ANTIVIRALES

Integrantes:
Michelle Goyeneche
Javier Lafont
Jesús Santana
Valentina Noguera
Isabella Méndez
Sofía Rueda
María José González
TABLA DE CONTENIDO

01. HERPES
02. HEPATITIS C
Antivirales para hepatitis C
Antivirales para el herpes

03. VIH
Antivirales para el VIH
04. OTROS ANTIVIRALES
01. HERPES
MECANISMO DE ACCIÓN DEL
VIRUS DEL HERPES

Piel - Mucosas
MECANISMO DE ACCIÓN DEL ACICLOVIR
● Inhibidor de la polimerasa viral (ADN), análogo de nucleósido (guanosina)
Mecanismo de acción del ACICLOVIR
Cadena original
 Contraindicación en pacientes con falla renal e

ACICLOVIR inmunodeprimidos

INDICACIONES ADME
● Herpes episodico ● Administración vía oral,
● Herpes recurrente intravenosa y tópica
● Supresion viral ● Dosis: 400 mg, 3 veces al día
● Encefalitis por 7 a 10 días VO

EFECTOS ADVERSOS CON QUE NO COMBINAR

● Mielosupresores (dapsona,
Cefalea, fatiga pentamicina, vincristina)

● Nefrtoxicos (analogos de
Daño renal
Granulocitopenia nucleosidos, anfotericina B)
Trombocitopenia

Diarrea, náusea, vomito,

dolor abdominal
GANCICLOVIR
 Contraindicación durante la lactancia, pacientes

GANCICLOVIR con insuficiencia renal

INDICACIONES
ADME
● tratamiento de la enfermedad por citomegalovirus (CMV) en ● IV (sal sodica), oftalmica
pacientes inmunodeprimidos (gel)
● tratamiento preventivo en pacientes con inmunosupresión ● Absorcion 6%-9%
iatrogénica (por ejemplo, después de un trasplante de ● Vida media 2.9hs
órgano) ● Excrecion renal

EFECTOS ADVERSOS
CON QUE NO COMBINAR
Disminución de agudeza visual ● Mielosupresores (dapsona,
pentamicina, vincristina)
Anemia
Trombocitopenia
● Zidovudina
Neutropenia
 Contraindicación durante la lactancia, pacientes

FOSCARNET con insuficiencia renal

MECANISMO DE ACCIÓN
ADME
Inhibe la ADN-polimerasa y la transcriptasa viral inversa. Es activo
frente a los virus herpes, VHB y VIH. ● IV
● Vida media 3h a 6h
● se elimina principalmente
INDICACIONES por vía renal
● Tratamiento de inducción y mantenimiento de infección por
CMV asociada a SIDA: gastrointestinal superior e inferior,
retinitis. CON QUE NO COMBINAR
● Medicamento de segunda línea, en inmunosuprimidos sin
respuesta a aciclovir IV
● Efecto nefrotóxico aditivo con:
aminoglucósidos, amfotericina B,
ciclosporina A, ritonavir,
EFECTOS ADVERSOS saquinavir.

Hipopotasemia, ● fármacos que afectan a calcemia

Hipomagnesemia, como: pentamidina IV.
Nefrotoxicidad
(arritmia/convulsiones)
Hipocalcemia
02. HEPATITIS C
Hepatitis C RNA monocatenario de sentido ´positivo

● Tiene gran heterogeneidad

genética
● Genotipos difieren 30-35% en
sitios de nucleótidos
● Subtipos difieren en menos del
15% de sitios de nucleótidos
● Transmisibilidad no difieren
● Progresión de la enf y respuesta
al tratamiento
● Genotipo 1 más prevalente 1a* y1b ➔ Proteínas estructurales E1 yE2
➔ Pp p7 canal ionico
● Genotipo 3 ➔ Pp no estructurales N2S,NS3,NS4A,NS4B,NS5A,NS5B
● Genotipos 2,4 y 6 25% px con HCV ➔ Replicación en el citoplasma
➔ Sin latencia y curable
➔ SVR-12 sem
 Objetivos y enfoques de tratamiento
Protesasa NS3 , NS5B polimerasa y NS5A

