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Antiviral Drugs for the treatment of COVID-19

Antiviral Drugs for the treatment of COVID-19

2020-03-12

With the release of  "Diagnosis and Treatment Program for COVID-19", antiviral drugs have come into our sight. What are they? What are their efficacy? Let's take a look together here

1. Classification of antiviral drugs

According to different effects, antiviral drugs are mainly divided into 5 categories:

(1) Anti-human immunodeficiency virus (HIV) drugs:

Indinavir, nelfinavir, derivadine, and nevira are equal;

(2) Anti-cytomegalovirus drugs

Foscarnet sodium, ganciclovir, etc .;

(3) Anti-hepatitis virus drugs: Interferon, adenosine monophosphate, lamivudine, glycyrrhizin;

(4) Anti-herpes virus drugs: Acyclovir, valacyclovir, faciclovir, adenosine arabinoside, etc .;

(5): Anti-influenza and respiratory virus drugs: Amantadine, rimantadine, ribavirin, antisense oligonucleotides, etc.

2. Characteristics of antiviral drugs

(1) Ribavirin (ribavirin, ribavirin)

Ribavirin belongs to a broad-spectrum antiviral drug and prevents viral replication by inhibiting the synthesis of DNA and RNA. It is effective against influenza A and B viruses, parainfluenza virus, adenovirus, respiratory syncytial virus, herpes virus, measles virus, varicella virus, and mumps virus.

The drug has few oral adverse reactions, occasional gastrointestinal reactions, dizziness, and rash; high-dose intravenous administration can cause leukopenia, anemia, immunosuppression, and abnormal liver function.

(2) Arabinoside

Anti-DNA virus medicine, has a significant inhibitory effect on various DNA viruses such as herpes simplex virus, varicella zoster virus, and hepatitis C virus. It can also be used for the treatment of AIDS complicated with herpes zoster, chickenpox, chronic hepatitis B, and it can be used for the treatment of herpes externally Keratitis.

Side effects include adverse reactions of the nervous system, ataxia, myalgia, etc., nausea, vomiting, abdominal pain, and bone marrow suppression, which can be restored after the drug is stopped.

(3) Acyclovir (acyclovir)

Acyclovir is an open-loop nucleoside broad-spectrum anti-DNA virus drug, mainly used to treat herpes simplex virus meningitis, skin herpes simplex virus (HSV) infection, herpes keratitis, genital herpes, etc. Because it has a certain inhibitory effect on varicella zoster virus, Epstein-Barr virus, cytomegalovirus and hepatitis B virus, it can also be used for the treatment of such viral infections.

Side effects include diarrhea, headache, nausea, vomiting, and allergic symptoms such as rash, urticaria, and fever. It can also cause liver enzymes and creatinine, leukopenia, and anemia. It should be used with caution in the treatment of neutropenia .

(4) Ganciclovir (propoxyguanosine)

Ganciclovir is an anti-DNA virus drug that can be converted into an activated triphosphate type under the action of viral thymidine kinase and cell kinase, and can persist in infected cells at a high concentration for several days. It is a first-line medication for severe cytomegalovirus (CMV) infection in children and is not prone to drug resistance. The drug is poorly absorbed orally and is mainly administered by intravenous injection.

The side effect is bone marrow suppression, which can cause a decrease in granulocytes and platelets, which can be restored after stopping the medication. Other side effects include

(5) Vanelovir (Valacyclovir)

Anti-DNA virus drugs, recently approved for herpes zoster and recurrent HSV infection of the reproductive tract. The medicine is easy to be taken orally and distributed widely after absorption, with the highest concentration in the digestive tract, kidney, liver, lymph nodes and skin. Children's pharmacokinetic and safety studies have not been completed, and children are expected to be well tolerated.

Side effects include headache, nausea, vomiting, and diarrhea.

(6)Lamivudine

Lamivudine is a pyrimidine nucleoside analog, mainly by incorporating into newly synthesized viral DNA to make the DNA chain extend and terminate. It can also competitively inhibit viral DNA polymerase. It is mainly suitable for patients with chronic hepatitis B, generally not For acute hepatitis. The drug can be quickly absorbed by oral administration, and liver function and blood routine should be monitored during the medication.

(7) Amantadine

Amantadine belongs to anti-RNA virus medicine. It prevents viral unshelling and nucleic acid release to inhibit viral replication. It is mainly used to treat and prevent influenza A virus infection. The drug is completely absorbed orally, and the drug is distributed more in nasal secretions, saliva and lungs.

Side effects include drowsiness, fatigue, anxiety, ataxia, heart failure, orthostatic hypotension, leukopenia, rash, etc.

(8) Rimantadine

Rimantadine belongs to anti-RNA virus drugs. It is mainly used for the treatment of influenza A by changing the surface charge of the host cell, inhibiting the process of virus penetration into sensitive cells and releasing nucleic acids, and inhibiting the proliferation of the virus.

Side effects include dizziness, drowsiness, irritability, and even delirium, convulsions, movement disorders and other neurological side effects and nausea, vomiting, loss of appetite, abdominal pain and other gastrointestinal adverse reactions. Those with a history of epilepsy should avoid it.

(9) Neuraminidase inhibitor

Neuraminidase inhibitors currently approved for clinical use include zanamivir and oseltamivir, of which oseltamivir has been approved for use in China, and its active metabolites can inhibit the nerves of influenza A and B viruses Aminase activity.

The most common side effects are gastrointestinal reactions, such as nausea, vomiting, indigestion, abdominal pain, etc., the incidence rate is 6% -15%, most of the symptoms are mild, and can disappear after stopping the drug. A small number of people may experience allergic reactions, manifested as rashes.

(10) Interferon

Interferon is a class of glycoproteins induced by viruses and other host cells, and exerts antiviral effects by regulating the body's immunity. Interferon is generally divided into four types: α, β, γ, and ω, and α and γ are the most widely used clinically. Take α-interferon as an example. It can inhibit the synthesis of DNA and RNA viruses. It is commonly used in the treatment of chronic viral infections of type B, C, and D, viral pneumonia in children, herpes zoster, condyloma acuminatum, and AIDS.

Side effects include fever, chills, fatigue, myalgia, joint pain, occasional gastrointestinal reactions, and some patients may have leukopenia and thrombocytopenia. Other side effects include hair loss, tachycardia, rash, high blood pressure, mental abnormalities, and changes in kidney function.

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