SWINE FLU

WHAT IS SWINE FLU?

Swine Influenza (swine flu) is a respiratory disease of Type A influenza viruses that causes regular outbreaks in pigs. Swine flu viruses have been reported to spread from person to person, but in the past, this transmission was limited and not sustained beyond three people.

SIGNS AND SYMPTOMS OF SWINE FLU IN PEOPLE

Symptoms of the swine flu are very similar to those of seasonal influenza and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

Swine flu in Numbers

HOW ARE HUMAN INFECTIONS WITH SWINE FLU DIAGNOSED?

To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness(when an infected person is most likely to be shedding virus). Identification as swine flu influenza A virus requires sending the specimen to a hospital laboratory for testing. In the case of Rajkot the Specimens are collected and sent to Ahemdabad for confirmation of disease however..

ARE THERE MEDICINES TO TREAT SWINE FLU?

Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in the body. They can make the illness milder and can make feel better faster and can also prevent serious flu complications.

The US CDC recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and/or prevention of infection with these swine influenza viruses.

OSELTAMIVIR (TAMIFLU)

Some Method of Preparation of Tamiflu and their Important Aspects

Hoffmann-La Roche process (Starting from Shikimic Acid or Quinic Acid) Current commercial synthesis method Karpf / Trussardi synthesis (Azide free synthesis) Corey synthesis (From butadiene and acrylic acid) Shibasaki synthesis (From Shikimic Acid) Fukuyama synthesis (From pyridine and acrolein) Trost synthesis (Shortest route of synthesis up till date)

Commercial Production Roche Method

BASIC CHEMICAL & PHYSICAL PROPERTIES

IUPAC Name: ethyl (3R,4R,5S)-4-acetamido-5amino-3-pentan-3-yloxycyclohexene-1carboxylate

TAMIFLU (oseltamivir phosphate) is available as capsules containing 30 mg, 45 mg, or 75 mg oseltamivir for oral use, in the form of oseltamivir phosphate, and as a powder for oral suspension

 Dissociation Constants: pKa = 7.7 at 25 deg C (primary amine) Solubility: In water, 1.6X10^3 mg/L at 25 deg C (est) Vapor Pressure: 1.3X10^8 mm Hg at 25 deg C (est) Molecular weight: 410.40. White crystalline solid H-Bond Donor: 2 H Bond Acceptor: 5 Exact Mass: 312.204907 g/mol

Working of Tamiflu
Neuraminidases, also called sialidases, catalyze the breakage of the pathogen from the newly formed virions and from the host cell receptors Neuraminidase inhibitors are a class of antiviral drugs targeted at the influenza virus, which work by blocking the function of the viral neuraminidase protein, thus preventing the virus from reproducing by budding from the host cell.

Viral neuraminidase is a type of neuraminidase found on the surface of influenza viruses that enables the virus to be released from the host cell. http://www.pharmasquare.org/flash/Tamiflu.html

DIFFERENT STRENGTH OF TAMIFLU MEDICINE

Tamiflu Quality Control Tests

TAMIFLU OPTIMUM DOSAGE

The dose for an adult for the treatment of influenza is a 75mg capsule, twice a day for 5 days.

The dose for a child 30-75 mg per day. Depending the weight of the child.

ZANAMIVIR (RELENZA)

BASIC PROPERTIES
IUPAC Name: (2R,3R,4S)-3-acetamido-4(diaminomethylideneamino)-2-[(1R,2R)-1,2,3trihydroxypropyl]-3,4-dihydro-2H-pyran-6-carboxylic acid

The active component of RELENZA is zanamivir

Color/Form White to off-white powder Melting Point 256 deg C Solubility In water, 18,000 mg/L at 25 deg C Vapor Pressure 4.4X10^18 mm Hg at 25 deg C (est)

OSELTAMIVIR VS ZANAMIVR

Tamiflu vs Relenza Dosage

 Influenza virus is a constantly mutating virus. Because of its high frequency of mutations, leading to change of its structure, it escapes immunity that humans develop against the virus. Recently, it has also been reported to have developed resistance to anti-viral drugs. So far, cases of viral resistance have been reported only against Tamiflu, whereas no viral resistance has been observed against Relenza, a finding that can have very significant implications in favor of Relenza in the long run. Recently, both the Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have acknowledged in their reports that there is widespread resistance to Tamiflu in treating the H1N1 virus, the strain that caused the 2009 flu pandemic, with almost 99.6 % samples being resistant, against only 12% resistance an year earlier. The high incidence of viral resistance in the case of Tamiflu will make it less useful for treating influenza, a fact that can tilt the priorities in favor of Relenza, which has so far been free of the viral resistance problem.

Drug Resistance

THANK YOU

By:Jinay Patel Shubham Garg Ishita Rupapara