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Eurartesim, INN-Piperaquine & INN-Artenimol
ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE MEDICINAL PRODUCT Eurartesim 160 mg/20 mg film-coated tablets. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains 160 mg piperaquine tetraphosphate (as the tetrahydrate; PQP) and 20 mg artenimol. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Film-coated tablet (tablet). White oblong biconvex film-coated tablet (dimension 11.5x5.5mm / thickness 4.4mm) with a break-line and marked on one side with the letters “S” and “T”. The tablet can be divided into equal doses. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Eurartesim is indicated for the treatment of uncomplicated Plasmodium falciparum malaria in adults, adolescents, children and infants 6 months and over and weighing 5 kg or more. Consideration should be given to official guidance on the appropriate use of antimalarial medicinal products, including information on the prevalence of resistance to artenimol/piperaquine in the geographical region where the infection was acquired (see section 4.4). 4.2 Posology and method of administration Posology Eurartesim should be administered over three consecutive days for a total of three doses taken at the same time each day. 2 Dosing should be based on body weight as shown in the table below. Body weight Daily dose (mg) Tablet strength and number of tablets per dose (kg) PQP Artenimol 5 to <7 80 10 ½ x 160 mg / 20 mg tablet 7 to <13 160 20 1 x 160 mg / 20 mg tablet 13 to <24 320 40 1 x 320 mg / 40 mg tablet 24 to <36 640 80 2 x 320 mg / 40 mg tablets 36 to <75 960 120 3 x 320 mg / 40 mg tablets > 75* 1,280 160 4 x 320 mg / 40 mg tablets * see section 5.1 If a patient vomits within 30 minutes of taking Eurartesim, the whole dose should be re-administered; if a patient vomits within 30-60 minutes, half the dose should be re-administered. -
Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications
International Journal of Molecular Sciences Review Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications Daniel Fernández-Villa 1, Maria Rosa Aguilar 1,2 and Luis Rojo 1,2,* 1 Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; [email protected] (D.F.-V.); [email protected] (M.R.A.) 2 Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, 28029 Madrid, Spain * Correspondence: [email protected]; Tel.: +34-915-622-900 Received: 18 September 2019; Accepted: 7 October 2019; Published: 9 October 2019 Abstract: Bacterial, protozoan and other microbial infections share an accelerated metabolic rate. In order to ensure a proper functioning of cell replication and proteins and nucleic acids synthesis processes, folate metabolism rate is also increased in these cases. For this reason, folic acid antagonists have been used since their discovery to treat different kinds of microbial infections, taking advantage of this metabolic difference when compared with human cells. However, resistances to these compounds have emerged since then and only combined therapies are currently used in clinic. In addition, some of these compounds have been found to have an immunomodulatory behavior that allows clinicians using them as anti-inflammatory or immunosuppressive drugs. Therefore, the aim of this review is to provide an updated state-of-the-art on the use of antifolates as antibacterial and immunomodulating agents in the clinical setting, as well as to present their action mechanisms and currently investigated biomedical applications. Keywords: folic acid antagonists; antifolates; antibiotics; antibacterials; immunomodulation; sulfonamides; antimalarial 1. -
Pharmacological and Cardiovascular Perspectives on the Treatment of COVID-19 with Chloroquine Derivatives
www.nature.com/aps REVIEW ARTICLE Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives Xiao-lei Zhang1, Zhuo-ming Li1, Jian-tao Ye1, Jing Lu1, Lingyu Linda Ye2, Chun-xiang Zhang3, Pei-qing Liu1 and Dayue D Duan2 The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing severe pandemic. Curative drugs specific for COVID-19 are currently lacking. Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. Therefore, chloroquine phosphate was first used in the treatment of COVID-19 in China. Later, under a limited emergency- use authorization from the FDA, hydroxychloroquine in combination with azithromycin was used to treat COVID-19 patients in the USA, although the mechanisms of the anti-COVID-19 effects remain unclear. Preliminary outcomes from clinical trials in several countries have generated controversial results. The desperation to control the pandemic overrode the concerns regarding the serious adverse effects of chloroquine derivatives and combination drugs, including lethal arrhythmias and cardiomyopathy. The risks of these treatments have become more complex as a result of findings that COVID-19 is actually a multisystem disease. While respiratory symptoms are the major clinical manifestations, cardiovascular abnormalities, including arrhythmias, myocarditis, heart failure, and ischemic stroke, have been reported in a significant number of COVID-19 patients. Patients with preexisting cardiovascular conditions (hypertension, arrhythmias, etc.) are at increased risk of severe COVID-19 and death. -
