Academic literature on the topic 'Ganciclovir. Cytomegalovirus infections. Ocular pharmacology'

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Journal articles on the topic "Ganciclovir. Cytomegalovirus infections. Ocular pharmacology"

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Sahin, Afsun, and Pedram Hamrah. "Acute Herpetic Keratitis: What is the Role for Ganciclovir Ophthalmic Gel?" Ophthalmology and Eye Diseases 4 (January 2012): OED.S7267. http://dx.doi.org/10.4137/oed.s7267.

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Herpes simplex keratitis (HSK) is a major cause of corneal blindness in the world. Following the primary infection, the virus enters into a latent phase. Recurrent infectious or immune keratitis cause structural damage to the cornea, scarring, and may lead to blindness. Several commercially available topical and oral antiviral drugs for HSK are currently available. However, toxicity and low patient compliance hamper their use in HSK. Further, oral antiviral drugs alone are not always effective in HSK. Thus, there had been a need for safe and effective topical antiviral agents against HSK. Systemic ganciclovir has been in use for the treatment of cytomegalovirus infections. Recently, topical ganciclovir has become available for use in patients with HSK. Ganciclovir 0.15% ophthalmic gel has been shown to be both safe and effective against viruses of the herpes family. Topical ganciclovir ophthalmic gel is well tolerated and does not cause significant toxic effects on the ocular surface. Several multicenter studies have revealed the potential role of ganciclovir ophthalmic gel in the treatment and prophylaxis of epithelial HSK. In this paper, we have reviewed the pharmacology, efficacy, side effects, and the role of ganciclovir ophthalmic gel 0.15% in the treatment of acute herpetic keratitis.
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Montero, Ma Carmen, Maite Pastor, Catalina Buenestado, Amparo Lluch, and Manuela Atienza. "Intravitreal Ganciclovir for Cytomegalovirus Retinitis in Patients with AIDS." Annals of Pharmacotherapy 30, no. 7-8 (July 1996): 717–23. http://dx.doi.org/10.1177/106002809603000701.

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OBJECTIVE: To assess the evolution of cytomegalovirus (CMV) retinitis and evaluate the possible complications associated with the use of intravitreal injections to treat this disease. DESIGN: A nonrandomized, retrospective study with case series was performed. The study took place over 34 months. SETTING: The study included patients with AIDS who developed CMV retinitis, and who were treated in the hospital, as outpatients, or both. PATIENTS: Twelve patients with AIDS and CMV retinitis diagnosed between June 1990 through April 1993 were included in the study. MAIN PATIENT PARAMETERS AND OUTCOME MEASURES: For each patient, the following data were recorded: age, risk factors, other systemic findings, dates of AIDS and CMV retinitis diagnoses, stage of AIDS, extent of the retinitis, CD4 lymphocyte count at the time of diagnosis of the retinitis, visual acuity, clinical evolution of the ocular infection, therapy, complications caused by the treatment, development of nonocular CMV, and the use of zidovudine or didanosine during the study period. RESULTS: Vision improved or remained stable in nine patients and worsened in three. Two patients developed optic neuritis. The retinitis progressed to the other eye in only one of the eight patients who had unilateral involvement. The rate of relapse with maintenance therapy was 8.3% (n = 1) within the first 8 weeks. Treatment was well tolerated. There was no evidence of toxicity after a total of 226 intravitreal ganciclovir injections. All patients were able to tolerate zidovudine or didanosine concomitantly with intravitreal ganciclovir. CONCLUSIONS: Intravitreal ganciclovir appears to be an effective alternative to systemic ganciclovir in patients with severe neutropenia and in patients who choose to continue receiving systemic zidovudine or didanosine. Early treatment and long-term maintenance therapy is essential for preserving sight.
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Fletcher, Courtney V., and Henry H. Balfour. "Evaluation of Ganciclovir for Cytomegalovirus Disease." DICP 23, no. 1 (January 1989): 5–12. http://dx.doi.org/10.1177/106002808902300101.

