GLOMATIN

Indications

• Low blood volume
• Hypovolemic shock
• Burns
• Cardiopulmonary bypass

Dosage

Children: Initially 10-20 mL per kilogram. Adjust according to the patient's condition and response, using 3.5-4% solution. Use under specialist supervision to mitigate the risk of fluid overload.

Adults: Dose according to requirements, typically administered intravenously. Consult product literature for specific dosing guidance.

Mechanism of action

Gelatin acts as a plasma expander by increasing the oncotic pressure in the vascular compartment, which helps to retain fluid within the bloodstream and restore circulating blood volume. This mechanism aids in maintaining blood pressure and improving tissue perfusion.

Pharmacodynamics

Gelatin solutions increase blood volume and improve hemodynamic stability in patients experiencing hypovolemic conditions. By drawing water into the vascular space, they help to counteract the effects of low blood volume, such as hypotension and compromised organ perfusion.

Pharmacokinetics

Gelatin is administered intravenously, and its effects can be observed relatively quickly. The half-life and the metabolic clearance depend on the formulation and concentration of the solution. Gelatin is gradually metabolized by macrophages and eliminated by the renal system. Close monitoring of fluid balance is essential, particularly in patients with cardiac or renal impairment.

Contra-indications

• Severe liver disease
• History of circulatory disease
• Severe cardiac disease

Adverse effects

• Fever
• Flushing
• Nausea
• Urticaria
• Rare or very rare shock

Interactions

• Calcium salts

Precautions

• Monitor cardiovascular and respiratory function
• Correct dehydration when administering
• Administer slowly to avoid rapid rise in blood pressure and cardiac failure
• Increased capillary permeability

Pregnancy

Consult product literature for specific guidance regarding use in pregnancy.

Breast-feeding

Consult product literature for specific guidance regarding use in breastfeeding.

Storage

Store at controlled room temperature, protect from light. Refer to product-specific storage instructions.

Formulations

• 5% solution for infusion
• 20% solution for infusion
• Concentrated solution (15-25% protein)
• Isotonic solution (3.5-5% protein)

Indications

• Relapsing forms of multiple sclerosis (RRMS)

Dosage

Children: Refer to the BNF for Children for appropriate dosing information.

Adults: 500 micrograms once daily.

Mechanism of action

Fingolimod is a sphingosine-1-phosphate receptor modulator. It binds to S1P receptors (specifically S1P1, S1P3, S1P4, and S1P5), preventing lymphocytes from exiting lymph nodes. This results in a reduced number of circulating lymphocytes, which decreases neuroinflammation and may help mitigate the effects of multiple sclerosis.

Pharmacodynamics

In the context of multiple sclerosis, fingolimod reduces neuroinflammation by binding to sphingosine receptors. It also causes transient bradycardia and may prolong the QT interval when treatment is initiated. There is some evidence suggesting fingolimod may also reduce lung inflammation in conditions like COVID-19, although its primary use is in MS.

Pharmacokinetics

Fingolimod is well absorbed after oral administration, with peak plasma concentrations typically occurring within 12-16 hours. It undergoes extensive first-pass metabolism to its active form, fingolimod phosphate. The half-life is approximately 6-9 hours for fingolimod and about 30 hours for its active metabolite. The drug is primarily excreted via urine and feces. The pharmacokinetics may be influenced by liver function and concurrent medications.

Contra-indications

• Known risk of cardiovascular events
• Pregnancy
• Women of childbearing potential not using effective contraception

Adverse effects

• Skin cancers
• Lymphoma
• Progressive multifocal leukoencephalopathy (PML)
• Bradycardia
• Transient reduction in heart rate
• Liver injury
• Herpes meningitis

Interactions

• Monoclonal antibodies (increases risk of generalized infection, possibly life-threatening)
• St. John's Wort (decreases exposure)
• Alemtuzumab (increases risk of generalized infection, possibly life-threatening)
• Live vaccines (increases risk of generalized infection, possibly life-threatening)

Precautions

• Perform baseline MRI and repeat as necessary during treatment
• Monitor for skin lesions before starting and every 6 to 12 months
• Assess benefit-risk balance on a case-by-case basis
• Pregnancy should be excluded before treatment initiation and monitored throughout
• Use effective contraception during treatment and for 2 months post-treatment
• Monitor for signs of infection and seek immediate medical attention if symptoms develop

Pregnancy

Fingolimod is contraindicated in pregnancy due to an increased risk of congenital malformations. Treatment should be stopped immediately if pregnancy occurs, and the patient referred for close monitoring.

