Nucleoside analog reverse transcriptase inhibitors (NRTIs) are nucleoside analogues that act as competitive inhibitors of HIV-1 reverse transcriptase. As shown in the animation, these drugs compete with nucleoside triphosphates for access to reverse transcriptase. All NRTIs lack a 3-hydroxyl group; thus, their incorporation into a growing DNA chain results in its termination. They require intracytoplasmic…
This post features two clinical guidelines on the management of community acquired pneumonia.
The British Thoracic Society updated this year many recommendations, including when to order a chest X-ray, and antibiotic management.
The guidelines issued by the Infectious Diseases Society of America and the AmericanThoracic Society have relevant recommendations concerning empirical antimicrobial therapy and its duration.
Vancomycin is a tricyclic glycopeptide that has gained clinical importance thanks to its effectiveness against organisms such as MRSA and enterococci. It has activity against Gram-positive rods and cocci, Gram-negative rods are resistant to its bactericidal action. Some clinical uses of IV vancomycin include treatment of infective endocarditis and sepsis caused by MRSA. Since vancomycin…
New clinical practice guidelines on the management of hepatitis B were published this year in Annals of Internal Medicine. These guidelines are the result of the latest National Institutes of Health Consensus Development Conference Statement on hepatitis B.
An excerpt of FDA’s press release issued 19th March 2009: The U.S. Food and Drug Administration today issued an alert to health care professionals reminding them that single-patient insulin pens and insulin cartridges should not be used to administer medication to multiple patients due to the potential risk of transmitting blood-borne pathogens such as HIV…
The Scottish Medicines Consortium issued an advice on the current indications for doripenem (Doribax): Doripenem (Doribax) is accepted for restricted use within NHS Scotland for the treatment of complicated intra-abdominal infections in adults. In patients with complicated intra-abdominal infection, doripenem is associated with clinical cure rates non-inferior to those of another carbapenem. Doripenem should be…
The following images created by the Dept. of Pharmacology at University of Utah are great for reviewing antifungals before a test like USMLE: This table contains the following agents: Trifluridine, Vidarabine, acyclovir, ganciclovir, foscarnet, azt, ddI, ribavirin, amantadine.
The following images created by the Dept. of Pharmacology at University of Utah are great for reviewing antifungals before a test like USMLE: Diagram of sites of action of major antifungals Table: Spectrum of activity of antifungal agents Agents: Amphotericin, nystatin, flucytosine, azoles: miconazole, ketoconazole, itraconazole, fluconazole, griseofulvin Technorati : Antifungals, mechanism of action, tables
This is an excerpt from the Scottish Medicines Consortium (SMC) advice on etravirine (Intelence). ADVICE: following a full submission etravirine (Intelence), in combination with a boosted protease inhibitor and other antiretroviral medicinal products, is not recommended for use within NHS Scotland for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in antiretroviral treatment-experienced…
On February 4th, 2009 the FDA announced an ongoing safety review of Xigris (Drotrecogin alfa [activated]). An introduction from Wikipedia: Drotrecogin alfa (activated) (Xigris, marketed by Eli Lilly and Company) is a recombinant form of human activated protein C ( rhAPC) that has anti-thrombotic, anti-inflammatory, and profibrinolytic properties. Drotrecogin alpha (activated) belongs to the class…
FDA recommends the clinical diagnosis of hypersensitivity reactions to Abacavir, instead of using the skin patch testing. From the FDA Drug Safety Newsletter Vol. 2 Number 1, 2009: Abacavir (Marketed as Ziagen) and Abacavir-Combination Products (Marketed as Trizivir and Epzicom): Hypersensitivity Reaction, HLA-B*5701, and Skin Patch Testing Abstract: As of July 2008, the Boxed Warning…
This animation represents the third step in HIV cell entry: fusion. It identifies gp41 as a drug target (Enfuvirtide). Mechanism of action of enfuvirtide (Fuzeon). From Wikipedia Enfuvirtide works by disrupting the HIV-1 molecular machinery at the final stage of fusion with the target cell, preventing uninfected cells from becoming infected.
What are interferons? From Wikipedia: Interferons (IFNs) are natural proteins produced by the cells of the immune system of most vertebrates in response to challenges by foreign agents such as viruses, parasites and tumor cells. Interferons belong to the large class of glycoproteins known as cytokines. Interferons are produced by a wide variety of cells…
The Scottish Medicines Consortium issued on 7th December, 2008 an advice on the recently approved protease inhibitor Atazanavir (Reyataz) Atazanavir (Reyataz) is accepted for use within NHS Scotland in antiretroviral treatment naïve HIV-1 infected adults in combination with other antiretroviral medicinal products. The combination of atazanavir and ritonavir was non-inferior to a standard boosted protease inhibitor…
