Virenza at Glance Docters Presentation

8/8/2019 Virenza at Glance Docters Presentation

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CiplaCaring for Life

Since 1935


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Changed the scenario inrespiratory segmentin 1976 by launching

Indias First Inhaler


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Autohaler

Maxiflo

Triohale

Duoset

Beckform

Fullform

Simplyone

Ciclohale

Zerostat V Spacer

Duova

Duonase

Tiova

Montair

Neohaler

Foracort

Levloin

Flomist

Duolin

Seroflo

Zerostat Spacer

Rotahaler

Flohale

Serobid

Budecort

Ipravent

Aerocort

Beclate

2009

Providing Largest ProductRange in Respiratory

segment

1976 Asthalin


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by making HIV treatmentaffordable and accessibleacross the world

TheREVOLUTION

which has given life

*In South African countries


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Cipla launched Worlds 1st

Oral Iron Chelator

1995

KelferChanged the lives of

thousands of Thalassemicpatients across the

WORLD


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The World Health Organization has reported 134504

confirmed cases

of influenza A (H1N1)infection from 89 countries as on

July 27.

There have been 816 deaths so far.


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Need of the hour is to provide,

Active Management against Influenza!!!


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Acute respiratory illness affecting the upper& lower respiratory tract, caused by infectiondue to the influenza virus.

Rapid onset high Fever (>38C)

Cough

Headache

Myalgia

Sore throat

Malaise

Chills

Watery nasal discharge


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Fever (>38C)

Cough

Headache

Myalgia

Sore throat

Watery nasal discharge Malaise

Chills

Any 2Diagnosis in 70% of cases

Lab tests not easily available

and diagnosis is clinical


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Clinical features of influenza. Seminary in respiratory infections 1992;7:26-37

Decompensation of chronic diseasesPulmonary disease Heart disease Renal insufficiency Metabolic disease

Bacterial pneumonia Respiratory disorders

Bacterial superinfections

Primary viralpneumonia.

Significant seriousness & death in high-risk groups


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Swine flu is a respiratory disease of pigs caused by type Ainfluenza virus which circulate in pigs.

Like all influenza viruses, swine flu viruses change constantly.

When the change is sufficient enough to cause a potential

infection in humans or When virus from pig interacts with the virus of human causing

a reassortment of the genes a new virus may result.

This virus may be capable of infecting humans.

For e.g.

H1N1 viruses - most of the recently isolated influenza viruses from pigs


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Manifestations of H1N1 influenza (swine flu) are similar to thoseof seasonal influenza.

Fever

Cough

Sore throat

Body aches Headache

Chills and fatigue

Diarrhea and vomiting (possible)

In children, signs of severe disease include apnea, tachypnea,dyspnea, cyanosis, dehydration, altered mental status, and

extremeirritability


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Since it was first detected in late April inMexico and the United States,

Swine flu has reached 89 countries, infecting

more than 1 lakh people

As of 27th July

The total no. of cases of pandemic H1N1(swine flu) were 1,34,504.

The no. of deaths caused were 816.

http://www.who.int


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ix more swine flu cases take tally to 56 -21 Jun 2009

Mumbai-based engineer tests positive forswine flu 20 Jun 2009

44 swine flu cases in India - 18 Jun 2009

One more person tests positive for Swine flu

in Karnataka-18 Jun 2009

Four more swine flu cases in Delhi; 35affected acrossIndia - 18 Jun 2009

9-yr-old Hyderabad boy takes flu tally to 31-17 Jun 2009


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Children aged 6mths-4yrs. Childrens who are receiving long-term aspirin therapy

The elderly (age 50 years or more)

Persons of any age with certain chronic medical conditionslike:

Diabetes mellitus Disorders of the respiratory system, including

asthma, COPD

Disorders of the cardiovascular system

Renal dysfunction

Hemoglobinopathies

Immunosuppression, including HIV.

Become pregnant during the influenza season


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Antiviral drugs in influenzaAntiviral drugs in influenza

Adamantanes

Amantadine

Rimantadine

Neuraminidase inhibitors

Oseltamivir

Zanamivir

R l f ti i l iR l f ti i l i


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Role of antivirals inRole of antivirals in

influenzainfluenza

Antiviral medications are effective when used early in thecourse of illness for treatment (within 48 hrs of symptoms).

Antivirals can also be used for prophylaxis during an

epidemic.

They can be used for post exposure prophylaxis aftercoming in contact with a case of influenza.


