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  • Pharmacists_coffee
    Sep 20, 2013
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      Pharmacists_coffee magazine
      Edition No. 523, year 7

      September 13, 2013
      Today’s edition sent to:
      31,526 Arabian Pharmacists



        Find Valuable attchment
        “5 Dysfunctions of a Team”
        may find attachment at the end of e-mail

      Medicine of the week

      Aciclovir  or acyclovir , chemical name acycloguanosine, abbreviated as ACV, is a guanosine analogue antiviral drug, marketed under trade names such as Cyclovir, Herpex, Acivir, Acivirax(Mash-Premier), Zovirax, Aciclovir (Sanofi-Aventis) and Zovir (GSK). One of the most commonly-used antiviral drugs, it is primarily used for the treatment of herpes simplex virus infections, as well as in the treatment of herpes zoster (shingles).
      Aciclovir was seen as the start of a new era in antiviral therapy, as it is extremely selective and low in cytotoxicity. Pharmacologist Gertrude B. Elion was awarded the 1988 Nobel Prize in Medicine, partly for the development of aciclovir. Dr. Richard Whitley, a University of Alabama at Birmingham researcher and pioneer in antiviral therapy, was the first to successfully use the drug in humans.

      Mechanism of action

      Aciclovir differs from previous nucleoside analogues in that it contains only a partial nucleoside structure: the sugar ring is replaced by an open-chain structure. It is selectively converted into acyclo-guanosine monophosphate (acyclo-GMP) by viral thymidine kinase, which is far more effective (3000 times) in phosphorylation than cellular thymidine kinase. Subsequently, the monophosphate form is further phosphorylated into the active triphosphate form, acyclo-guanosine triphosphate (acyclo-GTP), by cellular kinases. Acyclo-GTP is a very potent inhibitor of viral DNA polymerase; it has approximately 100 times greater affinity for viral than cellular polymerase. As a substrate, acyclo-GTP is incorporated into viral DNA, resulting in chain termination. Although acyclovir resembles a nucleotide, it has no 3' end. Therefore, after its incorporation into a growing DNA strand, no further nucleotides can be added to this strand. It has also been shown that viral enzymes cannot remove acyclo-GTP from the chain, which results in inhibition of further activity of DNA polymerase. Acyclo-GTP is fairly rapidly metabolised within the cell, possibly by cellular phosphatases.
      In sum, aciclovir can be considered a prodrug: it is administered in an inactive (or less active) form and is metabolised into a more active species after administration.


      Aciclovir is active against most known species in the herpesvirus family. In descending order of activity:[2]
      • Herpes simplex virus type I (HSV-1)
      • Herpes simplex virus type II (HSV-2)
      • Varicella zoster virus (VZV)
      • Epstein-Barr virus (EBV)
      • Cytomegalovirus (CMV) -- least activity
      Activity is predominantly against HSV, and to a lesser extent VZV. It is only of limited efficacy against EBV and CMV. It is inactive against latent viruses in nerve ganglia.


      Resistance to aciclovir is rare, but is more common in patients on chronic antiviral prophylaxis (transplant recipients, people with acquired immunodeficiency syndrome due to HIV infection). Mechanisms of resistance in HSV include deficient viral thymidine kinase; and mutations to viral thymidine kinase and/or DNA polymerase, altering substrate sensitivity. Acyclovir has also shown cross-resistance with Valacyclovir and Famcyclovir.


      Aciclovir is poorly water soluble and has poor oral bioavailability (15-30%), hence intravenous administration is necessary if high concentrations are required. When orally administered, peak plasma concentration occurs after 1–2 hours. Aciclovir has a high distribution rate; only 30% is protein-bound in plasma. The elimination half-life of aciclovir is approximately 3 hours. It is renally excreted, partly by glomerular filtration and partly by tubular secretion.
      The poor oral bioavailability may also be improved by administering Valaciclovir, which has an oral bioavailability of about 55%. Valaciclovir is then converted to Aciclovir by esterases via hepatic first-pass metabolism.
      Clinical use:


