This document summarizes drugs used to treat cytomegalovirus (CMV) infections, including ganciclovir, valganciclovir, foscarnet, and cidofovir. Ganciclovir and valganciclovir are nucleoside analogs that are preferentially phosphorylated in infected cells and inhibit viral DNA polymerase. Foscarnet binds viral polymerase and prevents DNA chain elongation. Cidofovir is a nucleoside analog that is not dependent on viral kinases for phosphorylation and can be used to treat ganciclovir-resistant CMV. All four drugs require dosage adjustment or monitoring for renal toxicity.
1. Viral retinitis, such as cytomegalovirus (CMV) retinitis, can occur in immunocompromised individuals and requires aggressive treatment.
2. CMV retinitis presents as areas of hemorrhage, whitening, and necrosis of the retina and typically occurs along the retinal arcades.
3. Treatment involves the use of antiviral drugs like ganciclovir, valganciclovir, cidofovir, and foscarnet to treat active infections and prevent recurrence in high-risk patients.
This document discusses the pharmacology of various antiviral drugs. It begins by explaining the life cycle of viruses and how antivirals work to inhibit viral replication. The optimal properties of antivirals are then outlined. Several classes of antivirals are described including those for herpes, hepatitis, HIV, and influenza. The mechanisms of specific antiviral drugs like acyclovir, valacyclovir, protease inhibitors, and neuraminidase inhibitors are summarized. Adverse effects and considerations for use are also mentioned.
The document discusses anti-viral drugs used to treat various viral infections such as HIV, hepatitis, herpes and influenza. It describes the classification, mechanism of action, dosing and side effects of various nucleoside analogues, protease inhibitors and other drugs. The summary of treatment of HIV includes the goals of combination antiretroviral therapy to suppress viral replication and prevent drug resistance in order to prolong life and improve quality of life for patients.
Chronic hepatitis refers to hepatic inflammation and necrosis that lasts more than 6 months. Chronic hepatitis B is defined by the presence of hepatitis B surface antigen for over 6 months. The risk of chronic infection is related to the age at which hepatitis B is acquired and the immune status of the host. Chronic hepatitis is classified based on cause, grade of histologic activity (inflammation), and stage of progression (fibrosis). Grading considers portal inflammation and lobular inflammation while staging evaluates the degree of fibrosis from none to cirrhosis. Chronic hepatitis can range from chronic persistent hepatitis with mild inflammation to chronic active hepatitis with piecemeal necrosis, bridging necrosis, and possible progression to cirrhosis. Several new antiviral drugs including lamiv
This document discusses renal involvement and glomerulopathies secondary to HCV infection. Some key points:
- HCV infection increases the risk of chronic kidney disease, proteinuria, and end-stage renal disease. It is associated with various types of glomerulonephritis.
- HCV can directly infect renal cells and also cause immune-complex mediated glomerulonephritis through mixed cryoglobulinemia. Common pathologies include membranoproliferative glomerulonephritis and membranous nephropathy.
- Screening HCV patients for renal markers annually and kidney biopsy if indicated can help diagnose HCV-induced glomerular lesions. While antiviral therapy treats the underlying
Viruses are obligate intracellular parasites composed of nucleic acid surrounded by a protein capsid and sometimes an envelope. They replicate by hijacking host cell machinery. Many antiviral drugs are nucleoside analogs that inhibit viral polymerases after being phosphorylated intracellularly. Common antivirals target herpesviruses (acyclovir, ganciclovir), hepatitis B (adefovir, entecavir), influenza (amantadine, oseltamivir), and HIV (reverse transcriptase inhibitors). While effective against actively replicating virus, they do not eliminate latent infections. Host immunity also plays a key role in viral clearance.
Viruses are obligate intracellular parasites composed of nucleic acid surrounded by a protein capsid and sometimes an envelope. They replicate by hijacking host cell machinery. Many antiviral drugs are nucleoside analogs that inhibit viral DNA or RNA polymerase after being phosphorylated intracellularly. Common antivirals target herpesviruses (acyclovir, ganciclovir), hepatitis B (adefovir), influenza (oseltamivir), and cytomegalovirus (ganciclovir, cidofovir, foscarnet). While effective against actively replicating virus, antivirals do not eliminate latent infections and host immunity remains important for recovery.
