Posted by
Savannah Momo on Tuesday, February 02, 2010 2:18:05 AM
Zidovudine or azidothymidine (AZT) is Pharmaceutical Intermediates , the first approved for treatment of HIV. Zidovudine was the first drug approved for the treatment of AIDS and HIV infection.
Like other reverse transcriptase inhibitors, AZT works by inhibiting
the action of reverse transcriptase, the enzyme that HIV uses to make a
DNA copy of its RNA. The viral double-stranded DNA is subsequently
spliced into the DNA of a target cell, where it is called a provirus.
Jerome Horwitz of Barbara Ann Karmanos Cancer Institute
and Wayne State University School of Medicine first synthesized AZT in
1964, under a US National Institutes of Health (NIH) grant.
It was
originally intended to anti-live cancer ,
but failed to show efficacy and had an unacceptably high side effect
profile. In 1985, when Samuel Broder, Hiroaki Mitsuya, and Robert
Yarchoan, three scientists in the National Cancer
Institute (NCI), collaborating with Janet Rideout and several other
scientists at Burroughs Wellcome (now GlaxoSmithKline), started working
on it as an AIDS drug .
After showing that this drug was an effective agent against HIV in
vitro, the team conducted the initial clinical trial that provided
evidence that it could increase CD4 counts in AIDS patients.
AZT does not destroy the HIV infection, but only delays the progression
of the disease and the replication of virus, even at very high doses.
During prolonged AZT treatment HIV has the ability to gain an increased
resistance to AZT by mutation of the reverse transcriptase. A study showed that AZT
could not impede the resumption of virus production, and eventually
cells treated with AZT produced viruses as much as the untreated cells.
So as to slow the development of resistance, it is generally
recommended that AZT be
given in combination with another reverse transcriptase inhibitor and
an antiretroviral from another group, such as a protease inhibitor or a
non-nucleoside reverse transcriptase inhibitor.
AZT
may be used in combination with other antiretroviral medications to
substantially reduce the risk of HIV infection following a significant
exposure to the virus (such as a needle-stick injury involving blood or
body fluids from an individual known to be infected with HIV). AZT
is also recommended as part of a regimen to prevent mother-to-child
transmission of HIV during pregnancy, labor and delivery. With no
treatment, approximately 25% of infants whose mothers are infected with
HIV will become infected.
AZT has been shown to reduce this risk to
approximately 8% when given in a three-part regimen during pregnancy,
delivery and to the infant for 6 weeks after birth. Use of appropriate
combinations of antiretroviral medications and cesarean section when
necessary can further reduce mother-child transmission of HIV to 1-2%.
Common side effects of AZT include nausea, headache, changes in body
fat, and discoloration of fingernails and toenails. More severe side
effects include anaemia and bone marrow suppression. These unwanted
side effects might be caused by the sensitivity of the γ-DNA polymerase
in the cell mitochondria. AZT has been shown to work additively or
synergistically with many anti-HIV agents; however, acyclovir and
ribavirin decrease the antiviral effect of AZT.
Formal Chemical Name (IUPAC)
1-((2R,4S,5S)-4-azido-5-(hydroxymethyl)tetrahydrofuran-2-yl)-5-methylpyrimidine-2,4(1H,3H)-dione
from:timepharm