Breast-feeding

Data on the excretion of fingolimod in human milk is not available, and caution is advised.

Storage

Store at room temperature, below 25°C, in a dry place. Keep out of reach of children.

Formulations

• Gastro-resistant capsule, 500 micrograms

Dosage

Children: Refer to specific guidelines or literature for dosing information.

Adults: Refer to specific guidelines or literature for dosing information.

Pregnancy

Consult healthcare professionals before use. Safety during pregnancy is not well established.

Breast-feeding

Consult healthcare professionals before use. Safety during breastfeeding is not well established.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Methemoglobinemia
• Urinary tract infections
• Surgical marking
• Treatment of certain types of cyanide poisoning

Dosage

Children: Refer to the BNF for Children for appropriate pediatric dosing information.

Adults: Refer to the relevant clinical guidelines or the BNF for specific dosing recommendations.

Mechanism of action

Methylene blue acts as a reducing agent, converting methemoglobin back to its functional form, hemoglobin. This is primarily achieved through its action as an electron donor, facilitating the reduction of ferric iron (Fe3+) in hemoglobin to ferrous iron (Fe2+), thereby restoring its oxygen-carrying capacity. It also exhibits antimicrobial properties through its ability to generate reactive oxygen species when exposed to light, which can inhibit bacterial growth.

Pharmacodynamics

The pharmacodynamics of methylene blue involve its role in enhancing oxygen delivery in patients suffering from methemoglobinemia. By converting methemoglobin back to hemoglobin, it effectively increases the amount of hemoglobin available for oxygen transport. The drug also shows effects on the vascular system, where it can induce vasodilation and influence blood pressure.

Pharmacokinetics

Methylene blue is rapidly absorbed after intravenous administration, with peak plasma concentrations occurring within 1 to 3 hours. It is extensively distributed in body tissues and fluids, including the liver, kidneys, and lungs. The drug undergoes hepatic metabolism, primarily through the cytochrome P450 system, and is excreted mainly through urine. The half-life ranges from 5 to 24 hours, depending on the dosage and individual patient factors.

Pregnancy

Consult healthcare provider before use, as safety in pregnancy is not established.

Breast-feeding

Consult healthcare provider before use, as safety during breastfeeding is not established.

Storage

Store in a cool, dry place away from direct sunlight.

Dosage

Children: Refer to specific drug guidelines for dosing information.

Adults: Refer to specific drug guidelines for dosing information.

Mechanism of action

The body operates through various biological mechanisms that involve the interaction of hormones, neurotransmitters, and enzymes. These interactions regulate numerous physiological processes including homeostasis, immune response, and metabolic pathways.

Pharmacodynamics

Pharmacodynamics in the context of the body involves understanding how different substances affect bodily functions. This can include the action of drugs, nutrients, and other chemical agents, which can modify physiological responses through receptor binding, enzyme activity modulation, or ion channel regulation.

Pharmacokinetics

Pharmacokinetics refers to how substances are absorbed, distributed, metabolized, and excreted within the body. Factors such as blood flow, tissue permeability, and enzymatic activity play crucial roles in determining how long a drug remains active in the body, its efficacy, and potential for toxicity.

Pregnancy

Consult healthcare provider before use, as safety during pregnancy may vary based on specific conditions.

Breast-feeding

Consult healthcare provider before use, as safety during breastfeeding may vary based on specific conditions.

Storage

Store in a cool, dry place away from direct sunlight and moisture.

Indications

• Cognitive enhancement
• Mood improvement
• Support for mental clarity
• Potential use in age-related cognitive decline

Dosage

Children: Refer to specific product guidelines for dosing information, as it varies widely based on the active ingredient.

Adults: Refer to specific product guidelines for dosing information, as it varies widely based on the active ingredient.

Mechanism of action

Common mechanisms of action for cognitive enhancers include the modulation of neurotransmitter levels, inhibition of enzymes that degrade neurotransmitters, and enhancement of synaptic plasticity. Some agents may act as antioxidants, reducing oxidative stress in neuronal tissues.

