This document discusses several antiviral agents including acyclovir, valacyclovir, famciclovir, and penciclovir. It provides details on their structures, synthesis methods, therapeutic uses for treating herpes viruses, and pharmacokinetic properties. The document is dedicated to the author's son and discusses how readership and website traffic have helped keep his son smiling by motivating the author in his work.
THIS PRESENTATION ABOUT ANTIMALARIAL DRUGS DETAILING THE COMPLETE INFORMATION ABOUT THE DRUGS USED WITH ITS MECHANISM OF ACTION, STRUCTURAL ACTIVITY AND DOSES.
Diuretics have been empirically developed. Inorganic mercury was used as diuretics from 16C. Guy's Hospital Pills (containing the equal part of Hg2Cl2, digitalis, and squill) was well known in the 19 C. Discovery of the diuresis of merbaphen has led to develop many organomercurial diuretics and to give suggestion of the drug design of ethacrynic acid. Diuresis in patients given sulfonamide was discovered in 1938. Inhibition of carbonic anhydrase by sulfonamide was related to its diuresis. Drug design aimed to enhance the inhibition of this enzyme has obtained acetazolamide, then chlorothazide. But, the discovery of remarkably enhanced diuretic activity (decreased inhibition on the enzyme) of hydrochlorothazide changed this drug design to rondom chemical modification of thiazide ring. Then, furosemide and other loop diuretics were obtained. The structure-activity relationship of thiazides using the electronic state and other physico-chemical indices was studied by us. A large hydrophobic center linked to a positive formal charge was assumed to the receptor of thiazide. Binding of thiazide to erythrocyte which gives mild and long acting diuretic property was found by us. Recently, shut down of the tubuloglomerular feedback by loop diuretics was reported. Loop diuretics are metabolized to loss their activity. Therapeutic drug monitoring is necessary to obtain a desirable diuresis. By wide clinical use of thiazides and loop diuretics, patients with hyponatremia with eu-or hypervolemic increased. I have proposed aquaretics since 1976. In 1992, nonpeptide selective vasopressin V2 receptor antagonist (OPC-31260) was first synthesized in Japan. This has been found to cause hypotonic diuresis and elevation of serum Na level in men. The combined use of loop diuretics and aquaretics should be considered.
THIS PRESENTATION ABOUT ANTIMALARIAL DRUGS DETAILING THE COMPLETE INFORMATION ABOUT THE DRUGS USED WITH ITS MECHANISM OF ACTION, STRUCTURAL ACTIVITY AND DOSES.
Diuretics have been empirically developed. Inorganic mercury was used as diuretics from 16C. Guy's Hospital Pills (containing the equal part of Hg2Cl2, digitalis, and squill) was well known in the 19 C. Discovery of the diuresis of merbaphen has led to develop many organomercurial diuretics and to give suggestion of the drug design of ethacrynic acid. Diuresis in patients given sulfonamide was discovered in 1938. Inhibition of carbonic anhydrase by sulfonamide was related to its diuresis. Drug design aimed to enhance the inhibition of this enzyme has obtained acetazolamide, then chlorothazide. But, the discovery of remarkably enhanced diuretic activity (decreased inhibition on the enzyme) of hydrochlorothazide changed this drug design to rondom chemical modification of thiazide ring. Then, furosemide and other loop diuretics were obtained. The structure-activity relationship of thiazides using the electronic state and other physico-chemical indices was studied by us. A large hydrophobic center linked to a positive formal charge was assumed to the receptor of thiazide. Binding of thiazide to erythrocyte which gives mild and long acting diuretic property was found by us. Recently, shut down of the tubuloglomerular feedback by loop diuretics was reported. Loop diuretics are metabolized to loss their activity. Therapeutic drug monitoring is necessary to obtain a desirable diuresis. By wide clinical use of thiazides and loop diuretics, patients with hyponatremia with eu-or hypervolemic increased. I have proposed aquaretics since 1976. In 1992, nonpeptide selective vasopressin V2 receptor antagonist (OPC-31260) was first synthesized in Japan. This has been found to cause hypotonic diuresis and elevation of serum Na level in men. The combined use of loop diuretics and aquaretics should be considered.
Tetracyclines are Octahydro napthacene derivatives which are bacteriostatic potent broad spectrum antibiotics and are the most widely prescribed form of antibiotic after penicillins.
TETRA means = four
CYCL means = hydrocarbon rings
INE means = derivation.
Tetracyclines are introduced 50 years ago as potent broad spectrum antibiotics.
They are biosynthesized form acetic acid and propionic acid units in microorganisms.
THIS IS ABOUT SCHEDULES AND RULES IMPLEMENTED FOR MANUFACTURING, IMPORT, EXPORT, PRESCRIPTION, STORAGE OF ALLOPATHY, AYURVEDIC AND UNANI DRUGS.THERE IS DIFFERENT SCHEDULE FOR DIFFERENT KIND OF DRUGS LIKE BIOLOGICAL PRODUCTS, NARCOTIC DRUGS ETC.
Tetracyclines are Octahydro napthacene derivatives which are bacteriostatic potent broad spectrum antibiotics and are the most widely prescribed form of antibiotic after penicillins.
TETRA means = four
CYCL means = hydrocarbon rings
INE means = derivation.
Tetracyclines are introduced 50 years ago as potent broad spectrum antibiotics.
They are biosynthesized form acetic acid and propionic acid units in microorganisms.
THIS IS ABOUT SCHEDULES AND RULES IMPLEMENTED FOR MANUFACTURING, IMPORT, EXPORT, PRESCRIPTION, STORAGE OF ALLOPATHY, AYURVEDIC AND UNANI DRUGS.THERE IS DIFFERENT SCHEDULE FOR DIFFERENT KIND OF DRUGS LIKE BIOLOGICAL PRODUCTS, NARCOTIC DRUGS ETC.
La disponibilidad de un sistema de multiplicación del virus de la hepatitis C (VHC) infeccioso en cultivos celulares está permitiendo investigar nuevos factores de respuesta a tratamientos antivíricos en condiciones controladas. Se presentará evidencia de que el fitness vírico puede ser un factor de multiresistencia a inhibidores y quese pueden obtener eficientes reducciones de carga viral empleando diseños secuenciales de administración de inhibidores que incluyan ribavirina. Se discutirán posibilidades de aplicación clínica.
