Friday, August 27, 2010

Antivirals for Influenza

Antivirals for Influenza
While vaccination is the method of choice for influenza prophylaxis, under specific conditions where the individual has not been or cannot be vaccinated, or is not fully protected by vaccination, the use of drugs should be considered for treatment or prevention of influenza infection.

Physician needs to know whether influenza is circulating in the community and how to diagnose influenza illness for the purpose of appropriate prescription of influenza antiviral drugs.

Antiviral drugs approved for treatment or prophylaxis of influenza include M2 channel inhibitor amantidine and rimantidine and the neuraminidase inhibitors zanamivir and oseltamivir.

The application of these drugs to clinical may be limited buy issues of efficacy with respect to the type of influenza virus (influenza A vs B), drug resistance, adverse effects and cost.

In the case of the M2 ion channel blockers, these drugs are only effective against influenza A, the induction of drug resistance is well documented and side effects can be significant, especially in older people.

M2 channel blockers of influenza virus destruct the virus’ ability to penetrate the cells and to release ribonucleoprotein.

While for Neuraminidase inhibitors destruct the ability of A and B influenza virus to penetrate the epithelial cells, break the virions’ outlet from the infected cell, reduce the virions’ resistance to the action of secretary factors.

While these issues have not been apparent with the more recent neuraminidase inhibitors, high cost may be prohibitive for broad use of these drugs, while for the inhaled zanamivir there is a caution against its use incases of airways hypersensitivity.

These issues not only limit the use of antivirals for individual treatment but also present major challenges to their potential use in future pandemics.
Antivirals for Influenza
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