Lecture 4 - Antivirals

Faculty of Nursing, Medicine & Health Science
Solomon Islands National University (SINU)

Diploma of PHARMACY TECHNOLOGY
TOPIC: INFECTIOUS DISEASES
MEDICINES/DRUGS
Lecture 4: ANTIVIRALS
Lecturer: Pressly Junior
Date: 12th JULY 2022
LEARNING OUTCOMES
At the end of the session student should be able

to understand
What is viral and HIV infection
Signs & symptoms of viral and HIV infection
Prevention and Treatment viral and HIV infection
Drug monographs of common drugs used to
treat viral and HIV infection
VIRAL INFECTIONS
Definition: Invasion of the body with viral
pathogens.
Viral infections include: Hepatitis B and C
 Common cold Herpes simplex – cold
Chicken pox sores
Measles Herpes complex
Shingles HIV
SYMPTOMS:
Fever
Pain
Muscle ache
Weakness
Rash
Skin sores
TRANSMISSION
These can be transmitted in different ways,

including
by air,
by touch,
by contaminated water or food
and by sexual intercourse.
TREATMENT
 Viral infections cannot be treated with antibiotics
 Vaccines are given to infants to prevent some viral
infections, including measles, hepatitis and chicken
pox.
 Anti-viral drugs are used to treat viruses.
 Anti-retroviral drugs are used to slow down the
progression of HIV infection.
 There are only a few anti-viral and anti-retroviral
drugs available in the Solomon Islands.
HUMAN IMMUNODEFICIENCY VIRUS
(HIV)
HIV is a type of virus called a retrovirus
It incorporates itself into the genetic material of
cells called 'CD4 white blood cells', which are
part of the immune system.
it enables HIV to replicate.
This leads to destruction of the CD4 cells and
damages the immune system.
A person infected with HIV can develop AIDS
HIV SYMPTOMS
A person may be infected with the HIV virus

without any symptoms.
The HIV virus destroys the immune system and
eventually a HIV-carrier will develop AIDS.
It may take 10 or 15 years before a person
develops AIDS.
HIV SYMPTOMS
The symptoms of AIDS include

weight loss,
diarrhoea, tiredness, weakness
secondary bacterial or fungal infections.
Eventually, a person with AIDS will die.
HIV TRANSMISSION
HIV is carried in the blood, semen, vaginal fluids

and breast milk.
HIV TRANSMISSION
You can become infected with HIV in the

following ways:
 Having sex with an infected person without a
condom
Sharing a needle with an infected person
Getting a blood transfusion of infected blood
Being born when the mother is infected, or
drinking the breast milk of an infected woman.
HIV PREVENTION
To decrease the risk of spreading HIV:
 Use condoms during sexual activity

Do not share needles
If you are HIV-infected and pregnant, talk with
your doctor about taking anti-HIV drugs
If you are an HIV-infected woman, don't breast
feed any baby
Protect cuts, open sores, and your eyes and
mouth from contact with blood.
HIV TREATMENT
There are no drugs that can cure HIV.

Anti-retroviral drugs destroy the HIV DNA
synthesis and help to slow down the spread of
the virus, but they do not completely destroy the
virus.
This is why prevention is so important.
ANTIVIRALS
Guanine analogues
Example: acyclovir
Neuraminidase inhibitors
Examples: oseltamivir, zanamivir
GUANINE ANALOGUES
 Examples: (acyclovir, famiciclovir, ganciclovir,

valiciclovir, valganciclovir)
 Mode of action: Work by inhibitng viral DNA
polymerase and DNA synthesis
 Indication: Used in herpes simplex infections,
shingles and CMV
 Precaution: Contraindicated in those with severe
reactions to the medication
 Adverse effects: nausea, heading and vomiting.
Medication can cause dizziness
NEURAMINIDASE INHIBITORS
Examples: (oseltamivir, zanamivir)

Mode of action: Works by reducining
influenza virus by inhibiting neuraminidase and
viral load
Adverse effects: nausea, vomiting, abdominal
pain and bronchospasm (zanamivir)
Counselling: Take with food with oseltamivir
HIV ANTIRETROVIRALS
 Nucleoside reverse transcriptase inhibitors (NRTIs)

Example: lamivudine, stavudine, zidovudine
 Non-nucleoside reverse transcriptase inhibitors
(NNRTIs)
Example: (delavirdine, efavirenz, nevirapine)
 Protease inhibitors
Examples: atazanavir, darunavir, fosamprenavir
NUCLEOSIDE REVERSE TRANSCRIPTASE
INHIBITORS (NRTIs)
 Example: (abacavir, didanosine, emtricitabine,
lamivudine, stavudine, zidovudine)
 Mode of action: Converted by cellular enzymes to

active phosphorylated metabolites that inhibit viral
reverse transcriptase and viral DNA synthesis
 Indication: Used in HIV in adults and children,

prophylaxis during pregnancy to prevent vertical
transmission of HIV
NUCLEOSIDE REVERSE TRANSCRIPTASE
INHIBITORS (NRTIs)
Adverse effects: headache, nausea, myalgia,
peripheral lipotrophy
Patient Counselling - lactic acid in body can

build up and cause symptoms, tell doctor if
nausea, vomiting fatigue stomach pain occurs
NON-NUCLEOSIDE REVERSE TRANSCRIPTASE
INHIBITORS (NNRTIs)
Example: (delavirdine, efavirenz, nevirapine)

Mode of action: Works by reversibly inhibiting
HIV-1 reverse transcriptase
Indication: Used for HIV infection
Precaution: Contraindicated in those with
serious adverse reactions to individual NNRTIs
Adverse effects: rash, malaise, nausea. Rash
occurs but treatment usually continues unless
severe
PROTEASE INHIBITORS
 Examples: (atazanavir, darunavir, fosamprenavir,
indiavir, lopinavir with ritonavir, nelfinavir,
ritonavir,saquinavir, tipranvir)
 Mode of action: Works by inhibiting HIV-1 and HIV-2
protease, preventing maturation and replication
 Indication: Used for HIV infection
 Precaution: Contraindicated in those with serious
reactions to protease inhibitors
 Adverse effects: headache, diarrhoea, nausea,
vomiting, fat accumulation, weightgain,
hyperglycaemia
REFERENCES
Australian Medicines Handbook, 2013

Pharmacology for Health Professionals
POC module 8A

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Faculty of Nursing, Medicine & Health Science

Solomon Islands National University (SINU)

At the end of the session student should be able

These can be transmitted in different ways,

A person may be infected with the HIV virus

The symptoms of AIDS include

HIV is carried in the blood, semen, vaginal fluids

You can become infected with HIV in the

 Use condoms during sexual activity

There are no drugs that can cure HIV.

 Examples: (acyclovir, famiciclovir, ganciclovir,

Examples: (oseltamivir, zanamivir)

 Nucleoside reverse transcriptase inhibitors (NRTIs)

 Mode of action: Converted by cellular enzymes to

 Indication: Used in HIV in adults and children,

Patient Counselling - lactic acid in body can

Example: (delavirdine, efavirenz, nevirapine)

Australian Medicines Handbook, 2013

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