Definition: Antiviral agents are substances used in the treatment and prophylaxis of disease caused by viruses.
Classification:
A] Agents involves the inhibition of early stage of viral replication (Adamantane derivatives)
Admantane
Amantadine
Rimantadine
Tromantadine
B] Interferon:
Tilorane
ABPP (Bromopirimine)
CP20,961
This presentation mainly deals with Rdna, its properties, sources and applications.According to my opinion the best ppt i have ever prepared to crack the seminar exam during my college days.I am sure everyone is going to like it and please comment if u all like it....
Science Behind The News: TAP(Triaminopyrimidine) discovered as a promising dr...Kiran Shaw
In a path breaking discovery, Scientists from Bengaluru and across the world have discovered triaminopyrimidine (TAP) as a promising drug candidate for malaria that kills the parasite rapidly over a long duration.This article published by Nature on the 31st of March dwells into the science behind this drug discovery.
A slideshow for my collegues in hospitals on 2014 Oct 15th.
This presentation is about a case who developed resistance to lamivudine, an anti-HBV agent, during treatment. We discussed about how resistance develop, how to interpret resistance result, and how to optimize the therapy in lamivudine-resistant settings. Time to stop anti-viral agents is also discussed.
What is IP, Patents in Pharma Industry by Dr Anthony Crasto, a complete guide for patenting in drug synthesis, discovery, process, polymorphs, AN INSIGHT INTO PCT, DATES, CLAIMS, DEFINITIONS ETC, all you want to know about criteria, method mode, advantages etc, EMAIL ME amcrasto@gmail.com, call +91 9323115463
BENAZEPRIL HYDROCHLORIDE SYNTHESIS BY DR ANTHONY CRASTO, WORLD DRUG TRACKER...............DR ANTHONY MELVIN CRASTO Ph.D ( ICT, Mumbai) , INDIA 25Yrs Exp. in the feld of Organic Chemistry,Working for GLENMARK GENERICS at Navi Mumbai, INDIA. Serving chemists around the world. Helping them with websites on Chemistry.Million hits on google, NO ADVERTISEMENTS , ACADEMIC , NON COMMERCIAL SITE, world acclamation from industry, academia, drug authorities for websites, blogs and educational contribution, ........amcrasto@gmail.com..........
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
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3. DDeeddiiccaatteedd ttoo mmyy ssoonn LLiioonneell
CCrraassttoo,,
He was only in first standard in school (dec2007) when
I was Paralysed head to toe.
His smiling face sees me through day in and day out.
Vast readership from academia and industry motivates me, and keeps me going.
I am helping millions with free advertisement free websites and has million hits on
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Thanks for helping me to keep lionel smiling
4. AANNTTII--VVIIRRAALL AAGGEENNTTSS
VIRUSES:
Single or double stranded DNA or RNA
enclosed in a protein – CAPSID
Obligate intracellular parasite
Replication depends on synthetic processes of
the host cell
Anti-viral drugs must either block entry or exit
from cell or be active inside the host cell
5. VVIIRRAALL RREEPPLLIICCAATTIIOONN
Viral attachment and entry (enfuvirtide, docosanol,
palivizumab)
Adsorption and penetration into susceptible host
cells (Globulins and interferon-alfa)
Un-coating of viral nucleic acid (Amantadine)
Synthesis of early regulatory proteins (Fomivirsen)
Synthesis of RNA or DNA (RT Inhibitors)
Synthesis of late regulatory proteins
(Protease Inhibitors)
Packing and Assembly (maturation) of viral
particles (Rifampicin)
Release from cells (Neuraminidase Inhibitors)
14. Title: Acyclovir
CAS Registry Number: 59277-89-3
CAS Name: 2-Amino-1,9-dihydro-9-[(2-hydroxyethoxy)methyl]-6H-purin-6-one
Additional Names: acycloguanosine; 9-[(2-hydroxyethoxy)methyl]guanine
Manufacturers' Codes: BW-248U; Wellcome 248U
Trademarks: Acicloftal (Bruschettini); Avirase (Lampugnani); Cycloviran (Sigma-Tau); Maynar (Ferrer); Virmen
(Menarini); Viruseen (Hommel); Zoliparin (Mann); Zovir (GSK); Zovirax (GSK)
Molecular Formula: C8H11N5O3
Molecular Weight: 225.20
Percent Composition: C 42.67%, H 4.92%, N 31.10%, O 21.31%
Literature References: Orally active acyclic nucleoside with inhibitory activity towards several herpes viruses.
Prepn: H. J. Schaeffer, DE 2539963; idem, US 4199574 (1976, 1980 to Wellcome). Convenient synthesis from
guanine: H. Matsumoto et al.,Chem. Pharm. Bull. 36, 1153 (1988). Selectivity of action: G. B. Elion et al., Proc. Natl.
Acad. Sci. USA 74, 5716 (1977). Chemistry, antiviral activity, metabolism: H. J. Schaeffer et al., Nature 272, 583
(1978). In vitro activity: P. Collins, D. J. Bauer, J. Antimicrob. Chemother. 5, 431 (1979). Effect on herpes simplex
infections in mice: H. J. Field et al., Antimicrob. Agents Chemother. 15, 554 (1979); on herpes zoster in
immunocompromised patients: H. H. Balfour et al., N. Engl. J. Med. 308, 1448 (1983). Treatment of primary
episodes of genital herpes simplex infection: Y. J. Bryson et al., ibid. 916; of recurrent genital herpes: S. E. Straus et
al., ibid. 310, 1545 (1984); J. M. Douglas et al., ibid. 1551. HPLC determn in serum and clinical pharmacokinetics: G.
Bahrami et al., J. Chromatogr. B 816, 327 (2005). Symposia on pharmacology and clinical studies: Am. J.
Med. 73, Suppl. 1A, 1-392 (1982); J. Antimicrob. Chemother. 12, Suppl. B, 1-202 (1983); Scand. J. Infect.