Annual Review 2004 Contents Contentsforeword
Annual Review 2004 Contents ContentsForeword ........................................................................................................................... 3 Editor’s Note ..................................................................................................................... 4 Organization Chart ............................................................................................................ 5 Administrative Board .......................................................................................................... 6 Special Events..................................................................................................................... 8 Consultants ...................................................................................................................... 13 Visiting Professors ............................................................................................................ 13 Faculty Board ...................................................................................................................13 Faculty Senate ..................................................................................................................14 Department of Clinical Tropical Medicine ........................................................................ 15 Department of Helminthology ......................................................................................... 22 Department of Medical Entomology ............................................................................... -
Plasmodium Falciparum Clinical Isolates: in Vitro Genotypic and Phenotypic Characterization Nonlawat Boonyalai1* , Brian A
Boonyalai et al. Malar J (2020) 19:269 https://doi.org/10.1186/s12936-020-03339-w Malaria Journal RESEARCH Open Access Piperaquine resistant Cambodian Plasmodium falciparum clinical isolates: in vitro genotypic and phenotypic characterization Nonlawat Boonyalai1* , Brian A. Vesely1, Chatchadaporn Thamnurak1, Chantida Praditpol1, Watcharintorn Fagnark1, Kirakarn Kirativanich1, Piyaporn Saingam1, Chaiyaporn Chaisatit1, Paphavee Lertsethtakarn1, Panita Gosi1, Worachet Kuntawunginn1, Pattaraporn Vanachayangkul1, Michele D. Spring1, Mark M. Fukuda1, Chanthap Lon1, Philip L. Smith2, Norman C. Waters1, David L. Saunders3 and Mariusz Wojnarski1 Abstract Background: High rates of dihydroartemisinin–piperaquine (DHA–PPQ) treatment failures have been documented for uncomplicated Plasmodium falciparum in Cambodia. The genetic markers plasmepsin 2 (pfpm2), exonuclease (pfexo) and chloroquine resistance transporter (pfcrt) genes are associated with PPQ resistance and are used for moni- toring the prevalence of drug resistance and guiding malaria drug treatment policy. Methods: To examine the relative contribution of each marker to PPQ resistance, in vitro culture and the PPQ survival assay were performed on seventeen P. falciparum isolates from northern Cambodia, and the presence of E415G-Exo and pfcrt mutations (T93S, H97Y, F145I, I218F, M343L, C350R, and G353V) as well as pfpm2 copy number polymor- phisms were determined. Parasites were then cloned by limiting dilution and the cloned parasites were tested for drug susceptibility. Isobolographic analysis of several drug combinations for standard clones and newly cloned P. falciparum Cambodian isolates was also determined. Results: The characterization of culture-adapted isolates revealed that the presence of novel pfcrt mutations (T93S, H97Y, F145I, and I218F) with E415G-Exo mutation can confer PPQ-resistance, in the absence of pfpm2 amplifcation. -
Supplementary Information
