Used in the Treatment of Chronic Postural Hypotension

Drugs Used in the Treatment of Chronic Postural Hypotension 

Protamine sulfate, a heparin antagonist, is used in heparin overdose (see also Table 17). 

Novel cysteine protease and serine protease inhibitors are being developed for respiratory and CV applications, for cancer and inflammation, and for viral targets. Indinovir and ritonavir are potent HIV inhibitors. 

HIV-1 encodes an aspartate protease consisting, in its active form, of two symmetric subunits. This enzyme is required for cleavage of polypeptide precursors that generate the structural proteins and enzymes of the vims, including reverse transcriptase, integrase, and the protease itself. 

Other inhibitors interact with catalytic residues and displace a stmctural water molecule. These protease inhibitors block viral maturation and are therefore active in both acutely and chronically infected cells. Resistance to these agents develops in vitro and in patients treated over a period of months, and may limit the usefulness of monotherapy. However, vimses with reduced susceptibility to stracturally similar compounds may retain susceptibility to others. Some of these protease inhibitors lack in vivo activity because of high plasma-protein binding, particularly to alpha-1 acid glycoprotein, low oral bioavailability, and/or short plasma elimination half-lives. Most peptidomimetic inhibitors are cleared through cytochrome P450 metabolism 

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