1. Antiviral agents

2. Viruses treatable with antiviral drugs
HSV
VZV
CMV
HIV
Influenza A and B
Respiratory syncytial virus (RSV)
Hepatitis A, B, and C viruses (HAV;HBV;HCV)
Papilloma
Picornavirus

3. Agents active against Herpesviruses-I
Acyclovir
Cidofovir
Famciclovir and penciclovir
Foscarnet
Fomivirsen

4. Agents active against Herpesviruses-II
Ganciclovir
Valacyclovir
Valganciclovir
Vidarabine
Topical agents: -Trifluridine
-Vidarabine

5. Revolution in the field of Infectious diseases:
The availability of
Increasing number of antiviral agents
Against a broadening spectrum of viral pathogens

6. Mechanism of action of antiviral agents
is essential ,
for appropriate clinical use and
for understanding and managing antiviral resistance !

7. Acyclovir HSV encephalitis Neonatal HSV infection Primer genital HSV
Mucosal and cutaneous HSV-1 and HSV-2 infections in immunocompromised patients
VZV infection
Recurrent genital herpes

8. Acyclovir resistance Mutation either in viral TK or
DNA polymerase genes.

9. Cidofovir Broad activity: -adenoviruses -herpesviruses -papovaviruses
-poxviruses

10. Cidofovir
Prophylaxis and treatment of CMV retinitis in patients with AIDS
Acyclovir and foscarnet resistent HSV infections

11. Famciclovir and Penciclovir
DNA polimerase inhibitor
Nucleoside analogue
Famciclovir: synthetic
Active metobolite: penciclovir
1% topical penciclovir

12. Famciclovir Singles (acute zoster) Genital HSV
Mucocutaneous HSV in HIV infected patients

13. Foscarnet Pyrophosphate analogue DNA polymerase inhibitor RT inhibitor
Active agains all herpesviruses, HIV, HBV

14. Foscarnet CMV retinitis in AIDS patients
Acyclovir resistant mucuccutaneous HSV infections in AIDS patients
Gancyclovir resistant CMV pulmoner infections in AIDS patients
Acyclovir resistant VZV infections in AIDS patients

15. Fomivirsen
Inhibits viral replication by antisense mechanism: its a nucleotide sequence which is complementary to a sequence in mRNA transkript and translation is inhibited.
Intravitreal injection for CMV retinitis

16. Ganciclovir Guanoside analogue DNA polimerase inhibitor
Similar to acyclovir
i.v, oral and intraocular application

17. Ganciclovir Prevention and treatment of CMV retinitis in AIDS patients
CMV disease in transplant patients

18. Valacyclovir
Active metobolite= acyclovir

19. Vidarabine Nucleosid analogue First licensed systemic antiviral agent
Acyclovir has supplanted vidarabine

20. Topical agents for HSV keratitis
Trifluridine
Vidarabine

21. Interferons Low molecular weight proteins
With complex antiviral, immunomodulating, antiproliferative activities.
Produced by eucaryotic cells in response to various inducers: viruses
3 types: IFN-a, IFN-β , INF- δ
IFN-a2b: widest application
Pegilated- IFN-a: + polyethylene glycol to the interferon, through a process known as pegylation, enhances the half-life of the interferon when compared to its native form.

22. HIV(Human immunodeficeincy virus)
Nucleoside analogue reverse transcriptase inhibitors:Zidovudine (azidothymidine)
Non- Nucleoside analogue reverse transcriptase inhibitors
Protease inhibitors
Fusion inhibitors
Integrase inhibitors

23. Hepatitis C: Interferon-a, ribavirin
Hepatitis B: INF-a, lamivudine (reverse transcriptase inhibitor), adefovir, …
Papillomavirus: Interferon-a
RSV: Ribavirin
CMV:ganciclovir, foscarnet
VZV: valacyclovir, famciclovir
Picornavirus: pleconaril

24. Anti-influenza drugs Influenza A: Amantadine Rimantadine
2. Influenza A and B
Zanamivir: enzyme inhibitors of neurominidase, virus release is inhibited.
Oseltamavir: the same
The length of disease is reduced if taken within the first 48hours