Heparin is a powerful anticoagulant that acts indirectly by binding to antithrombin III and inactivating clotting factors. It can be given intravenously or subcutaneously. Heparin is used to treat and prevent conditions involving blood clots such as deep vein thrombosis, pulmonary embolism, and arterial thromboembolism. Adverse effects include bleeding and heparin-induced thrombocytopenia. Warfarin is an oral anticoagulant that works by interfering with vitamin K dependent clotting factor synthesis in the liver. It is used long-term for conditions requiring anticoagulation like atrial fibrillation. Risks include bleeding and fetal harms
1. Viral retinitis, such as cytomegalovirus (CMV) retinitis, can occur in immunocompromised individuals and requires aggressive treatment.
2. CMV retinitis presents as areas of hemorrhage, whitening, and necrosis of the retina and typically occurs along the retinal arcades.
3. Treatment involves the use of antiviral drugs like ganciclovir, valganciclovir, cidofovir, and foscarnet to treat active infections and prevent recurrence in high-risk patients.
This document discusses the pharmacology of various antiviral drugs. It begins by explaining the life cycle of viruses and how antivirals work to inhibit viral replication. The optimal properties of antivirals are then outlined. Several classes of antivirals are described including those for herpes, hepatitis, HIV, and influenza. The mechanisms of specific antiviral drugs like acyclovir, valacyclovir, protease inhibitors, and neuraminidase inhibitors are summarized. Adverse effects and considerations for use are also mentioned.
The document discusses anti-viral drugs used to treat various viral infections such as HIV, hepatitis, herpes and influenza. It describes the classification, mechanism of action, dosing and side effects of various nucleoside analogues, protease inhibitors and other drugs. The summary of treatment of HIV includes the goals of combination antiretroviral therapy to suppress viral replication and prevent drug resistance in order to prolong life and improve quality of life for patients.
Chronic hepatitis refers to hepatic inflammation and necrosis that lasts more than 6 months. Chronic hepatitis B is defined by the presence of hepatitis B surface antigen for over 6 months. The risk of chronic infection is related to the age at which hepatitis B is acquired and the immune status of the host. Chronic hepatitis is classified based on cause, grade of histologic activity (inflammation), and stage of progression (fibrosis). Grading considers portal inflammation and lobular inflammation while staging evaluates the degree of fibrosis from none to cirrhosis. Chronic hepatitis can range from chronic persistent hepatitis with mild inflammation to chronic active hepatitis with piecemeal necrosis, bridging necrosis, and possible progression to cirrhosis. Several new antiviral drugs including lamiv
This document discusses renal involvement and glomerulopathies secondary to HCV infection. Some key points:
- HCV infection increases the risk of chronic kidney disease, proteinuria, and end-stage renal disease. It is associated with various types of glomerulonephritis.
- HCV can directly infect renal cells and also cause immune-complex mediated glomerulonephritis through mixed cryoglobulinemia. Common pathologies include membranoproliferative glomerulonephritis and membranous nephropathy.
- Screening HCV patients for renal markers annually and kidney biopsy if indicated can help diagnose HCV-induced glomerular lesions. While antiviral therapy treats the underlying
Viruses are obligate intracellular parasites composed of nucleic acid surrounded by a protein capsid and sometimes an envelope. They replicate by hijacking host cell machinery. Many antiviral drugs are nucleoside analogs that inhibit viral polymerases after being phosphorylated intracellularly. Common antivirals target herpesviruses (acyclovir, ganciclovir), hepatitis B (adefovir, entecavir), influenza (amantadine, oseltamivir), and HIV (reverse transcriptase inhibitors). While effective against actively replicating virus, they do not eliminate latent infections. Host immunity also plays a key role in viral clearance.
Viruses are obligate intracellular parasites composed of nucleic acid surrounded by a protein capsid and sometimes an envelope. They replicate by hijacking host cell machinery. Many antiviral drugs are nucleoside analogs that inhibit viral DNA or RNA polymerase after being phosphorylated intracellularly. Common antivirals target herpesviruses (acyclovir, ganciclovir), hepatitis B (adefovir), influenza (oseltamivir), and cytomegalovirus (ganciclovir, cidofovir, foscarnet). While effective against actively replicating virus, antivirals do not eliminate latent infections and host immunity remains important for recovery.
