Left part is for HIV, right part is for other virus.

Tip

See HIV therapy for NRTIs and NNRTIs…

Oseltamivir, zanamivir

• Inhibit influenza neuraminidase → ↓ release of progeny virus.
  • A viral enzyme that cleaves neuraminic acid residues from glycoprotein, which results in viral release from the host cell. Found in influenza virus.
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Guanosine analogue

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Acyclovir, famciclovir, valacyclovir

• Guanosine analogs.
• HSV/VZV-coded thymidine kinase monophosphorylates the guanosine analogue to an active intermediate → phosphorylation by cellular kinases → acyclovir triphosphate (ACV-TP)
• The phosphorylated drug is incorporated into the replicating viral DNA strand → inhibition of viral DNA polymerase via chain termination
• Mechanism of antiviral resistance: Mutation of viral thymidine kinase

Ganciclovir, Valganciclovir

• Phosphorylation to 5’ monophosphate by the CMV-coded UL97 kinase → further phosphorylation to triphosphate by cellular kinases

Foscarnet, Cidofovir

Inhibits viral DNA polymerase

• Indications
  • CMV retinitis in immunocompromised individuals (e.g., patients with AIDS)
  • Acyclovir-resistant HSV
• Adverse effects
  • Common: nephrotoxicity
  • Foscarnet: hypocalcemia, hypokalemia
    • Foscarnet can chelate calcium.