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Neuraminidase Inhibitors

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Topic updated on 05/02/17 8:23am

Snapshot
  • A 25-year-old young man presents to your clinic "feeling terrible."  He explains that for the past 24 hours he has had a fever and a headache as well as diffuse muscle aches and chills.  He has not been drinking or eating well and states that overall he feels, "terrible."
Introduction
  • Classification
    • antiviral
      • neuraminidase inhibitors
  • Drugs
    • oseltamivir (oral)
    • zanamivir (intranasal)
    • pentamivir (IV)
      • used if patient cannot tolerate inhaled or enteral agents
Mechanism
  • Action
    • inhibits neuraminidase of influenza A and B
      • neuraminidase cleaves bonds between new virus particles, increasing the number of circulating virus particles
      • neuraminidase inhibitors decrease the release of viral progeny which can shorten symptom duration if started early
  • Resistance
    • via mutations in neuraminidase
    • resistance is currently rare
Uses
  • Both influenza A and B
    • prophylaxis
    • treatment
      • may decrease duration of symptoms by a few days
Adverse effects
  • GI upset (oseltamivir, pentamivir)
  • Upper respiratory discomfort (zanamivir)
  • Rash, SJS (pentamivir)


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