Heparin is a powerful anticoagulant that acts indirectly by binding to antithrombin III and inactivating clotting factors. It can be given intravenously or subcutaneously. Heparin is used to treat and prevent conditions involving blood clots such as deep vein thrombosis, pulmonary embolism, and arterial thromboembolism. Adverse effects include bleeding and heparin-induced thrombocytopenia. Warfarin is an oral anticoagulant that works by interfering with vitamin K dependent clotting factor synthesis in the liver. It is used long-term for conditions requiring anticoagulation like atrial fibrillation. Risks include bleeding and fetal harms
Recent changes in behavior of plasmodiumBhargav Kiran
Recent Changes in Behavior of Plasmodium
This document discusses recent changes observed in the behavior of the Plasmodium parasite, which causes malaria. It notes that Plasmodium vivax, previously considered a benign infection, has shown a new potential for severe and life-threatening disease. The document also reviews the epidemiology and pathophysiology of malaria, including clinical manifestations like anemia, renal failure, pulmonary edema, and complications in pregnancy. It discusses investigations, treatment approaches for uncomplicated and severe malaria, drug prophylaxis, emerging drug resistance, and strategies for controlling the mosquito vector.
The document discusses malaria, caused by parasites of the Plasmodium genus transmitted via mosquito bites. It affects over 100 countries and kills approximately 2,000 people per day. The most common species causing malaria in India are P. vivax, P. falciparum, P. ovale, and P. knowlesi, with P. falciparum being the most lethal. Malaria symptoms include fever, fatigue, nausea, and in severe cases can include cerebral malaria, acidosis, anemia, renal failure, pulmonary edema, hypoglycemia, and death. Diagnosis involves examining blood smears under a microscope for parasites. Treatment depends on the Plasmodium species and may include chloroquine,
This document summarizes various aspects of antiviral drugs, including their classification, mechanisms of action, and use for specific viruses. It discusses drugs that target DNA viruses like herpes simplex virus and hepatitis B virus. These include nucleoside analogues like acyclovir and ganciclovir that inhibit viral DNA polymerase. It also covers drugs for influenza viruses like amantadine and oseltamivir that inhibit the viral M2 protein and neuraminidase enzyme. Antivirals for hepatitis C virus and human immunodeficiency virus are also outlined, such as interferons, ribavirin, protease inhibitors, and integrase inhibitors. The document provides brief descriptions of each drug's mechanism, pharmac
This document discusses various classes of drugs that influence coagulation, including anticoagulants, antiplatelet drugs, and thrombolytic drugs. It describes several classes of anticoagulants such as heparins, warfarin, direct thrombin inhibitors, and direct factor Xa inhibitors. It provides details on specific drugs within each class, their mechanisms of action, dosing, monitoring, indications, and drug interactions. The focus is on drugs used for venous thromboembolism and non-valvular atrial fibrillation.
This document summarizes the management of autosomal dominant polycystic kidney disease (ADPKD). Current therapy focuses on treating renal and extrarenal complications through pain management, infection control, and hypertension management. New therapies targeting vasopressin receptors like tolvaptan have shown benefits in slowing kidney growth and decline. Kidney transplantation remains the treatment of choice for end-stage renal disease from ADPKD.
Cerebral malaria is the most severe complication caused by Plasmodium falciparum infection. It is characterized by coma and occurs when infected red blood cells sequester in the brain's microvasculature. Sequestration is mediated by cytoadherence of parasite proteins on infected cells to endothelial receptors and results in reduced blood flow and organ damage. Diagnosis involves identifying the parasite on blood smears with treatment consisting of intravenous artesunate or quinine along with supportive care. Prompt and complete antimalarial therapy is needed to prevent relapses.
Hepatitis B virus (HBV) is a DNA virus that causes hepatitis B. It replicates in liver cells and can lead to both acute and chronic infections. HBV is transmitted through bodily fluids and can be spread through sexual contact, sharing needles, or from mother to child during birth. While acute HBV infection may clear spontaneously, chronic HBV requires treatment to prevent progression to cirrhosis or liver cancer. Vaccination provides effective prevention against HBV infection.
Malaria is a protozoan infection transmitted by mosquitoes that infects red blood cells. P. falciparum malaria can cause severe complications such as cerebral malaria, acute renal failure, pulmonary edema, liver dysfunction, hypoglycemia, and acidosis due to parasite sequestration in vital organs. Treatment involves antimalarial drugs like artesunate or quinine plus supportive care for organ dysfunction. Cerebral malaria requires airway control, anticonvulsants, treatment of hypoglycemia, and blood transfusion for severe anemia.