Evita la ruptura de poliproteína viral y formación del complejo de replicación

Esencial para la replicación y síntesis del ARN complementario de cadena negativa y posterior ARN genómico 2 tipos NS5B RdRp : nucleótidos
(inhibidor en sitio activo ) y no nucleósidos (inhibidor alostérico)
Esencial para replicación y ensamblaje de nuevas partículas virales
Sofosbuvir Analogo de uridina
Se metaboliza a GS-461203 este compite con el
Resistencia trifosfato de uridina para su incorporación al ARN del
HCV por la polimerasa NS5B.
Alta barrera a la resistencia
S282T RAV
Activo en todos los
2003 Usos genotipos
ADME
terapeuticos Se usa en combinación con
otros DAA
Dosis de 400mg/dia 2005
- Biodisponibilidad 80%
- Con ingesta de comidas ricas en Sin toxicidad relevante
- Es sustrato para
grasas aumenta el AUC en un 207 transportadores de eflujo Pgp y
67-91% BCCRP
- 63% unida a proteína
Efectos adversos e - NO usarse con rifampina, hierba

- Elimina por filtración glomerular interacciones de san juan , fenitoina,

carbamazepina
No debe usarse en px con FG de - Bradicardia, marcapaso, paro
cardiaco-amiodarona
menos de 30ml/min/1.73m2 - Monitorizacion
Daclatasvir
Inhibidor de NS5A
Se une al extremo N-terminal de NS5A e inhibe la
replicación del RNA viral y el ensamblaje del virión

30 y 60 mg -CYP3A
ADME Biodisponibilidad de 67%
Con comidas altas en grasas se reduce
su exposición en un 23%
Union a pp 99%

Genotipo 3
USOS En coinfección con HIV y enfermedad
hepática avanzada
TERAPEUTICOS Se usa en co fórmulas
Px cirroticos con genotipo 3 -ribavirina

Buena tolerancia
Cefalea, fatiga, náuseas,
EFECTOS ADVERSOS anemia
E INTERACCIONES NO usar en niños o
ancianos
03. VIH
FISIOPATOLOGÍA
 FISIOPATOLOGÍA
1. Después del mecanismo de transmisión, ❖ Pero tiene mayor afinidad por los
puede afectar a estas células: macrófagos y LT CD4
 FISIOPATOLOGÍA
2. Se adhiere a la membrana por la gp120 y se fusiona con el LTCD4 por gp41

Liberación del ARN viral

 Efectivo, pero ante una mutación de la

ZIDOVUDINA transcriptasa inversa disminuye su efectividad

CLASE FARMACOLÓGICA FARMACOCINÉTICA

Administración vía oral y se
Antagonista de la
absorbe en el TGI
transcriptasa inversa

EFECTOS ADVERSOS
MECANISMO DE ACCIÓN
Anemia, granulocitopenia
Zidovudina trifosfato se
une al ADN vírico e inhibe
su cadena
● Px con anemia
● Alteración dental
● IR
 LAMIVUDINA Sinergismo con zidovudina
*Resistencia por mutaciones

CLASE FARMACOLÓGICA FARMACOCINÉTICA

Antagonista de la *Administración vía oral
transcriptasa inversa y de *Biodisponibilidad 82%
ADN polimerasa del VHB

EFECTOS ADVERSOS
MECANISMO DE ACCIÓN
Náuseas, vómitos, diarrea,
*Se une al ADN vírico e inhibe dolor abdominal, fiebre, etc
su cadena
*Se une ADN del VHB e inhibe
● IR: aclaramiento de
la formación de la cadena
creatinina *Poco frecuente porque
<50mL/min no causa toxicidad
 efavirenz con dos inhibidores nucleosídicos de la transcriptasa inversa

EFAVIRENZ
MECANISMO DE ACCIÓN ADME
Concentraciones máximas
Inhibidor no competitivo de la plasmáticas: primeras 5 horas
transcriptasa inversa del VIH-1, Biodisponibilidad aumenta
induciendo un cambio en su
hasta el 20% con la ingesta de
conformación que perjudica la
actividad catalítica. alimentos con abundante
grasa
EFECTOS ADVERSOS
DESVENTAJAS Mareo, dificultad para la
concentración, disforia,
Resistencia pronta sueños vívidos o inquietantes
No en el embarazo
e insomnio

La combinación de efavirenz o nevirapina con otros antirretrovíricos suprime en forma eficaz y a largo plazo la viremia
y eleva la cuenta de linfocitos CD4+
No debe administrarse como monoterapia por su rápida resistencia, por lo que se administra en un esquema triple de
nevirapina, zidovudina y didanosina reduce la concentración plasmática del RNA vírico hasta cifras indetectables

