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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Didanosine is a nucleoside analog that is used to treat HIV. It was used in the first trimester by 427 women, and there was no increased frequency of birth defects, although it was slightly elevated (4.68 percent) compared to the CDC rate (2.7 percent) (Antiretroviral Registry, 2018). The NIH states that this drug is “not recommended for pregnant women (aidsinfo.nih.gov). The drug was not teratogenic in experimental animals given 12 to 14 times the usual human dose.
Didanosine
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
The goal of combination antiretroviral therapy is to decrease plasma HIV RNA levels to < 50 copies/ml, a validated surrogate end point for clinical efficacy (Hammer et al., 2006). Nucleoside analogs remain the cornerstone of antiretroviral therapy. As a member of the nucleoside analog class, didanosine is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and children.
HIV and AIDS Pain
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Maurice Policar, Vasanthi Arumugam
In patients with AIDS, pancreatitis is 35 to 800 times more common than in those without HIV infection. In addition to alcohol use and gallstones, other pathologies related to pancreatitis in HIV infection include medications such as didanosine, Kaletra, and pentamidine, as well as opportunistic infections including CMV, toxoplasmosis, mycobacteria, and cryptosporidium (Dassopoulos & Ehrenpreis, 1999). Infiltration of the pancreas by lymphoma or KS is rare. The presentation is similar to that seen in immunocompetent hosts, but tends to be more severe. Diagnosis relies primarily on symptoms, an elevated amylase and lipase, and ultrasound or CT evidence of pancreatic inflammation. Stool studies or blood cultures may be helpful for some infections, but CMV requires tissue diagnosis. Associated pain will usually respond to pareneterally administered narcotic analgesics, preferably by PCA pump. When pancreatitis is a result of drug toxicity, the offending agent must be discontinued. Patients with a history of pancreatitis should not receive didanosine, Kaletra, or pentamidine. When an infection is the cause, specific antimicrobial therapy should be administered.
Advances in biocatalytic and chemoenzymatic synthesis of nucleoside analogues
Published in Expert Opinion on Drug Discovery, 2022
Sebastian C. Cosgrove, Gavin J. Miller
A pioneering example of a fully engineered biosynthetic pathway was reported by Birmingham et al. [30]. The authors described an engineering campaign of a suite of biocatalysts, to deliver a five-enzyme cascade toward the nucleoside analogue didanosine 5, which is used as a combination antiretroviral treatment for HIV/AIDS [31]. A bioretrosynthetic approach was used to design the pathway to 5. Inspired by a nucleoside salvage pathway (Scheme 3A), the group focussed on the pathway for inosine 3, closely related to their target. By running this degradative pathway in reverse, it was theorized that the enzymes could be engineered for activity toward non-natural components and deliver a biocatalytic cascade to synthesize 5.
Anti-cytomegalovirus preemptive therapy to prevent cytomegalovirus disease in HIV-infected patients: a systematic review
Published in Infectious Diseases, 2023
Prenali Dwisthi Sattwika, Yanri Wijayanti Subronto, Heni Retnowulan, Karina Ambar Sattwika, Detty Siti Nurdiati
HAART as a therapy for HIV was introduced in the period 1995–1996 [21]. The RCTs investigated in this review were mostly conducted before the HAART period [11,13,17,18,20]. During this period, HIV therapy were single therapy or two combinations of nucleoside analog drugs such as zidovudine, didanosine, zalcitabine or stavudine. When the included studies in this review were conducted, the use of high doses of acyclovir or ganciclovir per oral was still an option of therapy. However, oral ganciclovir is currently out of production and CMV management guidelines do not recommend high-dose acyclovir [22–24].
Didanosine-induced Retinopathy: New Insights with Long-term Follow-up
Published in Ocular Immunology and Inflammation, 2022
Céline Faure, Maxime Chassery, Raphaëlle Ores, Isabelle Audo
Didanosine, also called ddI, with the trade name of Videx®, was the second FDA-approved antiretroviral drug against the human immunodeficiency virus (HIV). Didanosine is an analog of adenosine, part of the nucleoside analog reverse-transcriptase inhibitors (or NRTIs). NRTIs compete with the natural deoxynucleotides for incorporation into the replicating viral DNA chain. However, 3ʹ-hydroxyl group are lacking in NRTIs and therefore they are acting as chain terminators and classified as competitive substrate inhibitors.