Antivirals

Rapid Review

• Mechanism of Action: Antiviral; inhibits DNA polymerase
• Indications: Commonly used to treat oral/genital herpes, varicella, zoster (shingles), and VZV encephalitis.
• Contraindications: allergy to class/drug
• Dosage: depends on condition; common dosage is 800mg PO 5x/day x 7 days.
• Half-life: 2.5 – 3.3 hours
• Adverse Reactions: Common side effects include N/V, headache, and rash. Serious reactions include hallucinations/psychosis
• Special Considerations: N/A

Pearls

Deep Dive

• Acyclovir (WikEM)

Rapid Review

Pearls

Deep Dive

• Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with COVID-19 (PubMed)

Rapid Review

• Mechanism of Action: Antiviral; competitively inhibits the influenza virus neuraminidase, preventing viral replication.
• Indications: Acute, uncomplicated influenza A or B
• Contraindications: Hypersensitivity
• Dosage: 75 mg PO BID x 5 days (adjust dose based on kidney function)
• Half-life: 1-3 hours
• Adverse Reactions: Nausea, vomiting, abdominal pain
• Special Considerations: Greatest benefit when taken within 48 hours of symptom onset

Pearls

Deep Dive

• Oseltamivir (PubMed)

Rapid Review

• Mechanism of Action: Antiviral; broad spectrum antiviral agent reduces virus production via disruption of viral RNA polymerase
• Indications: COVID-19
• Contraindications: Hypersensitivity, ALT levels > 5x upper limit of normal, severe renal or hepatic impairment
• Dosage: 200 mg IV loading dose, followed by 100 mg IV daily X 5-10 days
• Half-life: 1-1.3 hours
• Adverse Reactions: Nausea, increased ALT/AST, diarrhea, hypokalemia

Pearls

Deep Dive

• Remdesivir (PubMed)