NEVIRAPINA
MECANISMO DE ACCIÓN
Inhibidor no competitivo de la
transcriptasa inversa del VIH-1,
induciendo un cambio en su
conformación que perjudica la
actividad catalítica.
INT. FARMACOLOGICAS
Disminuye concentración
plasmática de etinilestradiol y
noretindrona un 20%
Reduce la concentración
algunos inhibidores de la proteasa
del VIH
ADME
- Concentraciones
plasmáticas:
máximas
primeras 5
horas
- Biodisponibilidad no
aumenta con la ingesta de
ningún alimento
- Atraviesa placenta y se aisló
de la leche materna
- Semivida : 25 a 30 horas
EFECTOS ADVERSOS
- Eritema con prurito
(empeora con administración
de glucocorticoides)
de - Hepatotoxicidad

Es utilizado para evitar transmisión madre e hijo

RITONAVIR
MECANISMO DE ACCIÓN CONTRAINDICACIONES

Es un inhibidor de la No combinar con

proteasa de VIH completa medicamentos como
midazolam, triazolam, la
el eje de simetría C2 del rifampicina pueden reducir sus
sitio activo de la enzima concentraciones

EFECTOS ADVERSOS USO CLÍNICO

Náuseas, vómitos, diarrea, Se utiliza en combinación de
anorexia, dolor abdominal otros inhibidores de CPY3A4
y trastornos del gusto como un potenciador
farmacocinético
Sinergismo de ritonavir
Al ser usado sólo como agente potenciador de la PK en
combinación con otros PI impidiendo que el VIH haga
copias de sí mismo y es posible que ayude a mejorar la
eficacia de otros medicamentos

Antivirales con los que se administra en conjunto:

- Lopinavir/Ritonavir
- Atazanavir/Ritonavir
- Darunavir/Ritonavir
- Indinavir/Ritonavir
INDINAVIR
MECANISMO DE ACCIÓN
Es un inhibidor de proteasa
del VIH (no tiene ventaja
ante los de su clase)
EFECTOS ADVERSOS
Produce cristaluria
nefrolitiasis por la solubilidad
del mismo, puede causar
hiperbilirrubinemia
conjugada
CONTRAINDICACIONES
Nos se puede administrar en
conjunto con otros sustratos de
CPY3A4 con índices terapéuticos
estrecho
USO CLÍNICO
y Adultos y niños infectados
por el VIH que han recibido
o no tratamiento
no
Se deben tomar con ritonavir o
durante el ayuno
 Otros
04. farmacos
 Oseltamivir
CONSIDERACIONES
MECANISMO DE ACCIÓN
Debe administrarse a las 72h
Inhibidor de la neuraminidasa siguientes del comienzo de los
de los virus de la gripe A y B, síntomas, de administración oral
impide liberación y
diseminación de partículas
víricas

USO CLINICO
Prevención y tratamiento de la
gripe A H1N1 y H3N2, la gripe
aviar H5N1 y la gripe B
EFECTOS ADVERSOS
Respiratorios y efectivos poco
importantes (náuseas,
molestias abdominales)
 Ribavirin
CONSIDERACIONES
MECANISMO DE ACCIÓN
Se administra por vía inhalatoria
Inhibe la síntesis de ácidos para la infección del virus
nucleicos y la formación de respiratorio sincitial, por vía oral o
proteínas virales, inhibiendo la intravenosa para el resto de
guanosina trifosfato
infecciones

USO CLINICO
EFECTOS ADVERSOS
Tratamiento para la infección del
virus respiratorio sincitial, Anemia, hipotension, parada
hepatitis C crónica y fiebres cardiaca
hemorrágicas virales
GRACIAS!
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OUR GRAPHS

MERCURY MARS
Mercury is the closest Despite being red,
planet to the Sun and Mars is actually a cold
the smallest one place full of iron oxide

VENUS SATURN
Venus has a beautiful Saturn has several
name and is the rings. It's composed
second planet mostly of hydrogen

Follow the link in the graph to modify its data and then paste the new one here. For more info, click here
 03.
PATIENT CARE
You can enter a subtitle
here if you need it
OUR SERVICES

MERCURY JUPITER
Mercury is the closest planet to the Sun Jupiter is the biggest planet of them all

VENUS SATURN
Venus has extremely high temperatures Saturn is mostly composed of hydrogen

MARS PLUTO
Mars is actually a very cold place Pluto is now considered a dwarf planet

NEPTUNE EARTH
Neptune is a very far-away planet Earth is where we all live on
FOUR COLUMNS

