Obat anti virus

Mechanism of action
• Antiviral→monophosphate→diphosphate
→ triphosphate(active form)
• Triphosphate incorporated into viral
DNA chain termination stop DNA
synthesis
• TP form  competitive inhibitor of reverse
transcriptase/ DNA polymerase
 Anti herpesvirus
• Acyclovir
• Famciclovir
• Valaciclovir
• Ganciclovir
• Idoxuridine,trifluridine
• Foscarnet,sidofovir,brivudine,fomivirxene
 Anti herpes agents
• Acyclovir, valacyclovir
• Ind: HSV-1& HSV-2 incl labial,genital,
neonatal, encephalitis, keratitis, and VZV
• SP : pregnancy,lactation,renal function↓
• AR : GI disturb, skin rash, headache,
neurological effect
• Dosage
 Famciclovir

• Acute herpes zoster and acute genital

herpes infections(HSV-1&2)
• CI: pregnancy, lactation
• SP: impaired renal function
• AR: nausea, headache
• Dose: 3x250 mg for 7 days
 Ganciclovir
• Ind: life/sight-threatening CMV infection in
immunocompromised patient(AIDS)
• Prevention of CMV inf in patient with organ
transplant
• CI: pregnancy, lactation, severe
neutropenia
• AR: fever, rash, leucopenia,anemia,
thrombositopenia
• Dose: 5 mg/kg infused 12 hrly 14 days
maintenance: orally 3 gr/day(3x4
caps)
 Brivudine
• Ind: HSV-1& VZV infection
• Inhibiting competitively viral DNA
polimerase & alternative substract.
• Mechanism action specific
phosphorylation by timidine kinase HSV-1
and VZV
• Dose: 125mg/day(1x) herpes zoster
keratitis&labialis herpetictopical
 Sidofovir
• Inhibiting viral DNA synthesis by stopping
chain elongation
• Active form: sidofovir diphosphate
competitive inhibitor & alternative
substract of viral DNA polymerase
• Ind: CMV retinitis in AIDS patients,
acyclovir-resistant HSV, CIN-III,
papillomatosis lesion, moluscum contag.
• Dose: -IV 5mg/kgBW/ week (2x)
5mg/BW/ 2 week
-Topical: cream, gel 1%
 Antiretrovirus
• NRTI(nucleoside RT inhibitor)
• NNRTI(non nucleoside RT inhibitor)
• NtRTI(nucleotide RT inhibitor)
 Antiretrovirus
• Zidovudine
• Zalcitabine
• Stavudine
• Didanosine
• Abacavir
• Nevirapine, delavirdine, efavirenz
• Ritonavir, nelfinavir, saquinavir,
amprenavir,lopinavir,indinavir,
 zidovudine
• Ind: asymptomatic and symptomatic HIV
inf, advanced inf w/ AIDS or AIDS
related complex, CD4< 200/mm3
• CI : neutrophil< 750/mm3 or Hb < 7,5 g%
• AR: anemia, netropenia,etc
• D : Start with 200 mg/ 4 hrly
 Didanosine
• Nucleoside Reverse Transcriptase
Inhibitor(NRTI)
• Ind: advanced HIV inf (prolonged prior
ZDV therapy)
• Resistance: mutation on reverse transcript
• AR: diarrhea,pancreatitis, neuropathy
• Dose: 400mg daily, single or in divided
doses
 Stavudine

