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 Anti Viral Drugs in Ophthalmology Presentation Transcript

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