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Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
Anti Viral Drugs in Ophthalmology
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.

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

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