Antivirals


Acyclovir

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

Video Credit: USMLE Pass


Nirmatrelvir/Rionavir

Rapid Review

Pearls

Video Credit: MED CRAM


Oseltamivir

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

Video Credit: Drug Talk


Remdesivir

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

Video Credit: ICU Advantage
Brandon Simpson, PA-C
Latest posts by Brandon Simpson, PA-C (see all)