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Cytomegalovirus (CMV) infections are a common cause of morbidity and mortality in immunosuppressed patients. Ganciclovir is an acyclic deoxyguanosine analog structurally similar to acyclovir but with superior activity against CMV. The median ganciclovir concentration required to inhibit viral replication by 50 percent is 2.15 μmol versus 72 μmol for acyclovir. Pharmacokinetic properties of ganciclovir include biexponential decay with a terminal half-life of 2.5 hours, tissue uptake, cerebrospinal fluid penetration, and renal dependence for elimination. CMV treatment approaches have commonly used dosages of 3–15 mg/kg/d. In uncontrolled trials, the response rate of CMV retinitis is approximately 80 percent. The overall response rate for CMV pneumonitis has been approximately 50 percent. However, AIDS (acquired immunodeficiency syndrome) and other immunosuppressed patients appear to respond more favorably (~ 70 percent) than do marrow transplant recipients. Relapse is common once ganciclovir is stopped and maintenance therapy may be required for sustained benefit. Neutropenia appears to be the drug-limiting adverse reaction. Although the development of ganciclovir-resistant CMV, risk factors for neutropenia, and alternative administration strategies all need further study, ganciclovir appears to have a role in the treatment of cytomegalovirus disease.
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Minces, Lucio R., M. Hong Nguyen, Dimitra Mitsani, Ryan K. Shields, Eun J. Kwak, Fernanda P. Silveira, Rima Abdel-Massih, et al. "Ganciclovir-Resistant Cytomegalovirus Infections among Lung Transplant Recipients Are Associated with Poor Outcomes despite Treatment with Foscarnet-Containing Regimens." Antimicrobial Agents and Chemotherapy 58, no. 1 (October 21, 2013): 128–35. http://dx.doi.org/10.1128/aac.00561-13.

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ABSTRACTGanciclovir-resistant cytomegalovirus (CMV) infections are reported infrequently among lung transplant recipients receiving extended valganciclovir prophylaxis. We performed a single-center, retrospective review of ganciclovir-resistant CMV infections in a program that employed valganciclovir prophylaxis for ≥6 months after lung transplant. CMV infections were diagnosed in 28% (170/607) of patients. UL97 mutations were detected in 9.4% (16/170) of CMV-infected patients at a median of 8.5 months posttransplant (range, 5 to 21) and despite prophylaxis for a median of 7 months (range, 4 to 21). UL97 mutations were canonical; 25% (4/16) of strains carried concurrent UL54 mutations. Ganciclovir-resistant CMV was more likely with breakthrough infections (75% [12/16] versus 19% [30/154];P= 0.00001) and donor positive/recipient negative (D+/R−) serostatus (75% versus 45% [69/154];P= 0.03). The median whole-blood CMV load was 4.13 log10copies/cm3(range, 2.54 to 5.53), and 93% (14/15) of patients had low-moderate immune responses (Cylex Immunoknow). Antiviral therapy was successful, failed, or eradicated viremia followed by relapse in 12% (2/16), 31% (5/16), and 56% (9/16) of patients, respectively. Eighty-seven percent (14/16) of patients were treated with foscarnet-containing regimens; toxicity developed in 78% (11/14) of these. Median viral load half-life and time to viremia eradication among foscarnet-treated patients were 2.6 and 23 days, respectively, and did not correlate with protection from relapse. Sixty-nine percent (11/16) of patients developed CMV pneumonitis, and 25% (4/16) died of it. Serum viral load was independently associated with death among foscarnet-treated patients (P= 0.04). In conclusion, ganciclovir-resistant CMV infections remained a major cause of morbidity and mortality following lung transplantation. Foscarnet-based regimens often eradicated viremia rapidly but were ineffective in the long term and limited by toxicity.
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Prichard, Mark, Caroll Hartline, Randall Lanier, and Earl Kern. "Evaluations of Combinations of CMX001 and Ganciclovir Against Cytomegalovirus Infections Using Real Time PCR." Antiviral Research 86, no. 1 (April 2010): A64—A65. http://dx.doi.org/10.1016/j.antiviral.2010.02.462.

