Anti Viral Drugs in Ophthalmology
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Anti Viral Drugs in Ophthalmology

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This presentation gives an overview of the current anti-viral drugs used in ophthalmology.

This presentation gives an overview of the current anti-viral drugs used in ophthalmology.

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Anti Viral Drugs in Ophthalmology Presentation Transcript

  • 1. Dr. Ankit M. Punjabi DOMS (Final Year), Dept of Ophthalmology, KIMS Hospital, Bangalore Karnataka, INDIA Email: drankitalways@gmail.com
  • 2.
    • Smallest living unit
    • Nutrition from host
    • Difficult to Rx
    • Difficult to diagnose
  • 3.
    • DNA Viruses
    • Herpes group
    • HSV & HZV
    • CMV
    • Adeno viruses
    • Variola & Vaccinia
    • Molluscum contagiosum
    • HPV
  • 4.
    • RNA Viruses
    • Picorna viruses
    • Measles
    • Mumps
    • Rubella
  • 5.
    • Adsorption
    • Entry
    • Uncoating
    • Transcription
    • Virus component synthesis
  • 6.  
  • 7.
    • Ist Generation drugs
    • Idoxuridine
    • Vidarabine
    • Trifluorothymidine
    • Cytarabine
  • 8.
    • 2 nd Generation Drugs
    • Acyclovir
    • Bromo vinyl deoxyuridine
    • Interferons
    • Famiclovir
    • Vabaciclovir
    • Foscarnet
    • Ganciclovir
  • 9.
    • Zidovudine
    • Sorvudine
  • 10.  
  • 11.
    • Thymidine analogue
    • Activated by cellular & viral kinase
    • Incorporation into viral genome
    • Faulty virus synthesis
  • 12.
    • TOXICITY
    • SPK
    • Indolent ulceration
    • Delayed epithelial healing
    • Stromal opacification
    • Chemosis
    • Hyperaemia
    • Follicles
  • 13.
    • Eyelid edema
    • Meibomian gland plugging
    • Punctal occlusion
    • DOSE
    • 0.1% e/d and 0.5% e/o
  • 14.
    • Idurin 0.1%
    • Ridinox 0.1%
    • Toxil 0.1%
  • 15.
    • Acute and Recurrent Herpetic keratoconjuctivitis
    • Keratitis
    • Purine nucleoside analogue
    • Phosphorylation by host kinases
  • 16.
    • Chain terminator for new viral DNA
    • Doesnot require viral thymidine kinase
    • Not effective against RNA viruses
  • 17.
    • Side effects
    • Irritation
    • SPK
    • Pain
    • Photophobia
    • Punctal occlusion
    • Secondary glaucoma
    • Corneal vascularisation
  • 18.
    • Fluorinated pyrimidine
    • Thymidine analogue
    • Phosphorylated to active form
    • More conc. In infected cells
    • Drug of choice for HSV Keratitis
    • Water and lipid soluble
    • Drug of choice for HSV
  • 19.
    • Side Effects
    • Burning & Stingy sensation
    • Hyperaemia
    • Keratitis sicca
    • Delayed wound healing
    • Raised IOP
  • 20.
    • DOSE
    • 1% Solution
    • 6 – 9 times till epithelium heals
    • then, 1 drop 4 times/day for week
  • 21.
    • Acyclic nucleoside analogue of Guanosine
    • Selective for herpes infected cells
    • Thymidine kinase & DNA polymerase
    • Chain termination
    • Oral, Topical, Intravenous administration
  • 22.
    • DOSE
    • Topical – 3% Ointment
    • Systemic – 1g/ 24 hr for 10 days
    • 200mg, 400mg, 800mg Tablets
    • Intravenous
    • 5 mg/ kg 8 hrly for 5 – 10 days
  • 23.
    • INDICATIONS
    • Primary HSV
    • Infectious epithelial keratitis
    • HSV iritis & blepharitis
    • Risk of recurrence of infectious ds.
    • Post PK for HSV
    • ARN
    • Immunosuppressed patients
  • 24.
    • SIDE EFFECTS
    • SPK
    • Burning sensation
    • GIT disturbances, nausea, diziness
    • Renal dysfunction
    • Iv rashes, fall in BP
  • 25.
    • Acivir
    • Cyclovir
    • Ocuvir
    • Syslovir
    • Virucid
    • Zovirax ophthalmic oint.
  • 26.
    • Guanine analogue
    • Structurally related to acyclovir
    • CMV retinitis
  • 27.
    • INDICATIONS
    • CMV Retinitis
    • Prevention in immunosuppresed patients
    • C/I
    • Hyperesensitivity to acyclovir or ganciclovir
  • 28.
    • DOSE
    • CMV retinitis
    • Induction regime
    • 5mg/kg every 12 hrs for 14-21 days
    • Maintenance regime
    • 5 mg/kg/hr once daily/ week
    • or
    • 6 mg/kg once daily 5 days /week
  • 29.
    • Oral, for maintenance only
    • 1000 mg 3 times daily
    • or
    • 500 mg 6 times daily every 3 hrs.
  • 30.
    • Prevention
    • 5 mg/Kg every 12 hrs for 7 –14 days
    • Then, 5 mg/kg once daily / week
    • or
    • 6 mg/Kg once daily 5 days / week
  • 31.
    • Ganciclovir intravitreal implant
    • Rx of CMV retinitis
    • 4.5 mg of drug
    • Released over 6 – 8 months
    • Stored at 15 – 30 * C
  • 32.
    • Glycoproteins
    • Host cell in response to viral infection
    • Broad antiviral, Immunomodulator
    • & Anti-proliferative
    • Three types
  • 33.
    • INDICATIONS
    • Herpes Zoster
    • AIDS related Kaposi’s sarcoma
    • DOSE
    • 30 – 400 million/ml once or twice a day for 2 weeks
  • 34.
    • Adverse effects
    • Fever, chills, Myalgia
    • Bonemarrow depression
    • Neurotoxicity
    • Hypersenstivity
  • 35.
    • Tri-sodium salt of phosphoformic acid
    • Inhibits viral DNA replication
    • Acyclovir and Ganciclovir resistant
    • Renal excretion
  • 36.
    • DOSE
    • 60 mg/Kg every 8 hrs for 2 –3 weeks
    • Maintenance
    • 90 – 120 Mg/Kg over 2 hrs once daily
  • 37.
    • Bromovinyl deoxyuridine
    • HPMPC