Pharmacodynamics

Pharmacodynamics depends on the specific substance referred to as 'bright.' Generally, cognitive enhancers may improve alertness, attention, and learning capabilities. They may also exhibit effects on mood, potentially reducing symptoms of anxiety or depression by enhancing the function of serotonin, dopamine, or norepinephrine in the brain.

Pharmacokinetics

Pharmacokinetics varies widely among different substances categorized under the term 'bright.' Typically, absorption occurs through the gastrointestinal tract, with peak plasma concentrations varying based on the agent. Distribution often involves crossing the blood-brain barrier, and metabolism occurs via liver enzymes, while excretion is usually renal. The half-life is variable and depends on the specific compound.

Indications

• Constipation
• Dietary fiber supplementation
• Irritable bowel syndrome
• Diverticular disease
• Weight management

Dosage

Children: Refer to appropriate guidelines for specific dosage; generally taken with adequate fluid intake.

Adults: Refer to appropriate guidelines for specific dosage; generally taken with adequate fluid intake.

Mechanism of action

Cellulose acts primarily as a bulk-forming laxative. It absorbs water in the intestines, which increases stool bulk and stimulates peristalsis, thus facilitating bowel movements. Additionally, cellulose is not digestible by human enzymes, leading to fermentation by gut bacteria, which may enhance gut health and alter gut microbiota composition.

Pharmacodynamics

Cellulose increases stool weight and frequency of bowel movements. It works by retaining water in the intestines, leading to softer stools and improved passage through the gastrointestinal tract. The bulking effect of cellulose can help alleviate constipation and promote overall digestive health. It may also play a role in cholesterol reduction and glycemic control through its effects on digestion and absorption of nutrients.

Pharmacokinetics

Cellulose is not absorbed into the bloodstream due to its indigestible nature. Instead, it passes through the gastrointestinal tract, where it adds bulk to the stool. Its fermentation by colonic bacteria produces short-chain fatty acids, which may have beneficial effects on colon health. The onset of action for cellulose as a laxative can vary but is generally within 24 to 72 hours after ingestion.

Adverse effects

• Bloating
• Flatulence
• Diarrhea
• Abdominal discomfort

Precautions

• Use with caution in patients with a history of gastrointestinal disorders.
• Monitor for potential allergic reactions in sensitive individuals.

Pregnancy

Cellulose is generally considered safe during pregnancy as it is a non-toxic, indigestible fiber.

Breast-feeding

Cellulose is also considered safe during breastfeeding; it is excreted in breast milk in negligible amounts.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Powder
• Capsules
• Tablets
• Granules

Indications

• Monitoring respiratory function
• Assessment of metabolic status
• Management of respiratory acidosis
• Management of respiratory alkalosis

Dosage

Children: Dosing for interventions related to carbon dioxide levels in pediatric patients should be guided by clinical protocols and the BNF for Children.

Adults: Dosing for interventions related to carbon dioxide levels is typically based on clinical assessment and individual patient needs. Refer to clinical guidelines for specific scenarios.

Mechanism of action

Carbon dioxide acts primarily as a signaling molecule in the body, influencing respiratory drive and blood pH. It is produced during cellular respiration and is a critical component of the bicarbonate buffering system, which helps maintain acid-base homeostasis. Elevated levels of CO2 in the blood stimulate ventilation in the lungs, increasing the rate of gas exchange and facilitating the removal of excess CO2.

Pharmacodynamics

The pharmacodynamic effects of dioxides, particularly carbon dioxide, are closely related to its concentration in the blood. As CO2 levels increase, it leads to respiratory acidosis, which can stimulate the respiratory centers in the brain to increase ventilation. Conversely, low levels of CO2 can cause respiratory alkalosis, potentially leading to decreased respiratory drive. CO2 also plays a role in vasodilation and can affect blood flow and pressure through its influence on smooth muscle tone.

Pharmacokinetics

Carbon dioxide is produced endogenously during metabolic processes and is transported in the bloodstream primarily in three forms: dissolved in plasma, as bicarbonate ions (HCO3-), and bound to hemoglobin. The half-life of CO2 in the bloodstream is very short due to its rapid exchange with alveolar gas in the lungs. The elimination of CO2 occurs through exhalation, making it a dynamic component of respiratory physiology.

Pregnancy

Data on the effects of dioxide during pregnancy are limited. Caution is advised due to potential risks associated with exposure.

Breast-feeding

Limited data are available regarding the excretion of dioxide in human milk. Caution is recommended.

Storage

Store in a cool, dry place, away from direct sunlight and moisture.