Malaria is a mosquito-borne disease caused by Plasmodium parasites. It is transmitted via the bites of infected Anopheles mosquitoes. The most severe form is caused by P. falciparum, which can lead to complications affecting multiple organ systems if not promptly treated. Treatment depends on the parasite species and severity of infection, but involves antimalarial medications such as artemisinin compounds, chloroquine, primaquine, and quinine. Prevention strategies center around reducing mosquito bites through insecticide-treated bed nets and chemoprophylaxis with antimalarial drugs.
This document provides an overview of acute liver failure (ALF), including its definition, classification, etiology, clinical manifestations, diagnosis, treatment, complications, prognosis, and liver support devices. ALF is defined as evidence of coagulation abnormalities and mental alterations in a patient without preexisting cirrhosis within 26 weeks of illness onset. Common etiologies in India include hepatitis E, drug-induced liver injury, and acetaminophen toxicity. Presentation may include jaundice, coagulopathy, and hepatic encephalopathy. Treatment involves supportive care and managing complications such as cerebral edema. Prognosis is assessed using scoring systems like King's College criteria, with liver transplantation indicated for those who do not recover spontaneously.
This document provides information about acute liver failure in children. It defines acute liver failure as resulting from massive liver cell death or impairment within 8 weeks without pre-existing liver disease. Causes include viral hepatitis, drugs/toxins, metabolic disorders. Clinical features include jaundice, encephalopathy. Management involves supportive care, treating the cause, and preparing for transplant if needed to prevent complications and allow the liver time to regenerate.
This document discusses the etiology and diagnosis of acute pancreatitis. It lists various etiological factors including mechanical obstruction, alcohol, hypertriglyceridemia, genetic mutations, drugs, infections, and trauma. It describes the diagnosis of acute pancreatitis based on abdominal symptoms, lipase or amylase levels, and imaging findings. It also discusses local complications like acute peripancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection, and walled-off necrosis. Organ failure is defined using the Modified Marshall Scoring System.
Management of adverse effects of cancer chemotherapy 2Dr. Pooja
This document discusses the management of adverse effects from cancer chemotherapy. It describes common general side effects such as nausea, vomiting, myelosuppression and mucositis. Specific organ toxicities are also reviewed including liver veno-occlusive disease, hemorrhagic cystitis, nephrotoxicity, neurotoxicity, pulmonary toxicity, cardiotoxicity, hand foot syndrome and tumour lysis syndrome. For each toxicity, the causative agents, pathogenesis, clinical features, prevention and treatment strategies are discussed.
This document summarizes different classes of antiviral drugs, including their mechanisms of action, pharmacokinetics, uses, and side effects. It discusses drugs that target herpes viruses like acyclovir and valacyclovir, influenza viruses like amantadine and oseltamivir, hepatitis viruses like lamivudine and ribavirin, and HIV like reverse transcriptase inhibitors and protease inhibitors. The document provides details on how these drugs inhibit virus replication through various mechanisms and their clinical applications and safety profiles.
This document discusses various antiviral drugs used to treat different viral infections. It begins by classifying antiviral drugs into categories based on the virus they target, such as anti-herpes viruses like acyclovir and valacyclovir, anti-influenza viruses like amantadine and oseltamivir, anti-hepatitis viruses/nonselective drugs like lamivudine and ribavirin, and anti-retroviruses used to treat HIV. It then provides more details on the mechanism of action, pharmacokinetics, uses, and side effects of representative drugs from each category.
This document discusses liver cirrhosis, including its definition, causes, clinical presentation, management, and treatment of complications. Cirrhosis is characterized by the replacement of liver tissue with scar tissue, leading to loss of liver function. The most common causes are fatty liver disease, viral hepatitis, and alcohol use. Management involves treating the underlying cause, managing complications, and liver transplantation for severe cases. Complications like ascites, bleeding, and encephalopathy are treated through dietary changes, medications, and procedures.
- Malaria is caused by Plasmodium parasites and spread by Anopheles mosquitoes. It is a major public health issue, with hundreds of millions of cases annually.
- The document discusses the epidemiology and transmission of malaria, symptoms, diagnosis, treatment including for severe and drug-resistant cases, prevention through vector control, and the use of artemisinin derivatives like artesunate which have improved treatment outcomes.
