1. Respiratory virus
(1) Common upper respiratory virus infections are rhinovirus , parainfluenza virus, and respiratory syncytial virus .
(2) Common lower respiratory virus infections are influenza virus , respiratory syncytial virus, and parainfluenza virus.
(3) The elderly should be vigilant about respiratory syncytial virus infection.
(4) Common virus types and clinical manifestations
Common virus types and clinical manifestations | |||
V | type | type | clinical manifestations |
human rhinovirus | single strand positive chain RNA virus | Nerve congestion, Rhinitis and Top soreness , bronchiolitis and AECOPD | |
Respiratory syncytial virus | negative single-strand RNA virus | influenza -like manifestations, lower respiratory tract infection | |
human parainfluenza virus html l2 | Single-stranded RNA virus | Mild Upper respiratory tract infection , lower respiratory tract infection mostly coexist with underlying diseases and is prone to mixed infection | |
html l3 people influenza virus | single-strand negative RNA virus | high fever, fatigue, headache, cough, and soreness of the body, and other symptoms of systemic poisoning are mainly mild, while respiratory symptoms are milder | |
human metapneumovirus | single negative strand RNA virus | acute upper and lower respiratory tract infection, causing bronchiolitis or pneumonia | Acute upper and lower respiratory tract infection, causing bronchiolitis or pneumonia |
Enest Virus | Hydrogen RNA Virus | Hydrogen RNA Virus | Acute upper respiratory tract infection or pharyngeal sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur sulphur |
Avian influenza virus | Single-stranded negative-stranded RNA virus | Initial manifestation is influenza-like symptoms , lesions When the condition is serious or develops rapidly, it shows respiratory symptoms such as chest tightness and dyspnea | |
SARS-CoV | single strand positive chain RNA virus | influenza-like symptoms, including fever exceeding 38℃, myalgia, difficulty breathing, and often no upper respiratory tract calorie symptoms, chest X-ray infiltration | |
Novel coronavirus SARS-CoV-2 | single strand positive chain RNA virus | fever, dry cough, and fatigue are the main manifestations of | |
human adenovirus | html l3 double-stranded DNA virus | invisible infection, acute upper and lower respiratory tract infections, a few can develop severe pneumonia | |
human Boca virus | single-stranded linear DNA virus | Most patients showed Community-acquired pneumonia |
2. Antiviral drugs
(1) The role of antiviral drugs is achieved by competing for cell surface receptors, preventing virus adsorption, hindering virus penetration and dehulling, inhibiting virus synthesis, enhancing host antiviral ability, blocking assembly maturation and other links.
(2) antiviral drugs mainly include broad-spectrum antiviral drugs, anti-DNA viral drugs, anti-RNA viral drugs, protease inhibitor antiviral drugs, and inhibition of RNA synthesis.
(3) Commonly used broad-spectrum antiviral drugs include interferon , ribavirin, abidol, anti-DNA virus drugs include ganciclovir , etc., anti-RNA virus drugs include M2 ion channel blocker adamantine, neuraminidase inhibitor oseltamivir, and protease inhibitor lopinavir/ ritonavir , etc. Antiviral drug treatment should be determined comprehensively based on pathogenesis, physical condition and drug antiviral spectrum.