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Gentry, Brian G., and John C. Drach. "Metabolism of Cyclopropavir and Ganciclovir in Human Cytomegalovirus-Infected Cells." Antimicrobial Agents and Chemotherapy 58, no. 4 (February 10, 2014): 2329–33. http://dx.doi.org/10.1128/aac.02311-13.

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ABSTRACTHuman cytomegalovirus (HCMV) is a widespread pathogen that can cause severe disease in immunologically immature and immunocompromised patients. The current standard of therapy for the treatment of HCMV infections is ganciclovir (GCV). However, high incidence rates of adverse effects are prevalent and limit the use of this drug. Cyclopropavir (CPV) is 10-fold more effective against HCMVin vitrothan GCV (50% effective concentrations [EC50s] = 0.46 and 4.1 μM, respectively) without any observed increase in cytotoxicity (S. Zhou, J. M. Breitenbach, K. Z. Borysko, J. C. Drach, E. R. Kern, E. Gullen, Y. C. Cheng, and J. Zemlicka, J. Med. Chem. 47:566–575, 2004, doi:10.1021/jm030316s). We have previously determined that the viral protein kinase pUL97 and endogenous cellular kinases are responsible for the conversion of CPV to a triphosphate (TP), the active compound responsible for inhibiting viral DNA synthesis and viral replication. However, this conversion has not been observed in HCMV-infected cells. To that end, we subjected HCMV-infected cells to equivalently effective concentrations (∼5 times the EC50) of either CPV or GCV and observed a time-dependent increase in triphosphate levels for both compounds (CPV-TP = 121 ± 11 pmol/106cells; GCV-TP = 43.7 ± 0.4 pmol/106cells). A longer half-life was observed for GCV-TP (48.2 ± 5.7 h) than for CPV-TP (23.8 ± 5.1 h). The area under the curve for CPV-TP produced from incubation with 2.5 μM CPV was 8,680 ± 930 pmol · h/106cells, approximately 2-fold greater than the area under the curve for GCV-TP of 4,520 ± 420 pmol · h/106cells produced from incubation with 25 μM GCV. We therefore conclude that the exposure of HCMV-infected cells to CPV-TP is greater than that of GCV-TP under these experimental conditions.
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Reddy, Subhakar, Mudit Tyagi, Shashwat Behera, and Rajeev Reddy Pappuru. "Cytomegalovirus retinitis in a patient of granulomatosis with polyangiitis on long-term immunosuppressants." BMJ Case Reports 14, no. 2 (February 2021): e236632. http://dx.doi.org/10.1136/bcr-2020-236632.

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A 69-year-old male patient presented to the retina clinic with a sudden decrease in vision in his right eye since 1 day. He was a known case of granulomatosis with polyangiitis and was on systemic immunosuppression for the past 3 years. The best-corrected visual acuity (BCVA) in his right eye was 20/60 and he has no perception of light in the left eye. Fundus examination revealed the presence of retinitis lesions in the right eye and total optic atrophy in the left eye. A vitreous biopsy was done and the PCR was found to be positive for cytomegalovirus (CMV). He was treated with intravitreal ganciclovir injections. Subsequently, the retinitis lesions regressed and BCVA in the right eye improved to 20/40.This case report elaborates on the risks of the development of opportunistic ocular infections in patients receiving long-term systemic immunosuppressants and the need for regular ocular examinations in such cases.
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Trofe, Jennifer, Lindsey Pote, Erin Wade, Emily Blumberg, and Roy D. Bloom. "Maribavir: A Novel Antiviral Agent with Activity Against Cytomegalovirus." Annals of Pharmacotherapy 42, no. 10 (August 26, 2008): 1447–57. http://dx.doi.org/10.1345/aph.1l065.

