Drug MOA Uses Forms AE Resistance Other Characteristics

ANTIHERPETICS
(Aint For Valentines, Goes Forever)
Acyclovir(Zovirax) HSV, VZV IV IV form: Crystalluria, Due to Thymidine kinase
Oral Neurotoxic changes in converts it to
Topical DNA acyclovir mono-
(-) DNA Polymerase then acyclovir
Polymerase→ triphosphate
DNA chain (active form)
Famciclovir & Valacyclovir termination HSV, VZV More expensive
*against strains than acyclovir
resistant to acyclovir
but NOT to TK strains
Ganciclovir (-) DNA HSV, VZV, CMV Retinal Dose-limiting Due to
Polymerase→ (prophylaxis + tx) implant HEMATOTOXOCITY (↓WBC, changes in
Ganulocyte(granulocyte) DOES NOT *CMV Retinitis IV plt) DNA
– WBC, thus CAUSE DNA Oral Mucositis, fever, rash, Polymerase
hematotoxicity chain Crystalluria, Seizures
termination
Foscarnet (-) DNA and RNA HSV, VZV, CMV IV Dose-limiting Common: Seizures
Polymerases→ NEPHROTOXICITY with ATN as AE
foscar
NEThrotoxicity DNA chain *identical to (acute tubular necrosis),
termination Ganciclovir, but > electrolyte imbalance, ↓Ca =
activity versus tremors and Seizures
acyclovir-resistant
strains of HSV

ANTIMYXOVIRUS
(viral nucleic acid synthesis inhibitors)

Ribavirin (-)viral RNA Aerosol HEMATOTOXIC, upper airway Teratogenic, CI to

Polymerase and RSV (respiratory Topical irritation preggy
end capping of syncytial virus)- CROUP,
viral RNA Infuenza A & B, Lassa
fever (Lassa virus of
arenaviridae),
hantavirus, adjuncts to
IFN-α in Hepatitis C

MINA, J.A
Made for Section 2B 2012
Drug MOA Uses Forms AE Resistance Other Characteristics

ANTI-RETROVIRUS
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
 Components of the most combination drug regimens used in HIV infection
 Use 2 NRTIs + PI (protease inhibitor)
 Used in HAART (highly active antiretroviral therapy)
*peripheral neuropathy- most common SE
Zidovudine/ZDV HIV-1, HIV-2, HTLV-1 Oral Dose-limiting HEMATOTOXICITY (PMN, Hematotoxic→ needs
(Azidothhmidine/ AZT) RBC, Plt), HA, asthenia, myalgia, blood transfusion
myopathy, peripheral neuropathy,
lactic acidosis
Didanosine/ddI HIV-1, HIV-2 Pancreatitis (major, dose-limiting),
(-) peripheral neuropathy, hyperuricemia,
liver, dysfunction
Mutation
Zalcitabine/ddC
Reverse HIV-1, HIV-2, HBV Peripheral neuropathy (major, dose-
limiting), GI distress, pancreatitis, in the
“Salisi (Zalci) gang will
Stab You (Stavu) causing
neutropenia, rash genes that peripheral neuropathy;
Stavudine/d4T Transcrip HIV-1, HIV-2 Peripheral neuropathy (major, dose- Salisi (Zalci) gang will
limiting), myelosuppression < ZDV codes RT also eat your Lomi
Lamivudine/3TC tase (RT) HIV-1, HIV-2, HBV LEAST TOXIC of NRTIs, but some GI (Lami) infected with
Hepa B”
effects and neutropenia

*Peripheral neuropathy
= Zalci + Stavu
*Hepa B = Zalci + Lami
Non-nucleoside RTIs (Non-NRTIs)
 Resistance emerges if used individually, thus used in combination with HAART
 “add-on” (the mistress, kabit, other woman, paramour)
 Additive/ synergistic against HIV
Protease Inhibitors
Indinavir (indi na virgin) Nephrolithiasis, GI distress, plt, (-) P450
Ritonavir (-) HIV GI distress, asthenia, paresthesia, (-
HIV-1, HIV-2
aspartate *In combination with 2 NRTIs
)P450
Saquinavir [Least toxic, very low oral
protease bioavailability]
Viral Neuraminidase Inhibitors
Oseltamivir Oral Nausea, vomiting Given in patients with
TUMMY FLU (i.e during
influenza A and B outbreak of H1N1)
Zanamivir (-) neuraminidase of Aerosol Nasal and throat irritation
*prophylaxis, ↓duration of
influenza A and B
flu symptoms by 2-3 days

NOTES:
>HEMATOTOXIC – Ganciclovir (WBC,plt), Ribavirin, ZDV/AZT (PMN, RBC, Plt),
>Crystalluria – Acyclovir, Ganciclovir

MINA, J.A
Made for Section 2B 2012