Antivirals topical

Category Antiviral Antiviral, topical Guanine nucleoside analog... 

Lemon balm isa perennial herb with heart-shaped leaves that has been used for hundreds of years. Its scientific name is Melissa officinalis. Traditionally the herb has been used for Graves disease (see Chap. 51), asa sedative, arrtispasmodic, and an antiviral agent. When used topically, lemon balm has antiviral activity against herpes simplex virus(HSM). No adverse reactions have been reported when lemon balm is used topically. 

Antiviral drugs are given systemically or as topical dragp. When used systemically these dm may be administered orally or intravenously (IV). Rapid IV administration can result in crystalluria (presence of crystals in the urine). The most common adverse reactions when these drugp are administered systemically... 

Localized skin infections may require the use of a topical anti-infective The topical anti-infectives include antibiotic, antifungal, and antiviral drag s. 

Acyclovir (Zovirax) and penciclovir (Denavir) are the only topical antiviral dragp currently available These dragp inhibit viral replication. Acyclovir is used in the treatment of initial episodes of genital herpes, as well as heqies simplex virus infections in immunocompromised patients (patients with an immune system incapable of fighting infection). Penciclovir is used for the treatment of recurrent herpes labialis (cold sores) in adults. 

Gentian violet solution is used to delineate the areas to be treated. Refrigerant topical anesthesia is used to freeze the skin prior to the procedure. Holding the skin taut, the dermabrader treats one anatomic unit at a time. Post-operatively, patients may have an open or closed dressing system, use antiviral agents, antibacterials and corticosteroids. The re-epithelialization is complete in 5-7 days and residual erythema is common for up to 4 weeks. 

Topical antivirals are not used to treat adenovirus conjunctivitis. Topical antibiotics are often prescribed for viral conjunctivitis, ostensibly to prevent bacterial superinfection. In reality, this is a case of the patient insisting on a medication to speed healing.11 Avoid the use of antibiotics for a viral infection.12 Eliminating superfluous antibiotic use also helps prevent the development of antibiotic resistance. 

B. S. Kwon, L. P. Gangarosa, N. H. Park, D. S. Hull, E. Fineberg, C. Wiggins, and J. M. Hill. Effect of iontophoretic and topical application of antiviral agents in treatment of experimental HSV-1 keratitis in rabbits. Invest Ophthalmol Vis Sci 18 984-988 (1979)... 

Sticks are a convenient form of administering topical medications and come in different sizes and shapes. They are transportable and can be easily eompounded. Examples of eompoimded sticks include those containing antivirals for herpes and emollients and sunscreens for environmental exposure (Table 4). 

Aciclovir is an antiviral indicated in the treatment and prophylaxis of cold sores. It is available for systemic administration (tablets) or topical use (cream, eye ointment). In the management of cold sores, the cream is applied every 4 hours and continued for 5 days. Its use should be started as soon as symptoms (tingling sensation) begin. 

The topical ophthalmic antiviral preparations appear to interfere with viral reproduction by altering DNA synthesis. Trifluridine is effective treatment for herpes simplex infections of the conjunctiva and cornea. Ganciclovir is indicated for use in immunocompromised patients with cytomegalovirus (CMV) retinitis and for prevention of CMV retinitis in transplant patients. Foscarnet is indicated for use only in AIDS patients with CMV retinitis. 

Vidarabine is administered only as a topical ophthalmic ointment. It has relatively limited solubility and is not significantly absorbed after application to the eye. Within the tissues, it is rapidly deaminated to its principal metabolite, arabinosyl hypoxanthine, which retains some degree of antiviral activity. 

Trifluridine (5-trifluoromethyl-2 -deoxyuridine) (Viroptic ) is marketed for the topical treatment of herpes simplex virus infection in the eyes. This antiviral drug is a mechanism-based inactivator of thymidylate synthase. The mechanism of inhibition and synthesis of trifluoridine are reported in Chapter 7. 

Although there has heen a great deal of research concerning how platinum(II) complexes hind to biological molecules and the hkely mechanism of antitumor activity of these platinum-containing species, far less attention has heen paid to the properties of other metal complexes in this arena. Recent attention has fallen on cohalt(II)-Schiff hase complexes, as several have heen discovered to have promise as antiviral agents. A review of recent work has appeared elsewhere [64], so the topic will not he covered here however, in addition to focusing on recent developments, emphasis is placed on the introduction of the new head unit, 3,6-diformylpyridazine (13), into Schiff-hase macrocyclic electrochemistry. 

Pyridinium or diisoquinolinium salts, such as (36) and (37), have been used as topical antifungals (60BRP839505, 33FRP738028), whilst acranil (38), an antiprotozoal based on an aminoacridine, possesses general antiviral activity (73MI20900). 

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