Dis. Suppl. 47, 1-176 (1985). Review: R. J. Whitley, J. W. Gnann, Jr., N. Engl. J. Med. 327, 782-789 (1992).
Properties: Crystals from methanol, mp 256.5-257°. LD50 in mice (mg/kg): >10,000 orally; 1000 i.p. (Schaeffer).
Melting point: mp 256.5-257°
Toxicity data: LD50 in mice (mg/kg): >10,000 orally; 1000 i.p. (Schaeffer)
Therap-Cat: Antiviral.
Keywords: Antiviral; Purines/Pyrimidinones.
17. DDeessccrriippttiioonn
The reaction of benzonitrile (I) with refluxing ethylene glycol (II) gives ethylene glycol
monobenzoate (III),
which is chloromethylated with formaldehyde a
and dry HCl in CH2Cl2 affording 1-benzoyloxy-2-chloromethoxyethane (IV). The
condensation of (IV) with 2,6-dichloropurine (V)
by means of triethylamine in DMF yields 2,6-dichloro-9-(2-
benzoyloxyethoxymethyl)purine (VI), which is aminated and
debenzoylated by treatment with
NH3 in methanol at 95 C in a pressure vessel giving 2-chloro-9-(2-
hydroxyethoxymethyl)adenine (VII).
The Sandmeyer reaction of (VII) with N
aNO2 in acetic acid affords 2-chloro-9-(2-hydroxyethoxymethyl)hypoxanthine (VIII),
which is finally amonolyzed with ammonia in methanol at 125 C in a pressure vessel.
20. Title: Valacyclovir
CAS Registry Number: 124832-26-4
CAS Name: L-Valine 2-[(2-amino-1,6-dihydro-6-oxo-9H-purin-9-yl)methoxy]ethyl ester
Additional Names: L-valine ester with 9-[(2-hydroxyethoxy)methyl]guanine; valaciclovir; ValACV
Molecular Formula: C13H20N6O4
Molecular Weight: 324.34
Percent Composition: C 48.14%, H 6.22%, N 25.91%, O 19.73%
Literature References: L-Valine ester prodrug of acyclovir, q.v. Prepn: T. A. Krenitsky et al., EP 308065; L. M.
Beauchamp, US4957924 (1989, 1990 both to Wellcome). Evaluation as prodrug: L. M. Beauchamp et al., Antiviral
Chem. Chemother. 3, 157 (1992). Clinical pharmacokinetics: S. Weller et al., Clin. Pharmacol. Ther. 54, 595
(1993). Review of pharmacology and clinical efficacy in herpes virus infections: C. M. Perry, D.
Faulds, Drugs 52, 754-772 (1996). Clinical trial to prevent cytomegalovirus disease in renal transplantation: D.
Lowance et al., N. Engl. J. Med. 340, 1462 (1999); to prevent transmission of genital herpes: L. Corey et
al., ibid. 350, 11 (2004).
Derivative Type: Hydrochloride
CAS Registry Number: 124832-27-5
Manufacturers' Codes: 256U; BW-256U87; BW-256
Trademarks: Valtrex (GSK)
Properties: Crystalline solid, occurs as hydrate. uv max (water): 252.8 nm (e 8530). Soly in water: 174 mg/ml.
Absorption maximum: uv max (water): 252.8 nm (e 8530)
22. DDEESSCCRRIPPTTIOONN
Acyclovir (I) was coupled with N-Cbz-L-valine (II) in the
presence of DCC and DMAP to afford the Cbz-protected valyl
ester (III). The N-benzyloxycarbonyl group of (III) was then
removed by either hydrogenation over Pd / C or by transfer
hydrogenation in the presence of formic acid.
24. Title: Famciclovir
CAS Registry Number: 104227-87-4
CAS Name: 2-[2-(2-Amino-9H-purin-9-yl)ethyl]-1,3-propanediol diacetate (ester)
Additional Names: 9-[4-acetoxy-3-(acetoxymethyl)but-1-yl]-2-aminopurine; FCV
Manufacturers' Codes: BRL-42810
Trademarks: Oravir (SKB); Famvir (SKB)
Molecular Formula: C14H19N5O4
Molecular Weight: 321.33
Percent Composition: C 52.33%, H 5.96%, N 21.79%, O 19.92%
Literature References: Prodrug of penciclovir, q.v. Prepn: M. R. Harnden, R. L. Jarvest, AU 85
47560; eidem, US 5246937 (1986, 1993 both to Beecham); M. R. Harnden et al., J. Med. Chem. 32, 1738 (1989).
HPLC determn in plasma and urine: J. R. McMeekin et al., Anal. Proc. 29, 178 (1992). Review of metabolism and
mode of action: R. A. Vere Hodge, Antiviral Chem. Chemother. 4, 67-84 (1993). Series of articles on pharmacology
and pharmacokinetics: ibid. Suppl. 1, 37-68 (1993). Review of clinical efficacy in herpes zoster and genital herpes: R.
Circelli et al., Antiviral Res. 29, 141-151 (1996).
Properties: White shiny plates from ethyl acetate-hexane, mp 102-104°. uv max (methanol): 222, 244, 309 nm
(e 27500, 4890, 7160). Sol in water (25°): >25% w/v initially; rapidly ppts as sparingly sol monohydrate (2-3% w/v).
Freely sol in acetone, methanol; sparingly sol in ethanol, isopropanol.
Melting point: mp 102-104°
Absorption maximum: uv max (methanol): 222, 244, 309 nm (e 27500, 4890, 7160)
Therap-Cat: Antiviral.
Keywords: Antiviral; Purines/Pyrimidinones.
25. FFAAMMCCIICCLLOOVVIIRR
First episode genital herpes
250 mg TID for 5-10 days
Recurrent genital herpes – 250 mg BID for 1 year
Herpes zoster of 3 days – 500 mg TID x 10 days It is as effective as
acyclovir in reducing healing time and zoster associated pain
Famciclovir is a guanine analogue antiviral drug used for the treatment of various herpesvirus
infections, most commonly for herpes zoster (shingles). It is aprodrug form of penciclovir with
improved oral bioavailability.
Famciclovir is marketed under the trade name Famvir (Novartis).