(4) Antiviral drugs indications and usage dosage
html Indications and usage of 3 antiviral drugs dosage | ||
drug | features | |
Broad spectrum antiviral drug | ||
interferon | interferon | html ml4 action mechanism : antiviral and immunomodulation, broad-spectrum antiviral drugs target virus : adenovirus , respiratory syncytial virus, influenza virus, herpes virus , 2019nCoVhtml ml2 dosage form : Injection Usage : 2019nCoV: IFN-α atomization inhalation (recommended air compression or oxygen discharging method), 5 million U per adult or equivalent dose 50μg, add 2mL of water for sterilization injection, 2 times/d Adverse reactions : influenza-like symptoms, myelosuppression, etc. |
Ribavirin | Mechanism of action : Host mediating function, transcriptase inhibitor, viral mutagen Target virus : Various types of respiratory viruses and enteroviruses caused by herpes pharyngeal inflammation dosage form : tablets, capsules, granules, injections, aerosols, sprays, etc. Usage : Intravenous infusion: 0.5g once for adults, 2 times/d, for 5 days; tablets or capsules once for adults, 0.15g once for adults, 3 times/d, for 7 days of treatment. Adverse reactions : hemolytic anemia , nausea, vomiting, appetite deficiency and other gastrointestinal reactions | |
Abidol | Mechanism of action : Hemagglutinin inhibitor, fusion blockade, immunity Adjustment into one, anti-RNA RNA 5 and DNA virus Target virus : Influenza A and B viruses and other respiratory infection viruses (2019nCoV) and enterovirus dosage form : tablet Usage : oral. Adults once, 0.2g, 3 times/d, take 5d Adverse reactions : mainly nausea, diarrhea, dizziness and increased serum aminotransferase | |
Anti-RNA virus drug | ||
Adamantine | Mechanism of action : M2 ion channel blocker Target virus : Influenza A Dose form : Tablets, capsules, granules, syrup Usage : Oral administration.Adults once 200mg, once per day or 100mg, once every 12h Adverse reactions : Common gastrointestinal and central nervous system reactions | |
Adamantine | Adamantine ethamstring | Mechanism of action : M2 ion channel blocker Target virus : Influenza A Dosage form : Tablets, capsules, granules, oral solution Usage : Oral. Adults once 100mg, 2 times/d Adverse reactions : Common gastrointestinal and central nervous system reactions |
oseltamivir | action mechanism : Neuraminidase inhibitor Target virus : Influenza A and B Dosage form : Capsules, granules Usage : Oral administration. Adults each time, 2 times/d, a total of 5d Adverse reactions : Common digestive tract reactions, renal insufficiency patients need to adjust the dose | |
Zanamivir | Mechanism of action : Neuraminidase Inhibitor Target virus : Influenza A and B Dose form : Capsule type inhalation powder mist Usage : 2 times/d, 2 inhalation each time (i.e. 2X5mg), continuous for 5 days, the total inhalation dose per day is 20mghtml ml2 Adverse reactions : Common digestive tract, central nervous system , respiratory system reaction | |
paramivir | Mechanism of action : Neuraminidase inhibitor html ml3 target virus : Influenza viruses include: influenza caused by H1, HA, H9N9 and other series of viruses, severe influenza dosage form : Injection Usage : Generally, the dosage is 300 mg, a single intravenous drip, the drip time is no less than 30 minutes. Patients with severe complications can use 600 mg, a single intravenous drip, and the drip time is no less than 40 minutes. For severe symptoms, you can do it repeatedly in succession of 1-5d Adverse reactions : diarrhea, leukopenia, neutropenia, proteinuria | |
Lopinavir/ritonavir | Action mechanism : Egg White enzyme inhibitor, anti-RNA virus Target virus : Human immunodeficiency virus-1 infection, SARS-CoV, 2019nCoV dosage form : tablets (lopinavir 200mg/ritonavir 50mg) Usage : Oral administration. The recommended dose is 2 tablets/time, 2 times/d Adverse reactions : Common adverse reactions are diarrhea, usually mild to moderate |
3. Antiviral treatment strategy
(1) For respiratory virus infection in non-high-risk populations, routine antiviral drugs are not recommended; however, for the common respiratory syncytial virus infection in high-risk populations, ribavirin antiviral drugs are recommended in the early stage.
(2) For SARS-CoV, no specific therapeutic drugs have been found, and lopinavir/ritonavir may be considered.
(3) For human infection with highly pathogenic avian influenza, especially H1 (H1N.), HA (HAN.), H9N9 and other series of viruses, neuraminidase can be selected to inhibit paramivir .
(4) For adult influenza A and B viruses, neuraminidase inhibitors oseltamivir, zanamivir, and paramivir, and hemagglutinin inhibitor Abidol can be selected.
(5) For new coronavirus pneumonia , α-interferon, chloroquine phosphate, ribavirin, abidol, etc. can be selected, but it is not recommended to use 3 or more antiviral drugs at the same time.
(6) Ribavirin has accurate antiviral efficacy, but generally requires the use of oseltamivir and other drugs.
(7) Interferon is mainly used for respiratory syncytial virus, influenza virus, herpes virus and other infections.
(9) Abidol can be used for influenza A and B viruses, novel coronaviruses, and other respiratory virus infections.
(10) antiviral drugs are generally given within 48 hours of onset or after the first visit. The duration of the drug is generally determined based on the course of the drug, and in principle it does not exceed 10 days.
References:
(1) Drug Instructions
(2) Adult Emergency Diagnosis and Treatment Experts in Acute Respiratory Virus Infection. Adult Emergency Diagnosis and Treatment Experts in Acute Respiratory Virus Infection. Chinese Journal of Emergency Medicine. 2021, 30(12):1417-1428.
Source: Clinical Drug Evaluation
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