Human Immunodeficiency Virus Book

http://www.fpnotebook.com/

ZalcitabineAka: ddC, Hivid

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  1. Mechanism
    1. Nucleoside Reverse Transcriptase Inhibitor
    2. Inhibits HIV replication
  2. Pharmacokinetics
    1. Well absorbed (87% oral bioavailability)
  3. Efficacy
    1. Combination treatment zalcitabine and Zidovudine (AZT)
      1. Late HIV without prior anti-Retroviral therapy
      2. Large and sustained CD4 Count increase
      3. Improves survival in patients with late HIV disease
  4. Dosing
    1. Zalcitabine 0.75 mg PO tid ($207/month)
  5. Adverse Effects
    1. Common symptoms during the first several weeks
      1. Effects
        1. Maculovesicular cutaneous eruptions
        2. Mucosal Ulcers
        3. Fevers
      2. Symptoms often resolve without stopping medication
      3. Consider Symptomatic therapy
        1. Tylenol
        2. Antihistamines
        3. NSAIDS
      4. Symptoms less frequent at a dose of 2.25 mg/day
    2. Painful Sensorimotor leg Peripheral Neuropathy (10-25%)
      1. Major dose limiting toxicity
      2. Discontinue drug at first signs of Neuropathy!
      3. Symptoms usually resolve over a few weeks
    3. Pancreatitis (<1%)

Zalcitabine (C0012132)

Definition (CSP)cytidine analog which inhibits reverse transcriptase and has potential efficacy against AIDS.
Definition (MSH)A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chain-terminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy.
Definition (PDQ)A synthetic dideoxynucleoside. After intracellular phosphorylation to its active metabolite, zalcitabine preferentially inhibits the gamma form of DNA polymerase present in tumor cell mitochondria, resulting in the inhibition of tumor cell mitochondrial DNA replication and tumor cell death. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40349&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40349&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C430" NCI Thesaurus)
Definition (NCI)A synthetic dideoxynucleoside. After intracellular phosphorylation to its active metabolite, zalcitabine preferentially inhibits the gamma form of DNA polymerase present in tumor cell mitochondria, resulting in the inhibition of tumor cell mitochondrial DNA replication and tumor cell death. (NCI04)
ConceptsNucleic Acid, Nucleoside, or Nucleotide (T114) , Pharmacologic Substance (T121)
MSHD016047
English2'3' dideoxycytidine, ddC, Dideoxycytidine, DIDEOXYCYTIDINE 002 003, Zalcitabine, ZALCITABINE PREPARATION
Spanishzalcitabina
Parent Concepts2',3'-Dideoxynucleosides (C0282384), Deoxycytidine (C0011485), Dideoxynucleosides (C0012136), Pyrimidine analog (C0280039), Antiviral Agents (C0003451), Zalcitabine (C0012132), Reverse Transcriptase Inhibitors (C0282519), Drug allergen (C1320237), Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors (C1579421)
SourcesCSP, LNC, MSH, MTH, MTHSPL, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Hivid (C0678123)

ConceptsNucleic Acid, Nucleoside, or Nucleotide (T114) , Pharmacologic Substance (T121)
MSHD016047
EnglishHivid, HIVID Roche, Hoffman-La Roche Brand of Zalcitabine, Roche Brand of Zalcitabine
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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