FEATURES OF THE USE OF ANTIVIRAL DRUGS FOR THE TREATMENT AND PREVENTION OF DISEASES CAUSED BY THE COVID-19 VIRAL INFECTION

Vlasenko N. A., Kapustnik Yu. О.

LITERATURE REVIEWS

Scentific article

Antiviral drugs ribavirin and remdesevir are of great importance in the treatment of various forms of coronavirus disease, including for the treatment of patients with severe form of it, when oxygen support is necessary for them. The mechanism of action of ribavirin is because this drug competes with guanazine and adenosine for binding with enzymes that provide DNA and RNA synthesis. Inhibition of the activity of viral polymerases is second effect. Ribavirin is a guanosine (ribonucleic) analog. It causes block of the synthesis of viral RNA. Thus, according to the mechanism of action, this drug is a nucleotide inhibitor. Ribavirin is a prodrug that is similar in structure to purine RNA. Ribavirin passes across the cell membranes and then it metabolized with the subsequent formation of mono-, di- and triphosphate. Only ribavirin triphosphate has pharmacological activity. This ribavirin triphosphate causes disruption of the synthesis of viral RNA due to a violation of RNA metabolism that occurs during virus replication. Remdesevir is a compound that contains adenosine nucleoside phosphate. The drug metabolizes in the cells of the human body with the subsequent formation of a pharmacologically active metabolite, which is nucleoside triphosphate. Remdesevir triphosphate is an analog of ATP. This drug competes with a natural ATP substrate for inclusion in the RNA chain, which creates due to action of the RNA-dependent RNA polymerase of the SARS-CoV-2 virus. The chain break delays during viral RNA replication under the influence of remdesevir. Unlike many other drugs that are terminators of the chain assembly, the effect of remdesevir is not associated with the prevention of the addition of the nucleotide, which is located immediately after it. The effect of remdesevir is realizeddue to interrupting the RNA assembly chain by adding five additional bases to the increasing RNA chain. Antiviral drugs favipiravir and its analogues avifavir, areplivir and coronavir, as well as ergoferon, can be useful only for the treatment of patients infected with SARS-CoV-2 virus, with a mild and moderate current of disease. The combined preparation lopinavir/ritonavir can be administered for facilitation of condition of patients even a severe form of coronavirus disease. In the complex of therapy of polysegmental COVID-pnemonia, it is necessary to include antibiotic drugs: semi-synthetic broad-spectrum penicillins amoxicillin, augmentin, cephalosporins, fluoroquinolones, azithromycin and doxycycline. Interferons and interferon inducers can be useful for the prevention and treatment of coronavirus disease. It is most advisable to use interferon alpha-2b and the interferon inducer cycloferon. It is advisable to use drugs that contain release-active antibodies to interferon – gamma-ergoferon and anaferon for the treatment of patients with coronavirus disease with a different severity. Besides, these preparations are useful for the prevention of COVID infection. Medicines that are made from the Solanum tuberosum plant, in particular panavir, have the greatest effectiveness for the prevention of coronavirus disease in comparison with other immunomodulating drugs of plant origin. The preventive effect of drugs from the wormwood plant, for example artemisinin, is not completely provable. The effect of arbidol for the prevention and treatment of patients with COVID infection is not completely provable also. The use of chloroquine (delagil), hydroxychloroquine (plakvenil) and other chloroquine derivatives, for example, mefloquine is not effective for the prevention and treatment of coronavirus disease.

coronavirus disease, antiviral drugs, interferons, interferon inducers.

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«Bulletin of problems biology and medicine» Issue 3 (161), 2021 year, 14-26 pages, index UDK 616.9:615. 281–085

10.29254/2077-4214-2021-3-161-14-26