Management of Hepatitis C infection in CKD patients.pptxIRFAN UL HAQ
This document discusses the management of hepatitis C infection in patients with chronic kidney disease. It provides background on HCV, including its structure and life cycle. It then discusses direct-acting antiviral drugs that target specific HCV proteins, including NS3/4A protease inhibitors, NS5A inhibitors, and NS5B polymerase inhibitors. The document reviews treatment goals of eradicating HCV to prevent liver and kidney complications. It recommends treatment for all patients with access to effective antivirals and discusses regimens like glecaprevir-pibrentasvir and sofosbuvir-containing combinations that have demonstrated efficacy and safety in patients with severe renal impairment including those on dialysis.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Recent changes in behavior of plasmodiumBhargav Kiran
Recent Changes in Behavior of Plasmodium
This document discusses recent changes observed in the behavior of the Plasmodium parasite, which causes malaria. It notes that Plasmodium vivax, previously considered a benign infection, has shown a new potential for severe and life-threatening disease. The document also reviews the epidemiology and pathophysiology of malaria, including clinical manifestations like anemia, renal failure, pulmonary edema, and complications in pregnancy. It discusses investigations, treatment approaches for uncomplicated and severe malaria, drug prophylaxis, emerging drug resistance, and strategies for controlling the mosquito vector.
The document discusses malaria, caused by parasites of the Plasmodium genus transmitted via mosquito bites. It affects over 100 countries and kills approximately 2,000 people per day. The most common species causing malaria in India are P. vivax, P. falciparum, P. ovale, and P. knowlesi, with P. falciparum being the most lethal. Malaria symptoms include fever, fatigue, nausea, and in severe cases can include cerebral malaria, acidosis, anemia, renal failure, pulmonary edema, hypoglycemia, and death. Diagnosis involves examining blood smears under a microscope for parasites. Treatment depends on the Plasmodium species and may include chloroquine,
This document summarizes various aspects of antiviral drugs, including their classification, mechanisms of action, and use for specific viruses. It discusses drugs that target DNA viruses like herpes simplex virus and hepatitis B virus. These include nucleoside analogues like acyclovir and ganciclovir that inhibit viral DNA polymerase. It also covers drugs for influenza viruses like amantadine and oseltamivir that inhibit the viral M2 protein and neuraminidase enzyme. Antivirals for hepatitis C virus and human immunodeficiency virus are also outlined, such as interferons, ribavirin, protease inhibitors, and integrase inhibitors. The document provides brief descriptions of each drug's mechanism, pharmac
This document discusses various classes of drugs that influence coagulation, including anticoagulants, antiplatelet drugs, and thrombolytic drugs. It describes several classes of anticoagulants such as heparins, warfarin, direct thrombin inhibitors, and direct factor Xa inhibitors. It provides details on specific drugs within each class, their mechanisms of action, dosing, monitoring, indications, and drug interactions. The focus is on drugs used for venous thromboembolism and non-valvular atrial fibrillation.
This document summarizes the management of autosomal dominant polycystic kidney disease (ADPKD). Current therapy focuses on treating renal and extrarenal complications through pain management, infection control, and hypertension management. New therapies targeting vasopressin receptors like tolvaptan have shown benefits in slowing kidney growth and decline. Kidney transplantation remains the treatment of choice for end-stage renal disease from ADPKD.
Cerebral malaria is the most severe complication caused by Plasmodium falciparum infection. It is characterized by coma and occurs when infected red blood cells sequester in the brain's microvasculature. Sequestration is mediated by cytoadherence of parasite proteins on infected cells to endothelial receptors and results in reduced blood flow and organ damage. Diagnosis involves identifying the parasite on blood smears with treatment consisting of intravenous artesunate or quinine along with supportive care. Prompt and complete antimalarial therapy is needed to prevent relapses.
Hepatitis B virus (HBV) is a DNA virus that causes hepatitis B. It replicates in liver cells and can lead to both acute and chronic infections. HBV is transmitted through bodily fluids and can be spread through sexual contact, sharing needles, or from mother to child during birth. While acute HBV infection may clear spontaneously, chronic HBV requires treatment to prevent progression to cirrhosis or liver cancer. Vaccination provides effective prevention against HBV infection.
Malaria is a protozoan infection transmitted by mosquitoes that infects red blood cells. P. falciparum malaria can cause severe complications such as cerebral malaria, acute renal failure, pulmonary edema, liver dysfunction, hypoglycemia, and acidosis due to parasite sequestration in vital organs. Treatment involves antimalarial drugs like artesunate or quinine plus supportive care for organ dysfunction. Cerebral malaria requires airway control, anticonvulsants, treatment of hypoglycemia, and blood transfusion for severe anemia.