On August 24, 2007, the United States Food and Drug Administration approved the first generic
version of famciclovir.
Generic Famciclovir Tablets (125 mg, 250 mg, 500 mg) are manufactured by
TEVA Pharmaceuticals and Mylan Pharmaceuticals.
26.
27. DDEESSCCRRIIPPTTIIOONN
Synthesis
This compound has been obtained by two similar ways (Scheme 10704402a): 1)
The reaction of 6-chloropurine-2-amine (I) with 6,6-dimethyl-5 ,7-dioxaspiro [2,5]
octane-4 ,8-dione (II) by means of K2CO3 in DMF gives the expected
condensation product (III), which is methanolized with HCl / methanol yielding 2 -
[2 - (2-amino-6-methoxypurin-9-yl ) ethyl] malonic acid dimethyl ester (IV). The
reduction of (IV) with NaBH4 in t-butanol/methanol affords the corresponding diol
(V), which is finally converted into pecnciclovir by hydrolysis with 2N NaOH. 2)
The reaction of purine (I) with 3-bromopropane-1 ,1,1-tricarboxylic acid triethyl
ester (VI) by means ofK2CO3 in DMF gives the expected condensation product
(VII), which is partially decarboxylated with sodium methoxide in methanol yielding
2 - [2 - (2-amino-6-chloropurin-9-yl) ethyl] malonic acid diethyl ester (VIII). The
reduction of (VIII) with NaBH4 in t-butanol/methanol followed by acetylation with
acetic anhydride affords the corresponding diol diacetate ( IX), which is finally
converted into penciclovir by hydrlysis with 2N HCl. Synthesis of 126242: A
synthesis of famciclovir that corresponds to that previously published and studies
on its oral bioavailability in rats and mice, identifying famciclovir as the preferred
prodrug of BRL-39123 (penciclovir), have been published. (Scheme 12624201a)
28. FFAAMMCCIICCLLOOVVIIRR
Comparable to valacyclovir in treating
zoster and reducing associated pain in
older adults
500 mg TID x 10 days is comparable to
high dose of acyclovir in treating zoster
in immuno-compromised patients and in
opthalmic zoster
Associated with dose-related reductions
in Hepatitis B Virus DNA and
transaminase levels in patients with
chronic HBV hepatitis
30. Title: Penciclovir
CAS Registry Number: 39809-25-1
CAS Name: 2-Amino-1,9-dihydro-9-[4-hydroxy-3-(hydroxymethyl)butyl]-6H-purin-6-one
Additional Names: 9-[4-hydroxy-3-(hydroxymethyl)but-1-yl]guanine; PCV
Manufacturers' Codes: BRL-39123
Trademarks: Denavir (SKB); Vectavir (SKB)
Molecular Formula: C10H15N5O3
Molecular Weight: 253.26
Percent Composition: C 47.42%, H 5.97%, N 27.65%, O 18.95%
Literature References: Carba analog of ganciclovir, q.v., active against several herpes viruses. Prepn: U. K. Pandit et
al., Synth. Commun. 2, 345 (1972); R. L. Jarvest, M. R. Harnden, US 5075445 (1991 to Beecham). Synthesis: M. R.
Harnden et al., J. Med. Chem. 30, 1636 (1987); J. Hannah et al., J. Heterocycl. Chem. 26, 1261 (1989). Crystal and
molecular structures: M. R. Harndenet al., Nucleosides Nucleotides 9, 499 (1990). In vitro activity of enantiomers in
comparison with acyclovir, q.v.: G. Abele et al.,Antiviral Chem. Chemother. 2, 163 (1991); against herpes simplex
viruses: A. Weinberg et al., Antimicrob. Agents Chemother. 36,2037 (1992). Clinical pharmacokinetics: S. E. Fowles et
al., Eur. J. Clin. Pharmacol. 43, 513 (1992). HPLC determn in plasma and urine: J. R. McMeekin et al., Anal.
Proc. 29, 178 (1992). Review of development and antiviral activity: M. R. Harnden, Drugs Future14, 347-358 (1989).
Properties: White crystalline solid from water, (monohydrate), mp 275-277°; also reported as colorless matted needles,
mp 272-275°. uv max (in water): 253 nm (e 11500). uv max (aq 0.01N NaOH): 215, 268 nm (e 18140, 10710). Sol in
water (20°): 1.7 mg/ml, pH 7.
Melting point: mp 275-277°; mp 272-275°
Absorption maximum: uv max (in water): 253 nm (e 11500); uv max (aq 0.01N NaOH): 215, 268 nm (e 18140, 10710)
Derivative Type: Sodium salt
Manufacturers' Codes: BRL-39123A
Properties: Occurs as monohydrate, stable crystalline solid. Sol in water (20°): >200 mg/ml. 30 mg/ml soln has pH 11.
Therap-Cat: Antiviral.
Keywords: Antiviral; Purines/Pyrimidinones.
31. PPEENNIICCIICCLLOOVVIIRR
Penciclovir (INN) is a guanine analogue antiviral drug used for the treatment of
various herpesvirus infections.
It is a nucleoside analogue which exhibits low toxicity and good selectivity.
Because penciclovir is absorbed poorly when given orally (by mouth)
it is used more as a topical treatment, and is the active ingredient in the cold
sore medications Denavir (NDC 0135-0315-52), Vectavir and Fenistil.
Famciclovir is a prodrug of penciclovir with improved oral bioavailability.
33. DDEESSCCRRIIPPTTIIOONN
The synthesis of penciclovir by two related ways has been reported: 1) The reaction of 2 - (hydroxymethyl)
butane-1 ,4-diol (I) with formaldehyde (or an aldehyde such as trimethylacetaldehyde) (II) by means of H2SO4
( or p-toluenesulfonic acid, TsOH) gives the dioxane (III), which by reaction first with methanesulfonyl chloride
and
triethylamine and then with NaI in acetone affords the corresponding 5 - (2-iodoethyl) -1,3-dioxane (IV).