      Aciclovir is indicated for the treatment of HSV and VZV infections, including:
      • Genital herpes simplex (treatment and prophylaxis)
      • Herpes simplex labialis (cold sores)
      • Herpes zoster (shingles)
      • Acute chickenpox in immunocompromised patients
      • Herpes simplex encephalitis
      • Acute mucocutaneous HSV infections in immunocompromised patients
      • Herpes simplex keratitis (ocular herpes)
      • Herpes simplex blepharitis (not to be mistaken with ocular herpes)
      • Bell's Palsy
      HIV-1 progression can be delayed by using Aciclovir, according to study led by Dr Jairam Lingappa. Effective in 16% of cases, can delay the HAART treatment by 1–2 years. University of Washington, Seattle. During a 2 year trial, 284 people progressed with the HIV-1, versus 324 who had not been treated with Aciclovir. It has been claimed that the evidence for the effectiveness of topically applied cream for recurrent labial outbreaks is weak. An earlier review of scientific literature showed that there is some effect in reducing the number and duration of lesions if aciclovir is applied at an early stage of an outbreak. However, it was concluded that oral therapy for episodes is inappropriate for most non-immunocompromised patients based on costs and benefits, presumably in countries where aciclovir is only available on prescription. It was concluded that there is evidence for an oral prophylactic role in preventing recurrences.

      Dosage forms

      Aciclovir is commonly marketed as tablets (200 mg, 400 mg, 800 mg and 1 gram), topical cream (5%), intravenous injection (25 mg/mL) and ophthalmic ointment (3%). Cream preparations are used primarily for labial herpes simplex. The intravenous injection is used when high concentrations of aciclovir are required. The ophthalmic ointment preparation is only used for herpes simplex keratitis. In Singapore, it is available as a 400 mg preparation known as Avorax and a 800 mg preparation known as Herperax.



      Pharmacy in Eastern area
      Needs pharmacist
      Please send your CV to:


      Pharmacies group in Riyadh

      Urgently required for pharmacies group in Riyadh need pharmacists
      contact no 05032704450
      or sent cv: dramrs@...


      Job Vacancy in KSA

      We are Saudi company
      We need Science or Pharmacy graduates for working in Regulatory Affairs field with the following criteria:
      1-  Bachelor degree in Pharmacy or Science.
      2- Fresh graduates or with experience.
      3- Self-motivated, Ambitious, Honest and Enthusiastic.
      4- Fluent in English.
      5- Computer literate.
      6- Has the ability to learn
      If you have the above mentioned criteria, you are kindly requested to send your CV within 2 weeks to:


      Med Rep For Riyadh and Eastern Area ( KSA To KSA )

      Well established pharmaceutical company in Saudi Arabia requires:
      highly dynamic calibers, self-motivated and result oriented candidate are invited to submit their CVs for the following vacancies:
      Medical Representative in the following Territory:
      1.Riyadh Area Code: MR1
      2. Eastern Area Code: MR2
      ·         · University degree in Bsc.or vet or science.
      ·         · TRANSFERABLE Iqama is a must.
      ·         · Age not more than 28 years old.
      ·         · Good command of English language and computer skills
      ·         · Presentable, Hard worker, ambitious.
      please send your CV to
      & write the code in the subject


      Medical Reps.for Jazaz and Najran

      Multinational Nutritional Company
      Currently looking for qualified candidates to join our successful team that are able to execute an effective promotional sales plan , build and develop business relationships.
      Criteria Required:
      1) Pharmacist or Vet.
      2) Previous experience in Jazan and Najran will be taken as an advantage.
      3) Self-motivated, Ambitious, , Honest and Enthusiastic.
      4) Good command of English and computer skills.
      5) Proved track record of success.
      6) Transferable Iqama.
      7) Age less than 30 years.
      Kindly send your CV within 10 days to the following email:


      Roxcel Pharmaceutical – KSA

      Due to our expansion  we are hiring new male Reps at Makkah and jeddah
      Must be resident at makkah and jeddah
      Age not more than 30 years
      pharmacist,vet. ar science
      at least ONE YEAR  experience at makkah and at jeddah
      Transeferable Iqama  is must
      Please send your C.V. for the following e-mails within one week
      Only male Reps Resident at makkah and jeddah send thier  C.V.


      Pharmacy in Riyadh for rent
      Area: 80 meter
      Rent: 30000 SAR
      Tel: 0568562221


      Multinational medical company

      urgently needed for a leading multinational medical company
      medical representatives in western region of Saudi institution business
      if you :
      own skills required for the role with Relevant scientific university degree.
      Customer focused with problem solving mindset
      • Planning and prioritizing skills
      •Excellent interpersonal, communication and presentation skills.
      • Energetic, self-motivated and pro-active attitude
      •Personal Integrity
      • Computer skills
      • English Language
      • Teaming and collaboration skills
      • Results & performance driver
      Age not exceeding 30.
      own transferable Iqama
      send your your resume to


      Product specialist – KSA

      Multinational specialty pharmaceutical company is looking for a product specialist to take care of its business at eastern province, Saudi.
      Should be a pharmacist.
      Preferred age is below 28 years.
      Institution experience is a plus.
      CV to be sent to