Indications

• Chronic hepatitis C virus infection
• Genotype 1 HCV infection

Dosage

Children: Refer to BNF for Children for specific dosing information tailored to paediatric patients.

Adults: Refer to BNF for specific dosing information based on the clinical scenario.

Mechanism of action

Paritaprevir inhibits the NS3/4A serine protease of the Hepatitis C Virus (HCV). This enzyme is responsible for cleaving the viral polypeptide into essential structural and nonstructural proteins necessary for the assembly of mature virus. By inhibiting NS3/4A, paritaprevir prevents viral replication and function.

Pharmacodynamics

At concentrations significantly above therapeutic levels, paritaprevir and its combination with ombitasvir do not prolong the QTc interval to a clinically relevant extent. This suggests a favorable safety profile concerning cardiac effects at therapeutic doses.

Pharmacokinetics

Paritaprevir is absorbed effectively after oral administration, with its pharmacokinetic profile characterized by a peak plasma concentration occurring within a few hours post-dose. It is extensively metabolized in the liver, primarily via CYP3A4, and is eliminated mainly through fecal excretion. The half-life of paritaprevir allows for once-daily dosing when used in combination therapies.

Pregnancy

The safety of paritaprevir in pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is unknown if paritaprevir is excreted in human milk. Caution is advised when administered to breastfeeding women.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Dosage

Children: Refer to specific pediatric dosing guidelines based on the identified drug, as 'hard' does not provide sufficient information.

Adults: Refer to specific drug information for dosing guidelines, as 'hard' does not specify a particular medication.

Mechanism of action

The mechanism of action for drugs termed 'hard' must be specified for accurate information, as this phrase does not designate a specific compound. Mechanisms may involve receptor interaction, enzyme inhibition, or modulation of biochemical pathways, depending on the drug in question. For example, opioid analgesics work primarily by binding to mu-opioid receptors in the central nervous system, leading to analgesic effects.

Pharmacodynamics

Pharmacodynamics refers to the effects of a drug on the body and its mechanisms of action. The pharmacodynamics of any drug classified as 'hard' would depend on its specific pharmacological profile, including its efficacy, potency, and the nature of its therapeutic effects. For instance, in the case of opioids, pharmacodynamic effects include pain relief, sedation, and potential respiratory depression.

Pharmacokinetics

Pharmacokinetics involves the absorption, distribution, metabolism, and excretion (ADME) of a drug. The pharmacokinetics of a substance termed 'hard' would vary significantly based on the specific drug. For many medications, absorption may occur via oral or parenteral routes, distribution may involve binding to plasma proteins, metabolism may occur in the liver, and excretion is typically renal. Each of these parameters is critical for understanding the drug's action and potential side effects.

Pregnancy

Consult a healthcare professional before use, as safety has not been established.

Breast-feeding

Consult a healthcare professional before use, as safety has not been established.

Storage

Store in a cool, dry place, away from direct sunlight.

Dosage

Children: Refer to the specific drug product information for pediatric dosing guidelines.

Adults: Refer to the specific drug product information for dosing guidelines.

Mechanism of action

The mechanism of action for imprinted medications varies widely depending on the active pharmaceutical ingredient contained in the formulation. Generally, the imprint does not influence the pharmacological activity of the drug itself but serves as a means to identify it. For specific drugs, their mechanisms of action can include receptor binding, enzyme inhibition, or modulation of ion channels, among others.

Pharmacodynamics

Pharmacodynamics of imprinted medications will depend on the active ingredients. Typically, the pharmacodynamic profile includes the relationship between drug concentration and its therapeutic effect, which is influenced by factors such as receptor affinity, intrinsic activity, and the drug's therapeutic window. The imprinted form itself does not alter these dynamics but ensures correct identification and administration.

Pharmacokinetics

The pharmacokinetics of imprinted medications are defined by the absorption, distribution, metabolism, and excretion (ADME) of the active ingredients. The imprinting process itself does not influence these pharmacokinetic properties. Factors such as the formulation type, presence of excipients, and patient-specific variables (age, weight, organ function) will determine the pharmacokinetic profile. Generally, pharmacokinetic studies are conducted on the drug as a whole rather than its imprinted form.

Pregnancy

Use with caution. Safety in pregnancy has not been established.

Breast-feeding

Use with caution. Limited data available on excretion in breast milk.

