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Updated: Mar 10 2019

Neuraminidase Inhibitors

  • 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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