The reaction of (IV) with 2-amino-6-chloropurine (V) by means of K2CO3 in DMF gives the corresponding
condensation product (VI),
which is finally hydrolyzed and deprotected with refluxing 2M aqueous HCl. 2) The reaction of triol (I)
with 2,2-dimethoxypropane (VII) by means of TsOH gives the corresponding
1,3-dioxane (VIII), which by reaction with triphenylphosphine and CBr4 is converted to the 5 - (2-bromoethyl)
derivative (IX) .
The reaction of (IX) with the purine (V) by means of K2CO3 as before affords the corresponding condensation
product (X),
which is hydrolyzed and deprotected with 2M HCl as before.
34. MMEECCHHAANNIISSMM OOFF AACCTTIIOONN
Inhibitor of viral DNA synthesis
Initially phosphorylated by viral thymidine kinase
Penciclovir triphosphate has a lower
affinity in competitive inhibition of viral DNA
polymerase thus can not cause chain termination
100 fold less potent in inhibiting DNA polymerase
than acyclovir but present in higher concentration
and prolonged period in infected cells
35. TTRRIIFFLLUURRIIDDIINNEE
Fluorinated pyrimidine nucleoside that
has an in vitro inhibitory activity against
HSV 1 & 2 , CMV, vaccinia and certain
adenoviruses
Inhibits viral DNA synthesis
Phosphorylated intracellularly into its
active form by cellular enzymes
Incorporation into both viral and cellular
DNA prevents its systemic use
36. Title: Trifluridine
CAS Registry Number: 70-00-8
CAS Name: a,a,a-Trifluorothymidine
Additional Names: 2¢-deoxy-5-(trifluoromethyl)uridine; 5-(trifluoromethyl)-2¢-deoxyuridine; F3TDR
Manufacturers' Codes: NSC-75520
Trademarks: TFT Thilo (Alcon-Thilo); Virophta (Dulcis); Viroptic (Burroughs Wellcome)
Molecular Formula: C10H11F3N2O5
Molecular Weight: 296.20
Percent Composition: C 40.55%, H 3.74%, F 19.24%, N 9.46%, O 27.01%
Literature References: Prepn: C. Heidelberger et al., J. Am. Chem. Soc. 84, 3597 (1962); eidem, J. Med.
Chem. 7, 1 (1964); C. Heidelberger, US 3201387 (1965 to U.S. Dept. HEW). Crystal structure: A. H.
Tench, Diss. Abstr. Int. B 33, 3587 (1973). NMR study: R. J. Cushley et al., J. Am. Chem. Soc. 90, 709
(1968). Metabolism: D. L. Dexter et al., Cancer Res. 32, 247 (1972); W. J. O'Brien, H. F. Edelhauser, Invest.
Ophthalmol. Visual Sci. 16, 1093 (1977). Pharmacodynamics: B. L. Wigdahl, J. R. Parkhurst,Antimicrob.
Agents Chemother. 14, 470 (1978); G. J. Smith et al., Biochem. Biophys. Res. Commun. 83, 1538 (1978).
Teratogenicity study: M. Itoi et al., Arch. Ophthalmol. 93, 46 (1975). Cytotoxicity and mutagenicity study: E.
Huberman, C. Heidelberger, Mutat. Res. 14, 130 (1972). Clinical studies: H. E. Kaufman, Invest.
Ophthalmol. Visual Sci. 17, 941 (1978); R. A. Hyndiuk et al., Arch. Ophthalmol. 96, 1839 (1978). Review of
mechanism of antiviral activity: C. Heidelberger, Ann. N.Y. Acad. Sci.255, 317 (1975). Review of
pharmacology and therapeutic use: A. A. Carmine et al., Drugs 23, 329-353 (1982).
Properties: Cryst from ethyl acetate, mp 186-189°. uv max (0.1N HCl): 260 nm (e 9960);
(0.1N NaOH): 260 nm (e 6590).
Melting point: mp 186-189°
Absorption maximum: uv max (0.1N HCl): 260 nm (e 9960);
(0.1N NaOH): 260 nm (e 6590)
Therap-Cat: Antiviral (ophthalmic).
37. MMEECCHHAANNIISSMM OOFF AACCTTIIOONN
Trifluridine monophosphate
irreversibly inhibits thymidylate
synthetase
Trifluridine triphosphate is a
competitive inhibitor of thymidine
triphosphate incorporation into DNA
by DNA polymerases
38. VVIIDDAARRAABBIINNEE
Adenosine analog with an in vitro activity
against HSV, VZV, and CMV
Phosphorylated intracellularly by host
enzymes to form ara-ATP and then
inhibits viral DNA polymerase
Vidarabine triphosphate is incorporated
into both viral and cellular DNA
Rapidly metabolized in vivo to
hypoxanthine arabinoside through
removal of 6-amino group by adenosine
deaminase – decrease viral activity
39. Title: Vidarabine
CAS Registry Number: 5536-17-4
CAS Name: 9-b-D-Arabinofuranosyl-9H-purine-6-amine monohydrate
Additional Names: 9-b-D-arabinofuranosyladenine monohydrate; arabinosyladenine; adenine arabinoside;
spongoadenosine; ara-A
Manufacturers' Codes: CI-673
Trademarks: Arasena-A (Mochida); Vira-A (Warner-Lambert)
Molecular Formula: C10H13N5O4.H2O
Molecular Weight: 285.26
Percent Composition: C 42.10%, H 5.30%, N 24.55%, O 28.04%
Literature References: Purine nucleoside first synthesized as a potential anticancer agent: Lee et al., J. Am. Chem.
Soc. 82,2648 (1960); Reist et al., J. Org. Chem. 27, 3274 (1962); Glaudemans, Fletcher, ibid. 28, 3004 (1963); Reist et
al., ibid. 29, 3725 (1964). Fermentation process using a strain of Streptomyces antibioticus: GB 1159290; J. D.
Howells, A. Ryder, US 3616208(1969, 1971 both to Parke, Davis). Crystal and molecular structure: Bunick, Voet, Acta
Crystallogr. 30B, 1641 (1974). Series of articles on antiviral activity: Antimicrob. Agents Chemother. 1968, 136-179.
