Influenza chemotherapy

B neuraminidase and its complex with sialic acid. Embo J 11 49-56 Burmeister WP, Henrissat B, Bosso C, Cusack S, Ruigrok RW (1993) Influenza B virus neuraminidase can synthesize its own inhibitor. Structure 1 19-26 Calfee DP, Hayden FG (1998) New approaches to influenza chemotherapy neuraminidase inhibitors, Drugs 56 537-553... 

Calfee DP, Hayden FG. New approaches to influenza chemotherapy neuraminidase inhibitors. Drugs 1998 56 537-553. 

Luscher-Mattli M. Influenza chemotherapy a review of the present state of art and of new dmgs in devdopment. Arch Virol. 2000 145 2233-2248. 

Hagiwara T, Kijima-Suda I, Ido T, Ohrui H, Tomita K (1994) Inhibition of bacterial and viral sialidases by 3-fluoro-V-acetyIneuraminic acid, Carbohydr Res 263 167-172 Haskell TH, Peterson FE, Watson D, Plessas NR, Culbertson T (1970) Neuraminidase inhibition and viral chemotherapy, J Med Chem 13 697-704 Hatakeyama S, Sugaya N, Ito M, Yamazaki M, Ichikawa M, Kimura K, Kiso M, Shimizu H, Kawakami C, Koike K, Mitamura K, Kawaoka Y (2007) Emergence of influenza B viruses with reduced sensitivity to neuraminidase inhibitors, JAMA 297 1435-1442 Hay AJ (1992) The action of adamantanamines against influenza A viruses inhibition of the M2 ion channel protein, Semin Virol 3 21-30... 

Ilyushina NA, Bovin NV, Webster RG, Govorkova EA (2006) Combination chemotherapy, a potential strategy for reducing the emergence of drug-resistant influenza A variants. Antiviral Res 70 121-131... 

Smee DE, Bailey KW, Morrison AC, SidweU RW (2002) Combination treatment of influenza A virus infections in ceU culture and in mice with the cyclopentane neuraminidase inhibitor RWJ-270201 and ribavirin. Chemotherapy 48 88-93... 

Yamashita M, Ohno A, TomozawaT, Yoshida S (2003) R-118958, a unique anti-influenza agenf. I. A prodrug form of R-125489, a novel inhibitor of influenza virus neuraminidase. In 43rd in-tersdence conference on antimicrobial agents and chemotherapy, Chicago, USA, Sept 14-17, Poster F-1829... 

The cancer patient and the HIV-positive patient are the two clinically important groups were the natural defence systems are disturbed either by the disease or by the treatment (chemotherapy, radiotherapy). Infections in the HIV-positive patient are discussed in Chapter 33B. Less prevalent immunocompromised hosts are patients with hypo- or agamma-globulinaemia or patients after splenectomy. These last patient groups with mainly humoral dysfunction generally suffer from infections by encapsulated bacteria S. pneumoniae, H. influenzae and N. meningitidis). In this section we will discuss patients with cellular immune dysfunction, mainly granulocytopenia. 

Many patients receive lengthy courses of antibiotics that probably should not have been started. More than half of courses of antimicrobial chemotherapy are inappropriate. Influenza pneumonia and viral upper respiratory infections, for example, are impervious to assault by antibiotics, although many patients with these illnesses receive such antibiotics. Of course, influenza may be complicated by postinfluenzal staphylococcal pneumonia, for which antibiotics are indicated. Careful sequential evaluation of seriously ill patients for whom antibiotics are deferred is as important as in patients for whom antibiotics are prescribed. 

Madren LK, Shipman C, Hayden FG. In vitro inhibitory effects of combinations of anti-influenza agents. Antiviral Chem Chemotherapy 1995 6(2) 109—113. 

Drug Discovery Today 7 25-27 Li AP (2004) In vitro approaches to evaluate ADMET drug properties. Curr Top Med Chem 4 701-706 Li W, Escarpe PA, Eisenberg EJ et al. (1998) Identification of GS 4104 as an orally bioavailable prodrug of the influenza virus neuraminidase inhibitor GS 4071. Antimicrobial Agents and Chemotherapy 42 647-653 Los LE, Welsh DA, Herold EG et al. (1996) Gender differences in toxicokinetics, liver metabolism, and plasma esterase activity observations from a chronic (27-week) toxicity study of enalapril/diltiazem combinations in rats. Drug Metab Dispos 24 28-33... 

Mild cases, characterised by pinkness or infection of the eardrum, often resolve spontaneously and need only analgesia emd observation. They are normally viral. A bulging, inflamed eardrum indicates bacterial otitis media usually due to Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Bran-hamella) catarrhalis. Streptococcus pyogenes (Group A) or Staphylococcus aureus. Amoxicillin or co-amoxiclav is satisfactory, but the clinical benefit of antibiotic therapy is very small when tested in controlled trials. Chemotherapy has not removed the need for myringotomy when pain is very severe, and also for later cases, as sterilised pus may not be completely absorbed and may leave adhesions that impair hearing. Chronic infection presents a similar problem to that of chronic sinus infection, above. 

Scholar EM, Pratt WB (2000) Chemotherapy of viral infections, I drugs used to treat influenza virus infections, herpes vims infections, and dmgs with broad-spectrum antiviral activity. In The Antimicrobial Drugs, pp 491-549. Oxford Oxford University Press. 

Which antiviral drugs work or how the disease is dealt with in terms of public health measures, depends, in part, on the type of virus. The DNA viruses are relatively stable in form since mutations are internally corrected, and here it is often more effective to use vaccination than chemotherapy. By these means smallpox has been eradicated. For some RNA viruses, vaccination is also effective, including poliomyelitis, rubella, measles and mumps, and some rabies strains. Other viruses mutate so rapidly that vaccination is more difTicult, e.g. influenza, the common cold, HIV. 

Hayden, F. G., Lobo, M., Esinhart, J., and Hussey, E., Efficacy of 4-guanidino Neu5Ac2en in Experimental Human Influenza A Virus Infection. 34th Interscience Conference on Antimicrobial Agents and Chemotherapy. Orlando, 4-7 October (1994). American Society for Microbiology, Washington DC 1994, p. 190... 

Impaired humoral immunity Loss of protective barriers Multiple myeloma Chronic lymphocytic leukemia Splenectomy Immunosuppressive therapy (steroids, chemotherapy) Bacteria S. pneumoniae, H. influenzae, N. meningitidis... 

Patients with active malignant disease may receive killed vaccines or toxoids but should not be given live vaccines. The MMR vaccine is not contraindicated for close contacts, however. Live virus vaccines may be administered to persons with leukemia who have not received chemotherapy for at least 3 months. Vaccines should be timed to avoid coinciding with the start of chemotherapy or radiation therapy. Annual influenza vaccine should be administered... 

The rest of this chapter will show how the most successful treatment modalities have developed. These include vaccination (for smallpox, polio, measles, etc.), and chemotherapy using anti-viral drugs. A large number of viral diseases still lack an effective means of treatment, and the chapter will also cover the attempts to treat the common cold and influenza the struggles with HIV and the emergence of viruses (Marburg, Ebola, Lassa) that cause haemorrhagic fever. 

Renal cell carcinoma Prevention of chemotherapy-induced thrombocytopenia Hepatitis B prevention Vaccination of infants against H. influenzae type B and hepatitis B... 

The influenza pandemic of 1918-1920 clearly demonstrated the inability of medical science to stand up to disease. More than 20 million people worldwide were killed by flu that attacked not the old and frail, but the young and strong. This was a disease that no magic bullet could cure and no government could stamp out. Chemotherapy research had to be improved and continued. 

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