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Objective: To review the pharmacology, pharmacokinetics, efficacy, and safety of maribavir, a novel antiviral agent in the benzimidazole drug class. Data sources: Articles were identified through searches of MEDLINE (January 1998-July 2008). Abstracts from recent scientific meetings and the manufacturer were also included. Study Selection and Data Extraction: All English-language in vitro and in vivo studies and abstracts evaluating maribavir were reviewed and considered for inclusion. All human studies were included. Data Synthesis: Maribavir has significant activity against both human cytomegalovirus (CMV) and Epstein-Barr virus, but not other herpesviruses Unlike ganaclovir. which needs to be phosphorated by UL 97 kinase to become an active inhibitor of DNA polymerase, maribavir directly inhibits UL 97 kinase. UL 97 kinase is an early viral gene product involved in viral DNA elongation, DNA packaging and egress or shedding of capsids from viral nuclei. Maribavir has also been found to be effective against ganciclovir-resistant CMV strains. Maribavir differs from current CMV antiwal agents in its adverse event profile. Maribavir is not associated with nephrotoxicity or hematologic toxicities, but has been associated with taste disturbances. In February 2007, maribavir was granted Food and Drug Administration orphan drug status for prevention of CMV viremia and diseases in at-risk populations. Maribavir Phase 2 trials in stem-cell transplant recipients have been completed, and there are ongoing Phase 3 trials in stem-cell and organ transplant recipients. Conclusions: Maribavir may be an option for treatment of ganciclovir-resistant CMV infections. Its bioavailability is greater than that of oral ganciclovir, but less than that of valganciclovir. No differences in pharmacokinetics were seen in renally impaired patients, although dialysis-dependent patients were not evaluated. Maribavir is not associated with hematologic toxicities; however, the high prevalence of taste disturbances may limit its tolerability.
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Smee, Donald F., Robert W. Sidwell, and Bill B. Barnett. "Combination of antiviral immunotoxin and ganciclovir or cidofovir for the treatment of murine cytomegalovirus infections." Antiviral Research 32, no. 3 (November 1996): 165–71. http://dx.doi.org/10.1016/s0166-3542(95)00986-8.

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10

Fan-Havard, P., M. C. Nahata, and M. T. Brady. "GANCICLOVIR—A REVIEW OF PHARMACOLOGY, THERAPEUTIC EFFICACY AND POTENTIAL USE FOR TREATMENT OF CONGENITAL CYTOMEGALOVIRUS INFECTIONS." Journal of Clinical Pharmacy and Therapeutics 14, no. 5 (October 1989): 329–40. http://dx.doi.org/10.1111/j.1365-2710.1989.tb00256.x.

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Dissertations / Theses on the topic "Ganciclovir. Cytomegalovirus infections. Ocular pharmacology"

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Duvvuri, Sridhar Mitra Ashim K. "Development and characterization of poly (D, L-lactide-co-glycolide) based sustained release formulation of ganciclovir in treatment of cytomegalovirus retinitis." Diss., UMK access, 2005.

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Thesis (Ph. D.)--School of Pharmacy and Dept. of Chemistry. University of Missouri--Kansas City, 2005.
"A dissertation in pharmaceutical science and chemistry." Advisor: Ashim K. Mitra. Typescript. Vita. Description based on contents viewed Mar. 12, 2007; title from "catalog record" of the print edition. Includes bibliographical references (leaves 138-147). Online version of the print edition.
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Kansara, Viral Mitra Ashim K. "Ocular delivery of peptide ganciclovir prodrugs following subconjunctival injection evaluation of episcleral drug delivery approach /." Diss., UMK access, 2007.

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Thesis (Ph. D.)--School of Pharmacy. University of Missouri--Kansas City, 2007.
"A dissertation in pharmaceutical sciences and pharmacology." Advisor: Ashim K. Mitra. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed May 23, 2008. Includes bibliographical references (leaves 210-225). Online version of the print edition.
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Books on the topic "Ganciclovir. Cytomegalovirus infections. Ocular pharmacology"

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A, Spector Stephen, ed. Ganciclovir therapy for cytomegalovirus infection. New York: M. Dekker, 1991.

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