Toxicity study: S. M. Kurtz et al., ibid. 180. HPLC determn in plasma and urine: W. P. McCann et al., ibid. 28, 265
(1985). Clinical trial in immunocompromised patients: R. J. Whitley et al., J. Infect. Dis. 165, 450 (1992).
Book: Adenine Arabinoside: An Antiviral Agent, D. Paven-Langston et al., Eds. (Raven Press, New York, 1975) xviii +
425 pp. Review of pharmacology and clinical experience: R. A. Buchanan, F. Hess,Pharmacol. Ther. 8, 143-171
(1980). Comprehensive description: W. Hong et al., Anal. Profiles Drug Subs. 15, 647-672 (1986).
Properties: Crystals from water, mp 257.0-257.5° (0.4 H2O). [a]D27 -5° (c = 0.25). uv max (pH 1): 257.5 nm
(e 12700); pH 7: 259 nm (e 13400); pH 13: 259 nm (e 14000). LD50 in mice (mg/kg): 4677 i.p.; >7950 orally (Kurtz).
Melting point: mp 257.0-257.5° (0.4 H2O)
Optical Rotation: [a]D27 -5° (c = 0.25)
Absorption maximum: uv max (pH 1): 257.5 nm (e 12700); pH 7: 259 nm (e 13400); pH 13: 259 nm (e 14000)
Toxicity data: LD50 in mice (mg/kg): 4677 i.p.; >7950 orally (Kurtz)
Therap-Cat: Antiviral.
Keywords: Antiviral; Purines/Pyrimidinones.
41. DDOOCCOOSSAANNOOLL
Saturated 22-carbon aliphatic alcohol.
Inhibits FUSION between plasma
membrane and HSV envelope resulting
in prevention of viral entry into cells and
subsequent viral replication.
Only for orolabial HERPES
44. Title: Ganciclovir
CAS Registry Number: 82410-32-0
CAS Name: 2-Amino-1,9-dihydro-9-[[2-hydroxy-1-(hydroxymethyl)ethoxy]methyl]-6H-purin-6-one
Additional Names: 9-[(1,3-dihydroxy-2-propoxy)methyl]guanine; 2¢-nor-2¢-deoxyguanosine; DHPG; 2¢NDG
Manufacturers' Codes: BIOLF-62; BW-B759U; BW-759; BW-759U; RS-21592
Molecular Formula: C9H13N5O4
Molecular Weight: 255.23
Percent Composition: C 42.35%, H 5.13%, N 27.44%, O 25.07%
Literature References: Nucleoside analog structurally related to acyclovir, q.v. Prepn: J. P. Verheyden, J. C.
Martin, US 4355032(1982 to Syntex); K. K. Ogilvie et al., Can. J. Chem. 60, 3005 (1982); W. T. Ashton et
al., Biochem. Biophys. Res. Commun. 108,1716 (1982); J. C. Martin et al., J. Med. Chem. 26, 759 (1983). Antiviral
spectrum in vitro: K. O. Smith et al., Antimicrob. Agents Chemother. 22, 55 (1982). Mode of action study: Y.-C.
Cheng et al., Proc. Natl. Acad. Sci. USA 80, 2767 (1983). Clinical treatment of cytomegalovirus infection in
immunodeficient patients: S. H. Koretz et al., N. Engl. J. Med. 314, 801 (1986). Symposium on pharmacology and
clinical efficacy vs cytomegalovirus: Rev. Infect. Dis. 10, Suppl. 3, S457-S572 (1988). Review:C. S. Crumpacker, N.
Engl. J. Med. 335, 721-729 (1996).
Properties: Crystals from methanol, mp 250° (dec) (Verheyden, Martin); also reported as crystalline monohydrate
from water, mp 248-249° (dec) (Ashton); crystals from water, mp >300° (Martin). uv max (methanol): 254 nm
(e 12880). Soly in water (25°): 4.3 mg/ml at pH 7. LD50 i.p. in mice: 1-2 g/kg (Martin).
Melting point: mp 250° (dec) (Verheyden, Martin); mp 248-249° (dec) (Ashton); mp >300° (Martin)
Absorption maximum: uv max (methanol): 254 nm (e 12880)
Toxicity data: LD50 i.p. in mice: 1-2 g/kg (Martin)
Derivative Type: Sodium salt
CAS Registry Number: 107910-75-8
Trademarks: Cymevan (Syntex); Cymevene (Syntex); Cytovene (Syntex); Denosine (Syntex); Vitrasert (Chiron)
Molecular Formula: C9H12N5NaO4
Molecular Weight: 277.21
Percent Composition: C 38.99%, H 4.36%, N 25.26%, Na 8.29%, O 23.09%
Therap-Cat: Antiviral.
Keywords: Antiviral; Purines/Pyrimidinones.
46. ddeessccrriippttiioonn
The reaction of epichlorohydrin (I) with benzyl alcohol (II) by means of
NaOH in water gives 1,3-di-O-benzylglycerol (III),
which is condensed with paraformaldehyde by means of HCl in methylene
chloride to yield 1,3-di-O-benzyl-2-O-(chloromethyl)glycerol (IV).
Acetylation of (IV) with potassium acetate in acetone affords 1,3-di-O-benzyl-
2-O-(acetoxymethyl)glycerol (V),
which is condensed with diacetylguanine (VI) by means of p-toluenesulfonic
acid in sulfolane giving N2-acetyl-9-[[1,3-bis(benzyloxy)-2-
propoxy]methyl]guanine (VII).
Finally, this compound is deprotected by a treatment with palladium
hydroxide in refluxing cyclohexane.
47. MMEECCHHAANNIISSMM OOFF AACCTTIIOONN
Monophosphorylated intracellularly by a virus-induced
enzyme
Phosphorylation is catalyzed by a viral thymidine
kinase during HSV, phosphotransferase UL97
encoded gene during CMV infection
Ganciclovir di & triphosphate formed by cellular
enzymes
Triphosphate is a competitive inhibitor of
deoxyguanosine triphosphate incorporation into
DNA inhibiting viral rather than cellular DNA
polymerase
Viral DNA incorporation causes cessation of DNA
chain elongation
48. VVAALLGGAANNCCIICCLLOOVVIIRR
L- valyl ester prodrug of ganciclovir
Hydrolyzed to active compound ganciclovir by intestinal and
hepatic enzymes
Well absorbed (60%) & rapidly metabolized in intestinal walls &
liver to ganciclovir
Renal excretion thru GN and TS
Usage:CMV retinitis in AIDS and for prevention of CMV in high risk
kidney, heart transplant.
