhibit RT of HIV. Prevent incorporation of viral DNA into host DNA.
- tox: BM suppression, etc - Can avoid with GM-CSF
- uses: HAART therapy
-
Fusion inhibitors
- Enfuvirtide
- mech: bind viral gp41 subunit, inhibit fusion, block entry and replication
- tox: HS reactions, incr risk of bacterial pneumo
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