Supplementary Information Network-based Drug Repurposing for Novel Coronavirus 2019-nCoV Yadi Zhou1,#, Yuan Hou1,#, Jiayu Shen1, Yin Huang1, William Martin1, Feixiong Cheng1-3,* 1Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA 2Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA 3Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA #Equal contribution *Correspondence to: Feixiong Cheng, PhD Lerner Research Institute Cleveland Clinic Tel: +1-216-444-7654; Fax: +1-216-636-0009 Email: [email protected] Supplementary Table S1. Genome information of 15 coronaviruses used for phylogenetic analyses. Supplementary Table S2. Protein sequence identities across 5 protein regions in 15 coronaviruses. Supplementary Table S3. HCoV-associated host proteins with references. Supplementary Table S4. Repurposable drugs predicted by network-based approaches. Supplementary Table S5. Network proximity results for 2,938 drugs against pan-human coronavirus (CoV) and individual CoVs. Supplementary Table S6. Network-predicted drug combinations for all the drug pairs from the top 16 high-confidence repurposable drugs. 1 Supplementary Table S1. Genome information of 15 coronaviruses used for phylogenetic analyses. GenBank ID Coronavirus Identity % Host Location discovered MN908947 2019-nCoV[Wuhan-Hu-1] 100 Human China MN938384 2019-nCoV[HKU-SZ-002a] 99.99 Human China MN975262 -
Computational Drug Target Screening Through Protein Interaction Profiles
www.nature.com/scientificreports OPEN Computational Drug Target Screening through Protein Interaction Profiles Received: 27 June 2016 Santiago Vilar1,2, Elías Quezada3, Eugenio Uriarte2, Stefano Costanzi4, Fernanda Borges3, Accepted: 24 October 2016 Dolores Viña5 & George Hripcsak1 Published: 15 November 2016 The development of computational methods to discover novel drug-target interactions on a large scale is of great interest. We propose a new method for virtual screening based on protein interaction profile similarity to discover new targets for molecules, including existing drugs. We calculated Target Interaction Profile Fingerprints (TIPFs) based on ChEMBL database to evaluate drug similarity and generated new putative compound-target candidates from the non-intersecting targets in each pair of compounds. A set of drugs was further studied in monoamine oxidase B (MAO-B) and cyclooxygenase-1 (COX-1) enzyme through molecular docking and experimental assays. The drug ethoxzolamide and the natural compound piperlongumine, present in Piper longum L, showed hMAO-B activity with IC50 values of 25 and 65 μM respectively. Five candidates, including lapatinib, SB-202190, RO-316233, GW786460X and indirubin-3′-monoxime were tested against human COX-1. Compounds SB-202190 and RO-316233 showed a IC50 in hCOX-1 of 24 and 25 μM respectively (similar range as potent inhibitors such as diclofenac and indomethacin in the same experimental conditions). Lapatinib and indirubin- 3′-monoxime showed moderate hCOX-1 activity (19.5% and 28% of enzyme inhibition at 25 μM respectively). Our modeling constitutes a multi-target predictor for large scale virtual screening with potential in lead discovery, repositioning and drug safety. Discovery of new targets for molecules is of great interest in drug design and development1,2. -
Downloaded and Saved in PDB Format
bioRxiv preprint doi: https://doi.org/10.1101/833145; this version posted November 6, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. 1 Full title: Efficacy of Lumefantrine against piperaquine resistant Plasmodium berghei parasites is 2 selectively restored by probenecid, verapamil, and cyproheptadine through ferredoxin NADP+- 3 reductase and cysteine desulfurase 4 5 Short title: Mechanisms of Lumefantrine resistance and reversal in Plasmodium berghei ANKA 6 7 Authors: Fagdéba David Bara1,2,3, Loise Ndung’u1, Noah Machuki Onchieku1, Beatrice Irungu2, 8 Simplice Damintoti Karou3, Francis Kimani4, Damaris Matoke-Muhia4, Peter Mwitari2, Gabriel 9 Magoma1,5, Alexis Nzila6, Daniel Kiboi5* 10 11 Affiliations: 1Department of Molecular Biology and Biotechnology, Pan African University 12 Institute for Basic Sciences, Technology and Innovation (PAUSTI), Nairobi, Kenya. 2Centre for 13 Traditional Medicine and Drug Research, Kenya Medical Research Institute, Nairobi, Kenya. 14 3School of Food and Biology Technology, Universite du Lome, Lome, Togo. 4Centre for 15 Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya. 16 5Department of Biochemistry, Jomo Kenyatta University of Agriculture and Technology 17 (JKUAT), Nairobi, Kenya. 6Department of Life Sciences, King Fahd University of Petroleum and 18 Minerals, Dharam, Saudi Arabia. 19 20 Corresponding author: [email protected] ; [email protected] 1 bioRxiv preprint doi: https://doi.org/10.1101/833145; this version posted November 6, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. -
Treatment Failure Due to the Potential Under-Dosing of Dihydroartemisinin-Piperaquine in a Patient with Plasmodium Falciparum Uncomplicated Malaria