• Ind : HIV infected patient

• AR : headace, neuropathy,SGOT/SGOT↑
• SP: pregnancy, laktation, elderly, renal↓
• Dose: adult > 60 kg 40 mg, < 60 kg 30 mg,
taken 2 times daily
child(< 30 kg) : 2 mg/kg/day
 Nevirapine
• Ind : HIV-1 inf in combination w/ other
anti retroviral agents, prevention mother-
to-child HIV transmission in pregnant
women
• Dose : prevention 200mg during labour,
 neonate: 2 mg/kg within 72 hr
after birth
• 200 mg—14 days, then 2x200 mg
• AR: GI effect, skin rash, fatigue
 Other antiviral agents
• Lamivudine
• Telbivudine
• Adefovir
• Tenofovir
• Interferon/pegylated interferon.
• ribavirin
• Zanamivir,oseltamivir
• Amantadine,rimantadine
 lamivudine
• Indication: HIV and HBV
• Inhibit RT & DNA polimerase activity
• SP: liver,renal dis,pregnancy, lactation
• AR: headache, GI disturb
• Tab 150 mg(3TC) & 100 mg( 3TC-HBV)
• Used in combination w/ zidovudine(HIV),
dose: 2x150 mg(adult) ,child: 4 mg/kgbw
 Ribavirin
• Ind : RSV(pneumonia), chronic hep C
• Inhibits replication of DNA&RNA virus
• AR : hemolysis,anemia,rigor
• Dose: - RSV→aerosol(nebulizer)
20 mg/ml
1,4 mg/kgbw/hour,12-18 hr/day
for 3-7 days
- HEP viral : < 75 kg: 1000 mg/day
> 75 kg: 1200mg/day
 Interferon/peginterferon
• Ind : chronic hep B and C
• Inhibiting RNA transcript, protein
synthesis, and assembly of the virus
• AR : fever, headache, fatigue, GI disturb,
alopecia
• D : peginterf alfa 2a: 180mcg/wk---- 6-12
mth( + ribavirin for hep C)
peginterf alfa 2b: 1-1,5mcg/kg/wk
6-12 mth(+ ribavirin for hep C)
 Anthelmintic drugs
• Piperazine
• Pyrantel pamoate
• Mebendazole
• Albendazole
• Tiabendazole
• Praziquantel
• Diethylcarbamazine
 piperazin
• Ind: ascariasis & E. vermicularis
• Memblokade respon otot cacing thd
asetillolin paralisis
• Absorpsi sal cerna baik
• ES: ggn sal cerna,alergi, skt kepala,
pusing me↑ kejang pd epilepsi
• KI: epilepsi, ggn hati&ginjal
 pirantel pamoat
• Ind: ascaris, ankilostomiasis, enterobiasis
• MK: me↑ frekwensi impuls otot cacing
• Kombinasi dng oksantel pamoat
• Absorpsi sal cerna tidak baik
• ES: sal cerna,demam, skt kepala,ggn hati
 SGPT/SGOT 
 mebendazol
• Spektrum antelmintik plg luas
• MK: -hambat glucosa uptake pd cacing
- hambat sekresi kolinesterase
- sterilisasi telur cacing
• Absorpsi oral buruk
• ES: ringan(diare, skt perut)
• Dosis: 2x100 mg selama 3 hr/ 500 mg SD
 Albendazol
• MK: blokade ambilan glukosa cacing
• Ind: kremi, gelang, trikuris, tambang, dan
S. stercoralis
• Pilihan u/ peny hidatid & sistiserkosis
• Dosis: SD 400 mg inf berat: 2-3 hr
• Peny hidatid: 800mg/hr 30 hr, diulang
2-3x interval 2 mg
• Sistiserkosis: 15mg/kgbb/hr 1 bln
 Dietilkarbamazin
• Drug of choice u/ filariasis
• MK: - me↓ aktivitas otot paralisis
- membranolitik efek
• Absorpsi oral baik
• ES: pusing, malaise, nyeri sendi, alergi
 matinya parasit/substansi parasit
• Dosis: 6 mg/kgbb/hr  2 mg
 Prazikuantel
• Efektif pd cestoda dan trematoda
• MK: vakuolisasi dan vesikulasi tegumen
cacing isi cacing keluar hancur oleh
mek pertahanan tbh hospes
• Absorpsi oral baik
• ES: skt kepala, pusing, sedasi, fatigue
• Schistosomiasis: 30-40mg/kgbb SD
• Taeniasis: 10 mg/kgbb, dosis tunggal
• Indication
• Mechanism of action
• Presentation/packing
• Dose