MERCURY JUPITER MARS NEPTUNE

Mercury is the Jupiter is a gas Mars is actually a Neptune is a gas

closest planet to giant and the cold place, not giant and the
the Sun and the biggest planet in hot. It's full of farthest planet
smallest one the Solar System iron oxide dust from the Sun
QUALITY IMPROVEMENT MEASURES

MERCURY MARS

Mercury is the smallest planet Jupiter is made of gas and it’s

JUPITER in the Solar System the biggest planet of them all

Venus is the second planet Saturn is a gas giant and has

SATURN from the Sun several rings

Despite being red, Mars is Neptune is the farthest planet

VENUS actually a cold place from the Sun
GOALS

VENUS MARS

GOAL 01 GOAL 02 GOAL 03 GOAL 04

Jupiter is the Mars is actually a Mercury is the Jupiter is a gas
biggest planet cold place smallest planet giant and it’s big
 “This is a quote, words full of
wisdom that someone
important said and can make
the reader get inspired.”

—SOMEONE FAMOUS
AREAS WE COVER

MERCURY VENUS MARS

Mercury is the closest Venus is the second Mars is actually a very
planet to the Sun planet from the Sun cold place

JUPITER SATURN NEPTUNE

Jupiter is the biggest Saturn is composed of Neptune is the farthest
planet of them all hydrogen and helium planet from the Sun
AREAS WE COVER

MERCURY VENUS
Mercury is the closest Venus is the second
planet to the Sun planet from the Sun

JUPITER SATURN
Jupiter is the biggest Saturn is composed of
planet of them all hydrogen and helium
SIX COLUMNS

MERCURY JUPITER
Mercury is the closest Jupiter is the biggest
planet to the Sun planet of them all

VENUS SATURN
Venus is the second Saturn is composed of
planet from the Sun hydrogen and helium

MARS NEPTUNE
Mars is actually a very Neptune is the farthest
cold place planet from the Sun
KEY ACCOMPLISHMENTS

VENUS
Venus is the second
planet from the Sun
SATURN
Saturn is composed
JUPITER mostly of hydrogen
Jupiter is the biggest
planet in our System MARS
Despite being red,
Mars is actually cold
20,000,000
Big numbers catch your audience’s attention
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DONE TO DO
You can list here all the activities you would like to try

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You can list here all the activities you would like to try

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PATIENT SATISFACTION

JUPITER
20% 30% Jupiter is a gas giant
and the biggest planet
MERCURY
Mercury is the closest
planet to the Sun
NEPTUNE
50% Neptune is the farthest
planet from the Sun
PATIENT SATISFACTION

95%
Mercury is the closest
planet to the Sun and
the smallest one in the
Solar System—it’s only a
bit larger than the Moon
KEY NUMBERS

50% 30% 20%

MERCURY JUPITER NEPTUNE

Mercury is the Jupiter is a gas Neptune is the
closest planet to giant and the farthest planet
the Sun biggest planet from the Sun
INNOVATIONS
MARS
Despite being red, Mars is
actually a cold place. It's full of
iron oxide dust

VENUS
Venus has a beautiful name
and is the second planet from
the Sun. It’s terribly hot

MERCURY
Mercury is the closest planet
to the Sun and the smallest
one in the Solar System
PATIENT PROFILE

75% 55%
Old Retired
women person

Mercury is the
smallest one in the
75% Solar System—it’s
Online only a bit larger
shopping than our Moon
MEDICAL CARE

JUPITER MERCURY
Jupiter is a gas Mercury is the
giant and the closest planet
biggest planet to the Sun

NEPTUNE PLUTO
Neptune is the Pluto is now
farthest planet considered a
from the Sun dwarf planet
OUR TEAM

JENNA DOE TIMMY JIMMY

You can talk a bit about You can talk a bit about
this person here this person here
OUR TEAM

JENNA DOE TIMMY JIMMY EMILY ROSE

You can talk a bit You can talk a bit You can talk a bit
about this person here about this person here about this person here
TESTIMONIALS

“Mercury is the closest “Despite being red, Mars

planet to the Sun” is actually a cold place”

JENNA DOE, 25 JOHN JAMES, 36

“Venus is the second “Neptune is the farthest

planet from the Sun” planet from the Sun”

FRED BLOGGS, 31 HELENA SMITH, 58

TESTIMONIALS

“Mercury is the closest planet to the Sun” JENNA DOE, 25

“Venus is the second planet from the Sun” FRED BLOGGS, 31
“Despite being red, Mars is actually a cold place” JOHN JAMES, 36
“Neptune is the farthest planet from the Sun” HELENA SMITH, 58
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