Malaria is a mosquito-borne disease caused by Plasmodium parasites. It is transmitted via the bites of infected Anopheles mosquitoes. The most severe form is caused by P. falciparum, which can lead to complications affecting multiple organ systems if not promptly treated. Treatment depends on the parasite species and severity of infection, but involves antimalarial medications such as artemisinin compounds, chloroquine, primaquine, and quinine. Prevention strategies center around reducing mosquito bites through insecticide-treated bed nets and chemoprophylaxis with antimalarial drugs.
This document provides an overview of acute liver failure (ALF), including its definition, classification, etiology, clinical manifestations, diagnosis, treatment, complications, prognosis, and liver support devices. ALF is defined as evidence of coagulation abnormalities and mental alterations in a patient without preexisting cirrhosis within 26 weeks of illness onset. Common etiologies in India include hepatitis E, drug-induced liver injury, and acetaminophen toxicity. Presentation may include jaundice, coagulopathy, and hepatic encephalopathy. Treatment involves supportive care and managing complications such as cerebral edema. Prognosis is assessed using scoring systems like King's College criteria, with liver transplantation indicated for those who do not recover spontaneously.
This document provides information about acute liver failure in children. It defines acute liver failure as resulting from massive liver cell death or impairment within 8 weeks without pre-existing liver disease. Causes include viral hepatitis, drugs/toxins, metabolic disorders. Clinical features include jaundice, encephalopathy. Management involves supportive care, treating the cause, and preparing for transplant if needed to prevent complications and allow the liver time to regenerate.
This document discusses the etiology and diagnosis of acute pancreatitis. It lists various etiological factors including mechanical obstruction, alcohol, hypertriglyceridemia, genetic mutations, drugs, infections, and trauma. It describes the diagnosis of acute pancreatitis based on abdominal symptoms, lipase or amylase levels, and imaging findings. It also discusses local complications like acute peripancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection, and walled-off necrosis. Organ failure is defined using the Modified Marshall Scoring System.
Management of adverse effects of cancer chemotherapy 2Dr. Pooja
This document discusses the management of adverse effects from cancer chemotherapy. It describes common general side effects such as nausea, vomiting, myelosuppression and mucositis. Specific organ toxicities are also reviewed including liver veno-occlusive disease, hemorrhagic cystitis, nephrotoxicity, neurotoxicity, pulmonary toxicity, cardiotoxicity, hand foot syndrome and tumour lysis syndrome. For each toxicity, the causative agents, pathogenesis, clinical features, prevention and treatment strategies are discussed.
This document summarizes different classes of antiviral drugs, including their mechanisms of action, pharmacokinetics, uses, and side effects. It discusses drugs that target herpes viruses like acyclovir and valacyclovir, influenza viruses like amantadine and oseltamivir, hepatitis viruses like lamivudine and ribavirin, and HIV like reverse transcriptase inhibitors and protease inhibitors. The document provides details on how these drugs inhibit virus replication through various mechanisms and their clinical applications and safety profiles.
This document discusses various antiviral drugs used to treat different viral infections. It begins by classifying antiviral drugs into categories based on the virus they target, such as anti-herpes viruses like acyclovir and valacyclovir, anti-influenza viruses like amantadine and oseltamivir, anti-hepatitis viruses/nonselective drugs like lamivudine and ribavirin, and anti-retroviruses used to treat HIV. It then provides more details on the mechanism of action, pharmacokinetics, uses, and side effects of representative drugs from each category.
This document discusses liver cirrhosis, including its definition, causes, clinical presentation, management, and treatment of complications. Cirrhosis is characterized by the replacement of liver tissue with scar tissue, leading to loss of liver function. The most common causes are fatty liver disease, viral hepatitis, and alcohol use. Management involves treating the underlying cause, managing complications, and liver transplantation for severe cases. Complications like ascites, bleeding, and encephalopathy are treated through dietary changes, medications, and procedures.
- Malaria is caused by Plasmodium parasites and spread by Anopheles mosquitoes. It is a major public health issue, with hundreds of millions of cases annually.
- The document discusses the epidemiology and transmission of malaria, symptoms, diagnosis, treatment including for severe and drug-resistant cases, prevention through vector control, and the use of artemisinin derivatives like artesunate which have improved treatment outcomes.
