Antiviral agents adverse effects

Hudarabine phosphate is a fluorinated nucleotide analog of the antiviral agent vidarabine. Its cytotoxicity is not well understood. It is rapidly dephospho-rylated at the cell membrane level and then rephos-phorylated intracellularly by deoxycytidine kinase to the active triphosphate derivative. It inhibits DNA polymerase and DNA primase. It is also incorporated into DNA and RNA. Hudarabine is administered intravenously by infusion over 30-120 min. It is eliminated by renal excretion with a terminal half life 10 hours. Adverse effects include myelosuppres-sion, nausea, vomiting, chills and fever. The number of CD4 positive cells is reduced and the incidence of opportunistic infections is increased. 

The treatment for smallpox is primarily supportive. Research is ongoing into antiviral therapies for smallpox but currently therapy for patients infected with smallpox remains supportive, with intravenous fluids, pain medications, and antibiotics as needed for secondary bacterial infections (Henderson, 1999). Cidofovir, an antiviral agent used primarily against cytomegalovirus infection, has shown some promise against orthopox viruses such as vaccinia and cowpox in animal studies (De Clercq, 2002). Currently it is approved in its IV form for use in the treatment of adverse effects of smallpox vaccination (CDC, 2003). 

Cost and the potential for adverse effects preclude available antiviral agents from being recommended routinely for use as suppressive therapy in all patients with recurrent genital herpes. Patients with frequent (greater than six per year) and physically or psychologically distressing recurrences, however, are candidates for suppressive therapy. " ... 

Acyclovir-resistant HSV has been isolated from patients with AIDS. The primary mechanism of resistance appears to be a deficiency in viral thymidine kinase. Strategies that have been employed for management of severe acyclovir-resistant HSV infections include increasing the dose of acyclovir, discontinuing acyclovir, and use of an alternative antiviral agent. Vidarabine and foscarnet, because they do not require phosphorylation by thymidine kinase, are examples of potential alternative agents. A randomized comparison of foscarnet and vidarabine indicated that foscarnet is more effective and associated with fewer adverse reactions than vidarabine. ... 

An ideal antimicrobial agent should be non-toxic and possess broad-spectrum antiviral, antibacterial, and antifungal activity and exclude resistance. This has led to the design of a combination agent, iodine-lithium-alpha-dextran [66 ]. This uses the non-specific antimicrobial action of molecular and ionized iodine and the systemic immunomodulatory effects of the polysaccharide complex of iodine and lithium. This new agent has been assessed by parenteral administration in HIV-infected patients. The adverse effects of phlebitis of punctured small veins and subfebrile fever,... 

Anti-infective Antiviral/bacterial agents, probiotics, prebiotics, lactoferrin Adverse immunological changes, allergic effects... 

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