Storage

Store in a cool, dry place, away from light.

Dosage

Children: For specific paediatric dosing information, please refer to the relevant product monograph or clinical guidelines.

Adults: For specific adult dosing information, please refer to the relevant product monograph or clinical guidelines.

Mechanism of action

The mechanism of action for opaque agents is generally related to their ability to block or scatter light. This is achieved through the use of specific excipients or coating materials that interact with light in such a way as to prevent transmission, thus preserving the integrity of the active pharmaceutical ingredient (API) within the formulation.

Pharmacodynamics

Pharmacodynamics of opaque formulations is primarily focused on the stability of the drug contained within. Light-sensitive drugs can undergo photodegradation, leading to a reduction in efficacy or the formation of harmful degradation products. By using opaque materials, the pharmacodynamic profile of the drug remains intact, ensuring that its therapeutic effects are maintained during storage and use.

Pharmacokinetics

The pharmacokinetics of opaque formulations can vary widely depending on the nature of the drug and its formulation. Generally, the pharmacokinetic parameters such as absorption, distribution, metabolism, and excretion (ADME) are not significantly altered by opacity, but rather focus on how the drug is protected from light. The delivery system must ensure that the drug is released effectively within the body while maintaining its stability against photodegradation during its shelf life.

Pregnancy

The safety of opaque medications during pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether opaque medications are excreted in human milk. Caution is advised when administering to breastfeeding women.

Storage

Store in a cool, dry place away from light. Ensure that the container is tightly closed to prevent contamination.

Indications

• Drug delivery
• Controlled release of medications
• Protection of sensitive compounds

Dosage

Children: Dosage for paediatric patients is also dependent on the specific active ingredient within the shell. Refer to the BNF for Children for appropriate dosing information.

Adults: Dosage depends on the specific formulation and active ingredient contained within the shell. Refer to the specific drug monograph for dosing recommendations.

Mechanism of action

The mechanism of action of shells depends on the specific active ingredients they contain. Typically, the shell serves as a barrier that controls the release of the drug, enabling it to reach the desired site of action. This can involve various pathways, including diffusion through the shell material, enzymatic degradation, or dissolution in the gastrointestinal tract.

Pharmacodynamics

Pharmacodynamics of shell formulations is related to their ability to modulate the release profile of the encapsulated drug. This can result in altered onset of action, duration of effect, and therapeutic efficacy. The properties of the shell material can influence these dynamics, including factors such as thickness, permeability, and solubility in biological fluids.

Pharmacokinetics

Pharmacokinetics of shell-based drug formulations involves the absorption, distribution, metabolism, and excretion of the active ingredient following its release from the shell. The release rate can be affected by the shell's composition and the physicochemical properties of the drug. Typically, the drug is absorbed in the gastrointestinal tract, distributed throughout the body, metabolized primarily by the liver, and excreted via urine or feces.

Pregnancy

Not enough information available to assess safety in pregnancy. Consult healthcare provider.

Breast-feeding

Not enough information available to assess safety during breastfeeding. Consult healthcare provider.

Storage

Store in a cool, dry place away from direct sunlight.

Dosage

Children: Refer to the specific drug's prescribing information for paediatric dosing guidelines.

Adults: Refer to the specific drug's prescribing information for adult dosing guidelines.

Mechanism of action

The mechanism of action would depend on the specific drug referred to by 'size'. Generally, drugs exert their effects through interaction with biological targets such as receptors, enzymes, or ion channels, leading to a physiological response.

Pharmacodynamics

Pharmacodynamics refers to the effects of the drug on the body, including the relationship between drug concentration and effect. This can involve receptor binding, signal transduction, and the resulting biological effects. Specific dynamics would vary based on the drug in question.

Pharmacokinetics

Pharmacokinetics describes the absorption, distribution, metabolism, and excretion (ADME) of a drug. Factors such as bioavailability, volume of distribution, half-life, and clearance would vary significantly based on the specific drug being considered.

Pregnancy

Safety in pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Use with caution, as it is not known whether it is excreted in human milk.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Orthopedic implants
• Dental implants
• Prosthetic devices
• Surgical instruments

Mechanism of action

Titanium does not have a specific mechanism of action as it is not a drug in the traditional sense. Instead, its biocompatibility allows it to integrate with biological tissues without eliciting significant immune responses, making it suitable for use in implants and prosthetic devices. The presence of titanium ions can influence biological processes, including cell proliferation and differentiation.

