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    Antivirusni 2

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    Pavle Nastasic
    The document discusses various antiviral drugs used to treat different viral infections. It covers drugs that target influenza viruses like amantadine, zanamivir, and oseltamivir. It also discusses acyclovir which is used to treat herpes infections. Antiretroviral drugs used to treat HIV are covered, including nucleoside analogs, non-nucleoside analogs, protease inhibitors, and their combinations in HAART therapy. Drugs to treat CMV like ganciclovir and foscarnet are mentioned. Other antiviral drugs discussed include ribavirin and interferons.

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    Antivirusni 2

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    Pavle Nastasic
    30 views18 pages
    The document discusses various antiviral drugs used to treat different viral infections. It covers drugs that target influenza viruses like amantadine, zanamivir, and oseltamivir. It also discusses acyclovir which is used to treat herpes infections. Antiretroviral drugs used to treat HIV are covered, including nucleoside analogs, non-nucleoside analogs, protease inhibitors, and their combinations in HAART therapy. Drugs to treat CMV like ganciclovir and foscarnet are mentioned. Other antiviral drugs discussed include ribavirin and interferons.

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    antivirusni.2

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    The document discusses various antiviral drugs used to treat different viral infections. It covers drugs that target influenza viruses like amantadine, zanamivir, and oseltamivir. It also discusses acyclovir which is used to treat herpes infections. Antiretroviral drugs used to treat HIV are covered, including nucleoside analogs, non-nucleoside analogs, protease inhibitors, and their combinations in HAART therapy. Drugs to treat CMV like ganciclovir and foscarnet are mentioned. Other antiviral drugs discussed include ribavirin and interferons.

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    30 views18 pages

    Antivirusni 2

    Uploaded by

    Pavle Nastasic
    The document discusses various antiviral drugs used to treat different viral infections. It covers drugs that target influenza viruses like amantadine, zanamivir, and oseltamivir. It also discusses acyclovir which is used to treat herpes infections. Antiretroviral drugs used to treat HIV are covered, including nucleoside analogs, non-nucleoside analogs, protease inhibitors, and their combinations in HAART therapy. Drugs to treat CMV like ganciclovir and foscarnet are mentioned. Other antiviral drugs discussed include ribavirin and interferons.

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    of 18

    NTIVIRUSNILEKOVI ogranienenzimskisistemvirusa )Lekovi protiv virusa Influence A i B ) Amantadin

    -uThiprofilaksigripa-virusinfluenceA -Dobraresorpcija,eliminiese>90%neprom. bubrezima,T=12h(>>insuf.bubrega, kumulacija) -Hemioprofilaksa,Thparkinsonizma(poveava oslobaanjeDA) Neeljenadejstva:glavobolja,nesanica,ataksija

    ) Zanamivir inhibitorneuraminidaze(povrinskiglikoprotein) inhprimenatopre2x10mg5dana(oprezkod starih,trudnica,astme) -virusinfluenceAiB(24-48hodpoetka simptoma)

    -derivat gvanozina, inhibiesintezu virusneDNA.U elijisefosforilie poddejstvom virusnetimidinkinaze. Fosforilisani aciklovirdeluje kaokompet. inhibitordeoxiGTPi ireverzibilno inaktivievirusnu DNApolimerazu

    herpessimpleksinfekcije(sistemski,lokalno), variela,profil.pritransplantacijiorgana Po(200-400mg/4-5x/dan),i.v.(5mg/kg/8h),lok. suzbijairenjeinfekcijealisenepostie eradikacijavirusa moeserazvitirezistencija

    3.LekoviuterapijiHIVinfekcije: 1)inhibitorireverznetranskriptaze a) analozi nukleozida(zidovudin,didanozin, zalcitabin,stavudin,lamivudin,abakavir) b) nenukleozidni inhibitori(nevirapin, efavirenz) c) nukleotidni inhibitori(tenofovir) 2)inhibitorivirusneproteaze (sankvinavir,ritonavir,indinavir,nelfinavir, amprenavir,lopinavir)