50. CCIIDDOOFFOOVVIIRR
(1-[(S)-3-hydroxy-2-(phosphonomethoxy)-
propyl]cytosine dihydrate)
Cytidine nucleoside analog with inhibitory activity against human
herpes, papilloma, polyoma, pox, and adenoviruses
Phosphorylation to active disphosphate is independent of viral
enzymes
After phosphorylation; it acts as potent inhibitor to viral DNA
polymerase
51.
52. Brodfuehrer, P (1994). "A practical synthesis of (S)-
HPMPC". Tetrahedron Letters 35: 3243. doi:
10.1016/S0040-4039(00)76875-4.
53. FFOOSSCCAARRNNEETT
Phosphonoformic Acid Inorganic
Pyrophosphate analog that inhibits viral
DNA polymerase, RNA polymerase and HIV
transcriptase directly without requiring
activation by phosphorylation
Taken up slowly by cells and does not
undergo significant intracellular
metabolism
Reversibly blocks the pyrophosphate
binding site of the viral polymerase
Inhibits cleavage of pyrophosphate from
deoxynucleotide triphosphates
54. SSIIDDEE EEFFFFEECCTTSS
Nephrotoxicity
Symptomatic hypocalcemia
Saline loading may reduce the
risk of nephrotoxicity
Concurrent administration with
pentamidine exacerbates both
nephrotoxicity and hypocalcemia
55. FFOOMMIIVVIIRRSSEENN
21 mer-phosphorothioate oligonucleotide
First FDA approved anti-sense therapy.
Binding to target mRNA results in
inhibition of immediate early region 2
protein synthesis – inhibiting viral
replication
Injected intravitreally in CMV retinitis in
AIDS
57. NNUUCCLLEEOOSSIIDDEE RREEVVEERRSSEE
TTRRAANNSSCCRRIIPPTTAASSEE
IINNHHIIBBIITTOORRSS((NNRRTTIIss))
Competitive inhibition of HIV 1 reverse
transcriptase and can be incorporated
into the growing viral DNA chain to
cause termination
Requires intracytoplasmic activation as
a result of phosphorylation by cellular
enzymes to the triphosphate form
Activity against HIV 1, HIV 2
Lactic acidosis & severe hepatomegaly
with steatosis
58. ZZIIDDOOVVUUDDIINNEE
((AAzziitthhyymmiiddiinnee,, AAZZTT))
Deoxythymidine analog
Decrease rate of clinical disease progression
and prolong survival of HIV infected individuals
Well absorbed from the gut and distributed
to most body tissues & fluids
Eliminated by renal excretion following
glucorinadation in the liver
Combination therapy with other anti-retroviral
agents enhance potency and delay resistance
59. DDIIDDAANNOOSSIINNEE ((ddddll))
Synthetic analog of deoxyadenosine
Activity is potentiated by hydroxyurea due to
depletion of intraocular pools of d-ATP
Chewable, dispersable tablet, enteric coated
Contains phenylalanine and Na
Should be taken on an empty stomach
Food, fluroquinolones and tetracycline
should be given 2 hrs before didanosine
60. EEMMTTRRIICCIITTAABBIINNEE
Formerly called FTC
Fluorinated analogue of LAMIVUDINE with a long
intracellular half-life(>39 hrs)
Oral bioavailability: 93%
CSF level is LOW
Mean plasma half-line: 8-9 hours
Renal excretion thru GF and TS
Contraindicated in children, pregnant women, and patients
with renal and hepatic failure (propylene glycol)
Most common side effects-HA, diarrhea, hyper-pigmentation
in palms and soles
Can not combine with LAMIVUDINE
61. LLAAMMIIVVUUDDIINNEE ((33TTCC))
Cytosine analog ,synergistic with other
antiretroviral nucleoside – Stavudine,
Zidovudine
Oral bioavailability exceeds 80% and it is
not food dependent
Elimination in urine is UNCHANGED
Used in combination therapy
NOTE: no combination with zalcitabine-may
inhibit intracellular phosphorylation of one
another thus decreasing potency.