Management of Hepatitis C infection in CKD patients.pptxIRFAN UL HAQ
This document discusses the management of hepatitis C infection in patients with chronic kidney disease. It provides background on HCV, including its structure and life cycle. It then discusses direct-acting antiviral drugs that target specific HCV proteins, including NS3/4A protease inhibitors, NS5A inhibitors, and NS5B polymerase inhibitors. The document reviews treatment goals of eradicating HCV to prevent liver and kidney complications. It recommends treatment for all patients with access to effective antivirals and discusses regimens like glecaprevir-pibrentasvir and sofosbuvir-containing combinations that have demonstrated efficacy and safety in patients with severe renal impairment including those on dialysis.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
3. Background
• CMV causes congenital infections & disease in
immunocompromised pts
• Retinitis, colitis, esophagitis, encephalitis, pneumonitis
• Usually, disease when CD4 count is low
• During pre-ART era ~25% developed CMV retinitis
• Prevalence in Ethiopia
• 94.4% +ve for IgG, 4·0% for CMV IgM in blood donors
• 88.5% +ve for IgG and 15% +ve for IgM in pregnant
• 1.3% +ve for IgM in newborn
3
4. Ganciclovir/Valganciclovir
• Valganciclovir prodrug converted to ganciclovir
• Analog of the nucleoside guanosine
• Converted IC to ganciclovir 5'-monophosphate by
viral kinase, encoded by CMV gene UL97
• Cellular kinases catalyze formation of ganciclovir
diphosphate & triphosphate
• Present in 10x greater conc in CMV or HSV-infected
cells than uninfected cells
4
5. Ganciclovir/Valganciclovir…
• Ganciclovir is inhibitor of nucleotide incorporation
• Preferential to viral than cellular DNA polymerase
• Poor substrate for chain elongation
• Primarily used in treating CMV infections
• In vitro synergy with Foscarnet against CMV
• Inhibits the replication of HSV-1 & 2, EBV, VZV,
HHV-6, and herpes simian B virus
• Drug of choice for symptomatic herpes simian B
virus disease, including CNS infections
5
6. Ganciclovir/Valganciclovir…
• Antiviral agents preferred for Rx of HSV infections
• Acyclovir, valaciclovir famciclovir,
• Resistance with continued use
• Mutations in the UL97-encoded phosphotransferase
• Alterations in UL54-encoded viral DNA polymerase
• UL97= moderate resistance, no cross-resistance
• UL97 + UL54 = high degree of res & cross-resistance
• Cidofovir and Foscarnet
6
7. Ganciclovir/Valganciclovir…
• Ganciclovir is excreted, unmodified, in the urine
with a plasma t1/2 of 2-4hrs
• IC t1/2 of ganciclovir triphosphate is 16.5 hours
• Dosage adjustment in impaired renal function
• Valganciclovir, L-valyl ester of ganciclovir
• Well absorbed after oral administration
• Rapidly hydrolyzed in the intestinal wall and liver
• bioavailability of ganciclovir from valganciclovir = ~60%
• 900 mg oral valganciclovir = 5 mg/kg IV ganciclovir
7
8. Ganciclovir/Valganciclovir…
Toxicity
• Bone marrow suppression
• Particularly leukopenia
• CMV itself could cause BM depression
• Not used when neutro. < 500/µL, platelet < 25,000/µL
• Renal insufficiency
• low risk from ganciclovir
• Ganciclovir and imipenem may increase risk of
seizure
8
9. Foscarnet
• For treatment of ganciclovir-resistant CMV
• Pyrophosphate analog
• Binds reversibly near the pyrophosphate-binding
site of DNA polymerase
• Blocks cleavage of pyrophosphate moiety from
deoxynucleotide triphosphates
• Halting DNA chain elongation
• Mammalian DNA polymerase requires a 100-fold
greater conc. than to block CMV replication
9
10. Foscarnet…
• Clinical use
• Exclusively to treat CMV infections, and acyclovir
resistant HSV & VZV
• Also Inhibits herpes family viruses, HBV, and HIV
• Cause of resistance; mutations in viral DNA pol.