    ) Zidovudin (azidotimidin) inhibiereverznutranskriptazunukleozida(aktivni metabolititrifosfata)-nastajudefektnilanciDNK dobraresorpcija,raspodelaiucerobrospinalnutenost, 75%sekonjugujeujetriaoko20%nepromenjen eliminiebubrezima uThHIVinfekcija(200mg/4h)iukombsainh.proteaza supresijakostnesri,glavobolja

    c) Lamivudin -analogcitidina,poredinhreverznetranskriptaze inhibieihepatitisBpolimerazu -umonoterapijihroninoghepatitisaB=100mg/danp.o. iThHIVinfekcija(ukombinaciji)

    Nenukleozidni inhibitori(nevirapin,efavirenz) Indikacija:progresivnaHIVinfekcijaukomb.sadrugim lekovima Neeljenadejstva:ospa,oteenjejetreiCNS-a

    nhibitori virusne proteaze


    nastaju nezrele estice HIV koje nisu infektivne) ndinavir, Ritonavir, Sankvinavir slabaresorpcija(BI=4%),98%sevezujezaproteine plazme,metabolieseujetriieliminieprekoui,slabo prolaziHEB

    Antiretrovirusnoleenje
    Cilj:postiipoboljanje(kliniko,virusoloko, imunoloko,farmakoloko) -HAART(highlyactiveantiretroviraltreatment) (smanjenjeumnoavanjaHIV-anamanjeod50 kopijaHIV1RNKumLplazme,smanjuje pojavuoportunistikihbolesti,smanjujesmrtnost ipopravljaimunolokistatus-CD4+Tly)

    Neeljenadejstvaantiretrovirusnogleenja: -analozinukleotida(laktana acidoza sa steatozom jetre) -nenukleozidnianalozi(osip po koi, StevensJohnsonov Sy) -inhproteaze(metaboliki poremeaji: hiperglikemija, rezistencija na insulin, poveanje Hol i TG) HAART:vea uestalost CVS komplikacija, avaskularna nekroza kostiju -hepatotoksinost

    UThkombinovanaprimena: dvaanaloganukleozida(zidovudin + lamivudin, didanozin; stavudin + lamivudin, didanozin) ...sanenukleozidnimanalogom(efavirenz) ...iliinh.proteaze(lopinavir, indinavir, sankvinavir + ritonavir)

    ) Lekovi protiv CMV ) Ganciklovir derivataciklovira,specifiniinhibitorDNApolimeraze CMV uThozbiljnihinfekcijacitomegalovirusom(retinitis, pneumonija,GIT) depresijakostnesri,oteenjebubrega,konvulzije ) Foskarnet

    ) Ostali antivirusni lekovi ) Ribavirin inhibiereplikacijuRNAiDNAvirusa,ometa formiranjegvanidin-MPisledstvenusintezuNK Threspir.sincic.virusakoddece(aerosol) 20mg/ml12-18hdnevno3-7dana;

    b)Interferoni (IF) -IFkojeprodukujeelijainficiranavirusom (tipI) -IFkojeprodukujuLyutokuimunog odgovora(tipII) ->otpornostelije,nisuspecifinizavirusve zavrstukojaihstvara,javljajusenekolikohpo nastankuinfekcijeizadravajunekolikonedelja poozdravljenju

    umaniIF: IFalfa(humanileukocitniIFtipI) IFbeta(humanifibroblastniIFtipI) IFgama(humaniimuniIFtipII) uThvievirusnihinfekcijaineoplazmi(herpes zosterkodCA,hroninihepatitisBiC,leukemije, Kapoijevsarkom106-109IJ/iv/dan

    eeljenadejstva:GITtegobe,alergijskereakcije, mijelotoksinost,nefroihepatotoksinost, neurotoksinost

    ) gama-globulini ogudasadrespecif.AtprotivpovrinskihAg nekihvirusa-morbili,hepatitis,besnilo,polio; rotektivnodejstvo2-3nedelje

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