Updated: 3/10/2019

Neuraminidase Inhibitors

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Snapshot
  • A 60-year-old man presents to the emergency room for malaise and fevers. He also reports having chills, muscle aches, fatigue, and a headache. His grandson was taken out of school for similar symptoms. He has never had a flu shot, reporting that he did not trust vaccines. His past medical history is significant for diabetes mellitus and smoking. A rapid antigen detection test for flu is positive for influenza A. He is started on a oseltamivir. (Influenza)
Introduction
  • Drugs
    • oseltamivir (oral)
    • zanamivir (intranasal)
    • peramivir (IV)
  • Mechanism of action
    • inhibits viral neuraminidase
      • the viral enzyme neuraminidase cleaves bonds between sialic acid moieties on the surface of the cell, increasing the number of circulating viral particles
      • inhibition of this neuraminidase will decrease the release of viral progeny
  • Clinical use
    • influenza A and B
      • treatment, if early, can shorten the clinical course and symptom duration
      • can also be used as prophylaxis
  • Adverse effects
    • gastrointestinal upset
    • Stevens-Johnson syndrome
 

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