Pharmacodynamics

Titanium itself does not exhibit pharmacodynamics as it is not administered as a drug. Its interactions within biological systems are primarily mechanical and structural, providing support and stability in orthopedic and dental applications. The biocompatibility of titanium allows for favorable tissue integration and reduced rejection rates compared to other materials.

Pharmacokinetics

As titanium is not a pharmacological agent, traditional pharmacokinetic parameters such as absorption, distribution, metabolism, and excretion do not apply. Titanium is typically utilized in solid forms, such as implants, where it remains localized and does not undergo metabolism or systemic circulation.

Pregnancy

There is limited data on the use of titanium during pregnancy. Consult a healthcare professional before use.

Breast-feeding

There is limited data on the excretion of titanium in breast milk. Consult a healthcare professional before use.

Storage

Store in a cool, dry place away from direct sunlight.

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing information.

Adults: Refer to the specific BNF guidelines for dosing information as it may vary based on the condition being treated.

Mechanism of action

The mechanism of action for White involves its interaction with specific biological pathways, leading to the desired pharmacological effects. The precise pathways may include modulation of receptor activity or alteration of enzyme function, although specific details are not provided.

Pharmacodynamics

Pharmacodynamics of White includes its effects on the body, including therapeutic effects and potential side effects. As a compound, it may exert its influence on multiple physiological systems, which can lead to changes in symptoms or disease progression.

Pharmacokinetics

Pharmacokinetics of White involves its absorption, distribution, metabolism, and excretion. Understanding these parameters can help predict how the drug behaves in the body, including onset of action and duration of effect. Detailed pharmacokinetic data is not specified.

Pregnancy

No specific data available, consult a healthcare professional.

Breast-feeding

No specific data available, consult a healthcare professional.

Storage

Store in a cool, dry place away from light.

Mechanism of action

Sphingosine‐1‐phosphate (S1P) is an important phospholipid that binds to various G‐protein‐coupled receptor subtypes, which can be identified as S1P1–5R. S1P and the receptors it binds to perform regular functions in the immune, cardiovascular, pulmonary, and nervous systems. S1P can be expressed ubiquitously, playing an important role in regulating inflammation. S1P1R, S1P2R, and S1P3R receptors can be found in the cardiovascular, immune, and central nervous systems. S1P4R is found on lymphocytic and hematopoietic cells, while S1P5R expression is found only on the spleen (on natural killer cells) or in the central nervous system. The active form of the drug, fingolimod phosphate, is a sphingosine 1-phosphate receptor modulator that exerts its mechanism of action in MS by binding to various sphingosine 1-phosphate receptors (1, 3, 4, and 5). It suppresses the exit of lymphocytes from lymph nodes, leading to a lower level of lymphocytes circulating in the peripheral circulation. This reduces the inflammation that is associated with MS. The mechanism of action of fingolimod is not fully understood but may be related to reduced lymphocyte circulation into the central nervous system. Immune modulating treatment such as fingolimod is not typically employed for SARS-CoV-2 pneumonia. Despite this, with the tissue findings of pulmonary edema and hyaline membrane formation, the timely use of immune modulators such as fingolimod can be considered to prevent acute respiratory distress syndrome (ARDS) associated with COVID-19.

Pharmacodynamics

In multiple sclerosis, fingolimod binds to sphingosine receptors, reducing its associated neuroinflammation.In COVID-19, it may reduce lung inflammation and improve the clinical outcomes of patients with this disease. Fingolimod causes a transient reduction in heart rate and AV conduction during treatment initiation. It has the potential to prolong the QT interval.

Mechanism of action

Paritaprevir is a potent inhibitor of the NS3/4A serine protease of Hepatitis C Virus (HCV). Following viral replication of HCV genetic material and translation into a single polypeptide, Nonstructural Protein 3 (NS3) and its activating cofactor Nonstructural Protein 4A (NS4A) are responsible for cleaving it into the following structural and nonstructural proteins required for assembly into mature virus: NS3, NS4A, NS4B, NS5A, and NS5B. By inhibiting viral protease NS3/4A, paritaprevir therefore prevents viral replication and function.

Pharmacodynamics

At concentrations approximately 6 and 1.8 times the therapeutic concentrations of paritaprevir and ombitasvir, the combination did not prolong QTc to any clinically relevant extent.