• Poor oral bioavailability, administered IV
• Vitreous levels approximate those in plasma
• CSF levels average 66% of those in plasma
10
11. Foscarnet…
• Not significantly metabolized and is excreted solely
by the kidneys
• dose adjustment in patients with renal insufficiency
• Renal insufficiency
• ~27% of people develop reduction in renal function
• Direct tubular damage
• Including nephrogenic diabetes insipidus
• Concomitant saline administration = reduced incidence
11
12. Foscarnet…
• Electrolyte disturbance
• Hypocalcemia = complex formation with free Ca+2
• Hypomagnesemia leading to hypocalcemia &
hypokalemia
• Seizure, genital ulcerations, anemia, nausea
12
13. Cidofovir
• Nucleotide mainly used for CMV retinitis in HIV pts
• Cytidine analog, inhibits viral DNA polymerase
• Incorporation of drug disrupts further chain elongation
• Not phosphorylated by a viral kinase
• Mechanism of resistance
• Mutations in the viral DNA polymerase gene
• Unaffected by mutations in CMV phosphotransferase
• Which confer resistance to ganciclovir
• Prolonged therapy with ganciclovir cause DNA
polymerase mutations; cross-resistance to cidofovir 13
14. Cidofovir…
• > 80 % excreted unchanged in urine within 24hrs
• contraindicated in proteinuria (2+ or greater) or
baseline serum creatinine greater than 1.5 mg/dL
• t1/2 in serum 2.4-3.2hrs, but IC 24-65 hours
• used every two weeks
• Most important adverse effects; renal toxicity
• Creatinine and urine protein checked within 48 hours
prior to each dose, reduced or avoided
• ~50% of pts developed either
• Proteinuria, ↑ creatinine, ↓ creatinine clearance
14
15. Cidofovir…
• Pts should receive 1 lt of saline prior to dose
• Repeat 1lt if pts tolerate either during or immediately
following the drug
• Also, probenecid 2g PO 3hrs prior, 1g 2hrs and 8h
following cidofovir
15
One study of 76 AIDS patients with cytomegalovirus (CMV) retinitis treated initially with ganciclovir reported resistance in 11 percent of patients at six months of treatment and 28 percent at nine months
Ganciclovir is given primarily as an intravenous formulation rather than orally because of its poor bioavailability (ie, 6 percent) that is only modestly increased by food
A sustained-release ganciclovir intraocular implant is also available for the treatment of CMV retinitis.
Ganciclovir intraocular implants, while avoiding systemic side effects, can be associated with complications of ophthalmologic surgery, such as endophthalmitis and intravitreal bleeding, and may increase the risk of early retinal detachment
The usual dose of ganciclovir for induction therapy is 5 mg/kg every 12 hours followed by 5 mg/kg as a single daily infusion for maintenance therapy
The duration of therapy will depend on the host and the severity of disease.
Generally speaking, the duration of induction is 14 to 21 days in the HIV-infected host with invasive infection
while the induction period is 7 to 14 days in the transplant patient with invasive disease.
In patients able to take and absorb oral medications, valganciclovir is a reasonable alternative to intravenous (IV) ganciclovir for both induction and maintenance therapy
The dosing of valganciclovir , in adult patients with normal renal function, is 900 mg twice daily for 21 days during induction therapy followed by single daily dosing during maintenance therapy
pregnancy category C substance
Foscarnet = trisodium phosphonoformate
Sequestration in bone with gradual release accounts for the fate of an estimated 10-20% of a given dose
Dose-limiting toxicities are nephrotoxicity and symptomatic hypocalcemia
Other electrolyte disturbances that may occur include hypophosphatemia, hypercalcemia, and hyperphosphatemia
it is unclear whether seizure reflects direct toxicity, drug-induced hypocalcemia, or underlying conditions
This problem, combined with the requirement for concomitant hydration and need for electrolyte monitoring, make this drug more difficult to administer than ganciclovir
These lesions are reversible and potentially preventable with careful urinary hygiene
Approximately 50 percent of patients receiving cidofovir in clinical trials developed either proteinuria (2+ or greater), increased serum creatinine (rise of at least 0.4 mg/dL) or decreased creatinine
Renal dysfunction is usually reversible with discontinuation of the drug
Nausea and vomiting are common side effects of probenecid and may be reduced by giving the drug with food or by administration of antiemetics. Rash is also common and management with an antihistamine and/or acetaminophen may be appropriate [ 8 ].
Neutropenia has been observed in approximately 20 percent of patients receiving cidofovir [ 8 ]; it is more difficult to establish causality for this finding given its common appearance in advanced AIDS