![References [1] Han Tingting, Guo Le, Shen Yuanying. Research progress of MicroRNAs in regulating host antiviral natural immunity [J]. Frontiers of Microgenesis, 2019, 8:15-21.doi:10.12677/AMB.2019.81003. [2] Li Shuchun. Clinical efficacy and adverse reaction analysis of AIDS anti - DayDayNews](https://cdn-dd.lujuba.top/img/loading.gif)
2. Characteristics of effects of common antiviral drugs [2]
(1) Ribavirin (triazole nucleoside, virzole): It is a broad-spectrum antiviral drug. It is effective against influenza A and B virus (Influenza), parainfluenza virus (PIV), adenovirus (ADV), respiratory syncytial virus (RSV), herpes virus, measles virus, chickenpox virus, mumps virus, etc. There are few adverse reactions to oral medications, occasionally with digestive tract reactions, dizziness, and rashes. Large doses of intravenous administration can cause leukopenia, anemia, , immunosuppression and abnormal liver function.
(2) Adenosine arata: an anti-DNA viral drug, which has a significant inhibitory effect on various DNA viruses such as herpes simplex virus (HSV), varicella zoster virus, hepatitis C virus (HCV). It can also be used for the treatment of HIV-related shingles, varicella, and chronic hepatitis B. topical use can treat herpes keratitis. Side effects include adverse neurological reactions, which may cause ataxia, myalgia, etc., and may also cause nausea, vomiting, abdominal pain and mastectomy. It can be restored after stopping the medication.
(3) Acyclovir (acyclic guanosine, ACV): It is a synthetic acyclic nucleoside, belongs to an anti-DNA viral drug, and is an important broad-spectrum antiviral drug, mainly used to treat herpes simplex virus (HSV) meningitis, skin HSV infection, herpes keratitis, and genital herpes. Because it has a certain effect on varicella zoster virus, EB virus, cytomegalovirus and hepatitis B virus, it can also be used for its treatment. Side effects include diarrhea, headache, nausea, vomiting, etc., and may also cause allergic symptoms such as rash, urticaria and fever. It can also cause increased liver enzymes and creatinine, leukopenia, and anemia. It should be used with caution during neutropenia.
(4) Ganciclovir (propoxyguanosine, GCV): is an anti-DNA viral drug that can be converted into activated triphosphate under the action of viral thymidine kinase and cell kinase. The concentration of activated GCV in infected cells is 100 times higher than that in non-infected cells and can last in cells for several days. It is a first-line drug for severe cytomegalovirus (CMV) infection in children and is not prone to drug resistance. Oral absorption is poor, mainly used for intravenous injection. Side effects are that myelosuppression can cause the decline of granulocytes and platelets, which can be restored after stopping the medication; other side effects include digestive tract reactions, rashes, fever, arrhythmia, etc.
(5) Vanelovir (valacyclovir, VCV): an anti-DNA viral drug, which was recently approved for herpes zoster and recurrent genital HSV infection. It is easy to absorb orally and is widely distributed after absorption, with high concentrations in the digestive tract, kidney, liver, lymph nodes and skin. Studies on pharmacokinetics and safety in children have not been completed and children are expected to be well tolerated. Side effects include headache, nausea, vomiting, diarrhea, etc.
(6)Faciclovir (faciclovir, FCV): is an anti-DNA viral drug, a purine nucleoside analog, recently approved for use in shingles and recurrent genital HSV infections, with side effects such as headache and nausea. The medication used in children has not been evaluated.
(7) Lamivudine (LAM): is a pyrimidine nucleoside analog, which mainly extends and terminates the DNA strand by incorporating newly synthesized viral DNA, and can also compete to inhibit viral DNA polymerase. It is mainly suitable for patients with chronic hepatitis B. Acute hepatitis is generally not used and can be quickly absorbed by oral administration. During the medication period, liver function and blood routine should be monitored, and the medication should be stopped after 1 year of treatment without effect.
(8) Others: Cytarabine is mainly used for CMV infection, and its 0.1% eye drop is used to treat keratitis; azidethymidine: an anti-HIV drug, effective for early HIV infection and AIDS-related syndrome; use less than pediatrics.
3. Introduction to newly discovered nucleoside antiviral drugs in recent years [3]
(1) Alovudine (3'-deoxy-3-fluorohimide, MIV-310, FLT, etc.) is a pyrimidine nucleoside analog, and has a strong anti-nucleoside reverse transcriptase inhibitor (NRT1) in vitro, including zidovudine-resistant HIV-1 virus.
(2) Emtricitabine: First approved for listing in the United States in July 2003. It is a novel nucleoside reverse transcriptase inhibitor and has antiviral activity against HIV-1, HIV-2, and hepatitis B virus (HBV).
(3) Adefovir diisovaleryloxymethyl ester (ADV for short) is a novel non-cyclic nucleoside analogue of anti-HBV drug.September 2002, approved by the U.S. FDA for marketing, is another oral anti-HBV drug after lamivudine. ADV is a phosphonucleotide analog of adenosine monophosphate. Preclinical antiviral studies have shown that ADV has strong antiviral activity against HBV, duck hepatitis B virus (DHBV), American marmot hepatitis virus (WHV), and other anti-HBV virus variants such as lamivudine.
