Left part is for HIV, right part is for other virus.

Oseltamivir, zanamivir

• Inhibit influenza neuraminidase �?�?release of progeny virus.
  • A viral enzyme that cleaves neuraminic acid residues from glycoprotein, which results in viral release from the host cell. Found in influenza virus.
• 

Guanosine analogue

Acyclovir, famciclovir, valacyclovir

• Guanosine analogs.
• HSV/VZV-coded thymidine kinase monophosphorylates the guanosine analogue to an active intermediate �?phosphorylation by cellular kinases �?acyclovir triphosphate (ACV-TP)
• The phosphorylated drug is incorporated into the replicating viral DNA strand �?inhibition of viral DNA polymerase via chain termination
• Mechanism of antiviral resistance: Mutation of viral thymidine kinase

Ganciclovir, Valganciclovir

• Phosphorylation to 5' monophosphate by the CMV-coded UL97 kinase �?further phosphorylation to triphosphate by cellular kinases

Foscarnet, Cidofovir

• Direct inhibition of viral DNA polymerases
• Does not require activation by viral kinase
  • Foscarnet already has phosphate in name
• Indications
  • CMV retinitis in immunocompromised individuals (e.g., patients with AIDS)
  • Acyclovir-resistant HSV
• Adverse effects
  • Common: nephrotoxicity
  • Foscarnet: hypocalcemia, hypokalemia
    • Foscarnet can chelate calcium.