Approved for the treatment of chronic
Hepatitis B infection
62. ZZAALLCCIITTAABBIINNEE ((ddddCC))
Cytosine analog with synergistic anti-HIV1
activity with a variety of antiretrovirals
against both zidovudine sensitive and
resistant strains
Associated with dose-dependent peripheral
neuropathy
Oral and esophageal ulcerations
Increase bioavailability in combination with
probenecid or cimetidine
Decrease bioavailability in combination with
antacids and metoclopramide
63. SSTTAAVVUUDDIINNEE ((dd44TT))
Thymidine analog
High oral bioavailability, not food dependent
Renal excretion thru GF and TS
Major dose-limiting toxicity:
Dose-related peripheral sensory neuropathy
Pancreatitis, arthralgias, elevation of serum
aminotransferases
Phosphorylation is reduced by zidovudine
64. AABBAACCAAVVIIRR
Guanosine analog
Well absorbed during oral administration
Metabolized by alcohol dehydrogenase
and glucuronosyl-transferase to inactive
metabolites
Fatal hypersensitivity reactions
Nausea, vomiting, diarrhea, headache,
fatigue
Hyperglycemia, hypertriglyceridemia and
lactic acidosis
66. TTEENNOOFFOOVVIIRR
Acyclic nucleoside phosphonate
competitively inhibits HIV reverse
transcriptase and cause chain
termination after incorporation to DNA
Indicated for use in combination with
other antiretroviral agents
67. NNEEVVIIRRAAPPIINNEE
Oral bioavailability is > 90%
Not food dependent
Used as a component of a combination
antiretroviral regimen
Effective in the prevention of transmission
of HIV from mother to newborn
Causes severe life threatening rashes
68. DDEELLAAVVIIRRDDIINNEE
Oral bioavailability of about 85 %
Metabolized to inactive metabolites by the
CYP3A & CYP2D6 P450 enzymes
Plasma concentrations are reduced by
antacids, didanosine, phenytoin,
phenobarbital, carbamazepine, rifabutin,
rifampin, nelfinavir & saquinavir
Concentrations increased by
clarithromycin, fluoxetine, & ketoconazole
70. PPRROOTTEEAASSEE IINNHHIIBBIITTOORRSS
Protease--responsible for cleaving
precursor molecules (immature budding
particles)
PI---result in the production of immature,
non-infectious viral particles
Associated w/ spontaneous bleeding in
hemophilia A & B
Do not undergo process of phosphorylation
71. SSAAQQUUIINNAAVVIIRR
Saquinavir H- hard gel capsule – poor
bioavailability, should be taken within 2 hrs
after a fatty meal
Saquinavir S – soft gel capsule – improved
absorption 3x than hard gel capsule
Subject to first pass-metabolism by CYP3A4
Levels are increased by ritonavir, nelfinavir,
delavirdine, indinavir, ketoconazole,
clarithromycin, & grapefruit juice
72. RRIITTOONNAAVVIIRR
An inhibitor of HIV 1 & HIV 2 proteases
High bioavailability that is increased
with food
Common adverse effects: GIT
disturbances, paresthesias, increase
aminotransferase level, altered taste,
hypertriglyceridemia
73. IINNDDIINNAAVVIIRR
Specific inhibitor of HIV- 1 & HIV-2 proteases
Higher CSF penetration
Must be consumed in empty stomach for
maximal absorption
Most common adverse effects are indirect
hyperbilirubinemia & nephrolithiasis due to
crystalization
75. AAMMPPRREENNAAVVIIRR
Rapidly absorbed from the GIT and
can be taken with or without food
High fat meals decrease absorption
Common adverse effects: nausea, vomiting,
diarrhea, peri-oral paresthesias, rash
Steven Johnson’s syndrome
Inhibits CYP3A4 activity
77. EENNFFUUVVIIRRTTIIDDEE ((TT--2200))
Newly approved antiretroviral agent
Blocks entry into the cell
A synthetic 36-amino acid peptide binds
to the gp41 subunit of the viral envelope
glycoprotein thus preventing the
conformational changes required for the
fusion of the viral and cellular
membranes
Administered subcutaneously in
combination with other retroviral agents
79. AADDEEFFOOVVIIRR
Phosphorylated by cellular kinases
to the active diphosphate metabolite
Competitively inhibits HBV DNA
polymerase
Chain termination after incorporation
into viral replication
80. EENNTTEECCAAVVIIRR
Oral guanosine nucleoside analog
Competitively inhibits all 3 functions of HBV
DNA polymerase—base priming, reverse
transcription of negative strand and synthesis
of positive strand of HBV DNA.
Taken by empty stomach half life 15 hours
Significantly HIGHER rates of HBV DNA
viral suppression than lamivudine.
81. IINNTTEERRFFEERROONN AALLFFAA
Endogenous proteins that exert complex
antiviral immunomodulatory & antiproliferative
activities through cellular metabolic process
Enzyme induction, suppression of cell
proliferation, immunomodulatory activities &
inhibition of viral replication
Inhibition of viral penetration & uncoating
Treatment of both HBV & HCV
82. IINNTTEERRFFEERROONN AALLPPHHAA 22aa
Approved for the treatment of chronic
Hepatitis C, AIDS associated Kaposi’s
sarcoma, hairy cell leukemia,
chronic myelogenous leukemia
83. AADDEEFFOOVVIIRR
Phosphorylated by cellular kinases
to the active diphosphate metabolite
Competitively inhibits HBV DNA
polymerase
Chain termination after incorporation
into viral replication
84. EENNTTEECCAAVVIIRR
Oral guanosine nucleoside analog
Competitively inhibits all 3 functions of HBV
DNA polymerase—base priming, reverse
transcription of negative strand and synthesis
of positive strand of HBV DNA.
Taken by empty stomach half life 15 hours
Significantly HIGHER rates of HBV DNA
viral suppression than lamivudine.
85. IINNTTEERRFFEERROONN AALLFFAA
Endogenous proteins that exert complex
antiviral immunomodulatory & antiproliferative
activities through cellular metabolic process
Enzyme induction, suppression of cell
proliferation, immunomodulatory activities &
inhibition of viral replication
Inhibition of viral penetration & uncoating
Treatment of both HBV & HCV
86. IINNTTEERRFFEERROONN AALLPPHHAA 22aa
Approved for the treatment of chronic
Hepatitis C, AIDS associated Kaposi’s
sarcoma, hairy cell leukemia,
chronic myelogenous leukemia
87. IINNTTEERRFFEERROONN AALLPPHHAA 22bb
Only preparation licensed for treatment of
HBV & acute HCV
Leads to loss of HbeAg, normalization of
aminotransferases
Administered subcutaneously or
intramuscularly
Hairy cell leukemia, malignant melanoma,
follicular non-Hodgkin’s lymphoma, AIDS
related kaposi’s sarcoma, & chronic
Hepatitis C
89. RRIIBBAAVVIIRRIINN
Guanosine analog that is phosphorylated
intracellularly by host cell enzymes
Interferes w/ the synthesis of guanosine
triphosphate
Inhibit capping of viral messenger RNA
Inhibit viral RNA dependent RNA polymerase of
certain viruses
Influenza A, parainfluenza, RSV, paramyxoviruses,
HCV & HIV 1
91. AMANTADINE/RRIIMMAANNTTAADDIINNEE
(1-aminoadamantane hydrochloride)
a-methyl derivative - rimantadine
Inhibits uncoating of viral RNA influenza A
within infected cell thus preventing
replication
Effectively reduce the duration of
symptoms of influenza when administered
within 48 hrs of onset
Primary target is M2 proteins
94. PPAALLIIVVIIZZUUMMAABB
Prevention of RSV in high risk
infants—premature and those with
broncho dysplasia and congenital
heart disease.
Humanized monoclonal antibody
IMQUIMOD
•Immune response modifier effective
in topical treatment of external
genitalia & perianal warts
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