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ADAMANTANES

NEURAMINIDASEINHIBITORs


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Pack : 20 rotacaps (5 mg

each) and aRevolizer

Price : Rs 800/-


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Mediandaysto

alleviationofm

ajorsy

mptoms

4.5**5***

6

7.5

MIST et al makela et al

zanamivir placebo

** p


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The symptoms were reduced by 0.8 days forotherwise healthy adults to 1.0 day for childrenand 2.0 days in the high risk group

BMJ 2003;326;1235-1242


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34/554

9/144

40/423

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zanamivi placebo

Post

exposu

re

prophy

laxi

s

Health

ypat i

ents

69% reduction

in the odds of developing flu

81% reduction in the odds

of development of flu after

prophylaxis with zanamivir

BMJ 2003;326;1235-1242


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%

ofp

atien

tsn

ot

de

veloping

flu

7972

85

0

10

20

30

40

50

60

70

80

90protective efficacy (%)

ITTpopulationFamilies with influenzapositive case

Families with influenzanegative case

Zanamivir reduced the likelihood ofdeveloping influenza

by upto 85% in various populations

Drugs 2002; 62 (1): 71-106


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Treatment of Influenza Virenza is indicated for treatment of uncomplicated acute illness

due to influenza A and B virus in adults and pediatric patients 7

years and older who have been symptomatic for no more than 2

days.

Prophylaxis of Influenza

Virenza is indicated in adults and pediatric patients 5 years of

age and older for prophylaxis of influenza.

Virenza is not recommended for treatment of patients withunderlying airways disease (such as asthma or chronic

obstructive pulmonary disease)


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Virenza is for administration to the respiratory tract by oral

inhalation using the Revolizer device only.

Treatment Prophylaxis

Adults Two rotacaps,

twice daily for

5 days

Household

settings: Two

rotacaps,once daily for

10 days

Community

Outbreaks: Two

rotacaps, oncedaily for 28

days

Children Same as above

(age 7 yrs orolder)

Same as

above(children 5 yrs

or older)

Same as

above(children 5 yrs

or older)

Note:Patients scheduled to use an inhaled bronchodilator at the

same time as Virenza should use their bronchodilator before takingVirenza.


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Novel (H1N1) influenza virus is sensitive to the neuraminidaseinhibitor antivirals like zanamivir and oseltamivir.

It is resistant to the adamantane antivirals like amantadineand rimantadine.

For antiviral treatment of novel influenza (H1N1) virusinfection, either oseltamivir or zanamivir are recommended

ACIP guidelines 2008WHO, IDSA guidelines for influenza


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Treatment is recommended for:

All hospitalized patients with confirmed,probable or suspected novel influenza (H1N1).

Patients who are at higher risk for seasonal

influenza complications.

www.cdc.gov /Interim Guidance on Antiviral

Recommendations

SELTAMIVIR OR ZANAMIVIR -RECOMMENDED
http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/


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Post exposure antiviral chemoprophylaxis

Close contacts of cases (confirmed, probable, or

suspected) who are at high-risk for complications ofinfluenza

Health care personnel, public health workers, who

have had an exposure to a person with novel(H1N1) influenza virus infection (confirmed,probable, or suspected) during that personsinfectious period.

OSELTAMIVIR OR ZANAMIVIR -RECOMMENDED

www.cdc.gov /Interim Guidance on AntiviralRecommendations
http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/


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Treatment or prophylaxis of influenza in individualswith underlying airways disease (such as asthma orCOPD)

If treatment with Virenza is considered for a patient withunderlying airways disease the patient should be closely

monitored for bronchospasm.

Should be stopped if any allergic reactions occur.

It is not indicated for bacterial infections that showsymptoms like flu.

In pregnancy and lactation can be given if thepotential benefit justifies the potential risk to thefetus.


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Diarrhoea

Nausea

Vomiting

Headache

Bronchitis

Cough and sinusitis

Bronchospasm and allergic-like reactions

have also been reported in some.


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Gives high lung deposition at various flow rates.

Gives 30% more drug deposition as compared to

Rotahaler.

And hence improves adherence.

Contemporary and stylish look

Simplicity is the hallmark of the device

The simple open & shut motion makes it easy to use

by all patients.


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Virenza is indicated for the treatment andprophylaxis of influenza A and B.

Virenza shortens the duration of influenzasymptoms by 1-2 days.

Virenza is directly delivered to the lungs by arevolizer.

Virenza is well tolerated and can be used forprophylaxis in children aged 5 yrs and above.

Also effective in oseltamivir-resistant influenza.


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Dr,Rx


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Virenza at Glance Docters Presentation

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