Drugs online research references








Genitourin Med. 1993 Dec;69(6):457-9.
The effect of suppressive oral acyclovir on the psychological morbidity associated with recurrent genital herpes.

Carney O, Ross E, Ikkos G, Mindel A.

Academic Department of Genitourinary Medicine, University College & Middlesex School of Medicine, Middlesex Hospital, London.

OBJECTIVES--To assess the psychological impact of recurrent genital herpes and to determine if longterm acyclovir has any impact on this morbidity. SETTING AND SUBJECTS--Patients with frequently recurring genital herpes attending a department of genitourinary medicine who were considered suitable for longterm acyclovir. METHODS--Patients completed an 80 item, self-administered psychological questionnaire before starting acyclovir and every three months for one year. Treatment was then stopped and three months later a further questionnaire was completed. The questionnaire consisted of the General Health Questionnaire (GHQ); the Hospital Anxiety and Depression Questionnaire (HADQ); Illness Attitude Scales and Illness Concern. Data were analysed by McNemar's test for changes in proportions and by Wilcoxon's test for changes in scores. RESULTS--102 patients were recruited: 55 men, and 47 women. Eighty two (80%) patients completed three months treatment, 75 (74%) six months, 64 (63%) nine months and 61 (60%) a year. Fifty (49%) of the original 102 patients completed the three months post treatment follow up. At first visit 63% (64/102) were designated as GHQ "cases". Within three months this decreased to 26% (21/82). McNemar's test showed that 67% (34/51) of the patients who were initially classified as GHQ "cases" became "noncases" after three months (p < 0.0001). There was a significant decrease in the proportion of HAD anxiety cases from visit one to visit two (p < 0.0001) and a decrease in illness concern scores from visit one to visit two (p < 0.0001). All these decreases were maintained throughout the years treatment with acyclovir. CONCLUSIONS--There is a substantial morbidity associated with frequently recurring genital herpes. However, acyclovir suppression significantly reduces illness concern and anxiety and is a useful addition to the treatment of this infection.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8282300&dopt=Abstract




Clin Infect Dis. 1998 Mar;26(3):659-63.
Perspectives on switching oral acyclovir from prescription to over-the-counter status: report of a consensus panel.

Sande MA, Armstrong D, Corey L, Drew WL, Gilbert D, Moellering RC Jr, Smith LG.

Department of Internal Medicine, University of Utah, Salt Lake City 84132, USA.

The proposed switching of oral acyclovir from prescription to over-the-counter (OTC) status for the 5-day episodic treatment of genital herpes was considered by a consensus panel. It was concluded that self-diagnosis/misdiagnosis, misuse, and adverse drug effects were potential problems with the OTC use of acyclovir. While acyclovir reduces asymptomatic shedding of herpes simplex virus type 2, the reduction in transmission of virus potentially resulting from increased acyclovir use was felt to be of unknown extent but likely to be of benefit overall. The availability of acyclovir would likely be improved. There were differences in opinion as to whether widespread availability of acyclovir (prescription or OTC) may speed the development of viral resistance. However, all panel members felt that granting OTC status may set an undesirable precedent for the switch from prescription to OTC use of other systemically administered antiinfective agents. The effect of this precedent, in terms of accelerating development of multidrug-resistant bacteria, was a major concern of all panel members. The consensus was that the switch of acyclovir to OTC status could not be supported.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9524840&dopt=Abstract




Antiviral Res. 1994 Aug;24(4):315-25.
Synthesis of 5-[1-hydroxy (or methoxy)-2,2-dihaloethyl]-2'- deoxyuridines with antiviral and cytotoxic activity.

Kumar R, Knaus EE, Wiebe LF, Allen TM.

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Canada.

The 5-[1-hydroxy (or methoxy)-2,2-dihaloethyl]-2'-deoxyuridines (3-12, Cl, Br and/or I) were synthesized by the addition of HOX or CH3OX (X = Cl, Br, I) to the vinyl substituent of the respective (E)-5-(2-halovinyl)-2'-deoxyuridines (1a-c). In vitro antiviral (HSV-1, HSV-2, HCMV, VZV, EBV) and cytotoxic (L1210) activities were determined. The 5-(1-hydroxy-2,2-dihaloethyl) series were generally more active than the 5-(1-methoxy-2,2-dihaloethyl) series against HSV-1, HSV-2, VZV and EBV. Anti-HSV-1 activity was dependent upon the steric orientation and/or hydrophobic properties of the halogen atom(s), with -CH(OH)CHBr(I) and -CH(OH)CHBr2 C-5 substituents providing the most potent activity. 5-(1-Hydroxy-2-bromo-2-iodoethyl)-2'-deoxyuridine (6), which exhibited the most potent anti-HSV-1 activity, was 12-fold less active than acyclovir. In contrast, the halogen atom(s) were not determinants of anti-VZV activity, where the approximately equipotent 5-(1-hydroxy-2,2-dihaloethyl) compounds (3, 4, 5, 6) exhibited anti-VZV activity comparable to that of acyclovir. All of the 5-(1-hydroxy (or methoxy)-2,2-dihaloethyl) analogs (3-12) were inactive against HCMV. The 5-(1-hydroxy-2-chloro-2-iodoethyl) compound (4) was an active cytotoxic agent as determined in the in vitro L1210 screen. The compounds 3-12 were non-toxic to uninfected host cells. The inhibitory effect on cell proliferation diminished upon replacement of the 5-(1-hydroxy-2,2-dihaloethyl) substituents of 3-6 with the corresponding 5-(1-methoxy-2,2-dihaloethyl) substituents (7-12).

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7993076&dopt=Abstract












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