(4) entecavir is a new type of carbocycle 2'-deoxyguanylate analog and is currently the most effective anti-HBV drug. Entecavir has not found any virus resistance in the current study. Studies have found that entecavir is an effective inhibitor , a DHBV infected in duck liver cells, and is well tolerated.
(5) Cidofovir: It is a broad-spectrum antiviral drug that can inhibit a variety of DNA viruses. It is clinically used to treat HSV?types 1 and 2, varicella zoster virus, CMV, EB virus, and human papillomavirus infection. The advantage is that the half-life is long and can reduce the number of medications taken. Side effects are obvious, common are granulopenia and irreversible dose-dependent nephrotoxicity. The pharmacokinetics and safety of children's applications have not been studied yet, and the application of children's cases should be extremely cautious.
(6) Adefovir: is a broad-spectrum antiviral drug, which is a purine nucleoside analog, used to treat chronic hepatitis B, AIDS, herpes virus infection, ADV, etc., and is effective for lamivudine and famciclovir resistant patients. The main side effects are nephrotoxicity and interference with toxic alkalone metabolism, and the pharmacokinetics and safety study of children is in the I stage.
(7) Adamantamide: It is an anti-RNA viral drug that inhibits viral replication by preventing virus dehumidification and nucleic acid release. It is mainly used to treat and prevent infection of type A Influ. The oral absorption is complete, and the drug is distributed more frequently in the nasal secretions, saliva, and lungs. Side effects include drowsiness, fatigue, anxiety, ataxia, heart failure, orthostatic hypotension, leukopenia, rash, etc.
(8) Adamantine: It is an anti-RNA viral drug, targeting Influ, with few side effects and rarely used in China.
(9) Sodium phosphate formate (PFA) is a non-nucleoside antiviral drug that can inhibit the synthesis of DNA and RNA. It has an inhibitory effect on CMV, varicella zoster virus, type B, type C, hepatitis D virus, Influ, HIV and type B encephalitis viruses. Oral absorption is poor, and it must be administered intravenously. It is widely distributed in the body, distributed in cerebrospinal fluid, bone, kidney, lung, heart, etc., and excreted from the urine. Adverse reactions are nephrotoxicity, and may also include anemia, hypocalcemia, hyperphosphatemia, thrombophlebitis, fever, headache, etc.
(10) Dipyridamole (Panshengding) is an antiplatelet drug that inhibits DNA and RNA viruses and is used to treat viral upper respiratory tract infections and pharyngitis caused by measles in children.
(11) Neuraminidase (NA) inhibitor NA is a glycoprotein on the surface of influenza viruses, which can promote the release of viruses from cells and spread in the respiratory tract. NA inhibitors inhibit the spread of viruses and are effective against both types A and B Influ. Currently, NA inhibitors approved for clinical use include zanamivir and oseltamivir , of which oseltamivir (Daffe) has been approved for use in my country. Some scholars have shown that the application of oseltamivir in the early stage of the disease (within 36 hours) can shorten the course of the disease by an average of 1.5 days, reduce the severity of the disease, reduce the chance of complications by 40%, and quickly relieve influenza symptoms. Research by
Kaiser and others found that oseltamivir can reduce the use of antibiotics in influenza patients, but some scholars have found that a few influenza A patients may develop drug resistance to oseltamivir. The recommended dose for children is 2 mg/kg, 2 times/d, for 5 days, and should be used early within 36 to 48 hours after onset. This drug is safe orally, with mild adverse reactions, including nausea and vomiting. The symptoms are transient. Other adverse reactions include insomnia, headache, dizziness, diarrhea, nasal congestion, etc. In addition, studies have confirmed that zanamivir can reduce the spread of avian influenza virus to lung tissue and completely prevent the spread of the virus to brain tissue. It can be used to treat mammals infected with avian influenza virus and reduce the mortality rate. Oseltamivir can also effectively treat mice infected with avian influenza H5N1 and H9N2.
(12) Interferon is a type of glycoprotein produced by viruses and other interferon inducers that act on certain cells of the body. It has extensive antiviral activity. According to its antigen specificity and molecular structure, IFN is divided into four types: α, β, γ, and ω. Among them, α and γ are the most widely used in clinical practice. α-IFN is a product of helper T cell type I, which inhibits the synthesis of DNA and RNA viruses. It is used to treat chronic viral infections of type B, C, and D, pediatric viral pneumonia, shingles, genital warts and AIDS, etc. Aerosol inhalation and nasal drops are used to treat viral upper respiratory tract infections and influenza. Adverse reactions include fever, chills, fatigue, myalgia, joint pain, occasional gastrointestinal reactions. Some patients may have white blood cells and thrombocytopenia, and other adverse reactions include hair loss, tachycardia, rash, hypertension, mental abnormalities and renal function changes.
References
[1] Han Tingting, Guo Le, Shen Yuanying. Research progress in microRNAs regulating host antiviral natural immunity [J]. Frontiers of MicroRNAs, 2019, 8(01):15-21.doi:10.12677/AMB.2019.81003.
[2] Li Shuchun. Clinical efficacy and adverse reaction analysis of AIDS antiviral drug treatment [J]. Chinese Community Physician, 2017, 33(33):24, 26.doi:10.3969/j.issn.1007-614x.2017.33.11.
[3] Jin Yuji. Observation on the efficacy of nucleoside antiviral drugs in the treatment of hepatitis B cirrhosis [J]. World Clinical Medicine, 2017, 11(2):115.
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