Class Summary
These agents interfere with viral replication; they weaken or abolish viral activity.
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Acyclovir (Zovirax)
A prodrug activated by cellular enzymes, acyclovir inhibits the activity of HSV-1, HSV-2, and varicella-zoster virus by competing for viral DNA polymerase and incorporation into viral DNA. Acyclovir is used in HSV meningitis.
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Ganciclovir (Cytovene)
Ganciclovir is a synthetic guanine derivative active against CMV. An acyclic nucleoside analog of 2'-deoxyguanosine, it inhibits the replication of herpes viruses in vitro and in vivo. levels of ganciclovir-triphosphate are as much as 100-fold greater in CMV-infected cells than in uninfected cells, possibly because of preferential phosphorylation of ganciclovir in virus-infected cells.
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Foscarnet
Foscarnet is an organic analog of inorganic pyrophosphate that inhibits the replication of known herpesviruses, including CMV, HSV-1, and HSV-2. It inhibits viral replication at the pyrophosphate-binding site on virus-specific DNA polymerases. Foscarnet is used to treat CMV meningitis in immunocompromised hosts at induction doses of 60 mg/kg IV q8h and maintenance doses of 90-120 mg/kg IV q24h.
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