INFECT DIS TROP MED 2019; 5: E525 Treatment failure due to the potential under-dosing of dihydroartemisinin-piperaquine in a patient with Plasmodium falciparum uncomplicated malaria I. De Benedetto1, F. Gobbi2, S. Audagnotto1, C. Piubelli2, E. Razzaboni3, R. Bertucci1, G. Di Perri1, A. Calcagno1 1Department of Medical Sciences, Unit of Infectious Diseases, University of Torino, Amedeo di Savoia Hospital, Torino, Italy 2Department of Infectious–Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy 3Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy ABSTRACT: — Background: Dihydroartemisinin/piperaquine (DHA-PPQ) 40/320 mg is approved for the treatment of Plasmodium falciparum uncomplicated malaria. Different recommendations are provided by WHO guidelines and drug data sheet about dosing in overweight patients. We report here a treatment failure likely caused by sub-optimal dosing of dihydroartemisinin-piperaquine in a case of uncomplicated P. fal- ciparum malaria in a returning traveler from Burkina Faso. INTRODUCTION kg). They, therefore, provided an updated dosing body weight dosing schedule in their 2015 guidelines for Dihydroartemisinin/piperaquine (DHA-PPQ) 40/320 malaria treatment that provides for a dose of 200/1600 mg tablet formulation is approved for the treatment mg (5 tablets) in individuals > 80 kg1. of Plasmodium falciparum uncomplicated malaria in adults and children > 6 months and > 5 kg of body weight. Following WHO guidelines, the daily -
Quinoline-Based Hybrid Compounds with Antimalarial Activity
molecules Review Quinoline-Based Hybrid Compounds with Antimalarial Activity Xhamla Nqoro, Naki Tobeka and Blessing A. Aderibigbe * Department of Chemistry, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa; [email protected] (X.N.); [email protected] (N.T.) * Correspondence: [email protected] Received: 7 November 2017; Accepted: 11 December 2017; Published: 19 December 2017 Abstract: The application of quinoline-based compounds for the treatment of malaria infections is hampered by drug resistance. Drug resistance has led to the combination of quinolines with other classes of antimalarials resulting in enhanced therapeutic outcomes. However, the combination of antimalarials is limited by drug-drug interactions. In order to overcome the aforementioned factors, several researchers have reported hybrid compounds prepared by reacting quinoline-based compounds with other compounds via selected functionalities. This review will focus on the currently reported quinoline-based hybrid compounds and their preclinical studies. Keywords: 4-aminoquinoline; 8-aminoquinoline; malaria; infectious disease; hybrid compound 1. Introduction Malaria is a parasitic infectious disease that is a threat to approximately half of the world’s population. This parasitic disease is transmitted to humans by a female Anopheles mosquito when it takes a blood meal. Pregnant women and young children in the sub-tropical regions are more prone to malaria infection. In 2015, 214 million infections were reported, with approximately 438,000 deaths and the African region accounted for 90% of the deaths [1–3]. Malaria is caused by five parasites of the genus Plasmodium, but the majority of deaths are caused by Plasmodium falciparum and Plasmodium vivax [1,4–6]. -
Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01 -
Review of Mass Drug Administration and Primaquine
Contents Acknowledgements ...................................................................................................................................... 2 Acronyms ...................................................................................................................................................... 3 Introduction .................................................................................................................................................. 4 Methods ....................................................................................................................................................... 4 Findings ......................................................................................................................................................... 6 Study objectives and design ............................................................................................................ 9 Contextual parameters - endemicity, seasonality, target population .......................................... 10 Outcome measures ....................................................................................................................... 13 Drug regimens ............................................................................................................................... 13 Co-Interventions ............................................................................................................................ 15 Delivery methods and community engagement ..........................................................................