Influenza medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by RNA viruses of the biological family Orthomyxoviridae (the influenza viruses). In humans, common symptoms of influenza infection are fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort
Medical therapy
People with the flu are advised to get plenty of rest, drink a lot of liquids, avoid using alcohol and tobacco and, if necessary, take medications such as paracetamol (acetaminophen) to relieve the fever and muscle aches associated with the flu. Children and teenagers with flu symptoms (particularly fever) should avoid taking aspirin during an influenza infection (especially influenza type B) because doing so can lead to Reye's syndrome, a rare but potentially fatal disease of the liver.[1] Since influenza is caused by a virus, antibiotics have no effect on the infection; unless prescribed for secondary infections such as bacterial pneumonia, they may lead to resistant bacteria. Antiviral medication is sometimes effective, but viruses can develop resistance to the standard antiviral drugs.
The two classes of anti-virals are neuraminidase inhibitors and M2 inhibitors (adamantane derivatives). Neuraminidase inhibitors are currently preferred for flu virus infections. The CDC recommended against using M2 inhibitors during the 2005–06 influenza season.[2]
Neuraminidase inhibitors
Antiviral drugs such as oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza) are neuraminidase inhibitors that are designed to halt the spread of the virus in the body.[3] These drugs are often effective against both influenza A and B.[4] The Cochrane Collaboration reviewed these drugs and concluded that they reduce symptoms and complications.[5] Different strains of influenza virus have differing degrees of resistance against these antivirals and it is impossible to predict what degree of resistance a future pandemic strain might have.[6]
M2 inhibitors (adamantanes)
The antiviral drugs amantadine and rimantadine are designed to block a viral ion channel and prevent the virus from infecting cells. These drugs are sometimes effective against influenza A if given early in the infection, but are always ineffective against influenza B.[4] Measured resistance to amantadine and rimantadine in American isolates of H3N2 has increased to 91% in 2005.[7]
References
- ↑ Glasgow, J (2001). "Reye syndrome — insights on causation and prognosis". Arch Dis Child. 85 (5): 351–3. PMID 11668090. Unknown parameter
|coauthors=ignored (help) - ↑ Centers for Disease Control and Prevention. CDC Recommends against the Use of Amantadine and Rimantadine for the Treatment or Prophylaxis of Influenza in the United States during the 2005–06 Influenza Season. January 14, 2006. Retrieved on 2007-01-01
- ↑ Moscona, A (2005). "Neuraminidase inhibitors for influenza". N Engl J Med. 353 (13): 1363–73. PMID 16192481.
- ↑ 4.0 4.1 Stephenson, I (1999). "Chemotherapeutic control of influenza". J Antimicrob Chemother. 44 (1): 6–10. PMID 10459804. Unknown parameter
|coauthors=ignored (help) - ↑ Jefferson, T. "Neuraminidase inhibitors for preventing and treating influenza in healthy adults". Cochrane Database Syst Rev. 3: CD001265. doi:10.1002/14651858.CD001265.pub2. PMID 16855962. Unknown parameter
|coauthors=ignored (help) - ↑ Webster, Robert G. (2006). "H5N1 Influenza — Continuing Evolution and Spread". N Engl J Med. 355 (21): 2174–77. PMID 16192481.
- ↑ "High levels of adamantane resistance among influenza A (H3N2) viruses and interim guidelines for use of antiviral agents — United States, 2005–06 influenza season". MMWR Morb Mortal Wkly Rep. 55 (2): 44–6. 2006. PMID 16424859.