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Drug for yellow fever?

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itsmetoo2 19 Jan 2010

You asked for a drug for yellow fever... There is none. But I did find this.
Hope this helps

http://emedicine.medscape.com/article/787964-treatment

Medication
Currently, no antiviral drug against yellow fever is approved. To date, nonclinical testing of antiviral agents has yielded modest results. Ribavirin, given at high doses to hamsters challenged with yellow fever, has been shown to reduce mortality when administered as late as 120 hours after infection. Interferon-α has also been found to reduce mortality when administered to monkeys with yellow fever; however, it was only effective when given within 24 hours of infection. These findings suggest that antiviral therapies may only be effective early in the course of disease when clinical symptoms are nonspecific and indistinguishable from other viral infections. Recent trials by Julander et al involving an active carboxamide drug [AT-1106 (2,4-dihydro-3-oxo-4-β -D-ribofuranosyl-2-pyrazinecarboxamide)] have been effective in hamsters when treatment was started on day 4, after the development of liver infection.5 Ongoingresearch and advances show promise for the future.

Adjunctive measures include nonhepatotoxic antipyretics to reduce fever and pain and an H2-receptor antagonist to prevent gastric bleeding. Use of heparin for documented cases of DIC is controversial. Additionally, the use of stress-dose corticosteroids is currently under investigation.5 Avoid drugs that act centrally, including phenothiazines, barbiturates, and benzodiazepines, because they may precipitate or aggravate encephalopathy. Avoid drugs dependent on hepatic metabolism, and, in cases of reduced renal function, medications should be renally dosed.

Histamine H2 antagonists
These agents are useful as an adjunctive therapy to prevent gastric bleeding. H2-receptor antagonists are highly selective, do not affect the H1 receptors, and are not anticholinergic agents. These are potent inhibitors of all phases of gastric acid secretion. They inhibit secretions caused by histamine, muscarinic agonists, and gastrin.

Famotidine (Pepcid)
Competitively inhibits histamine at the H2 receptor of the gastric parietal cells, resulting in reduced gastric acid secretion, gastric volume, and reduced hydrogen concentrations.

DosingInteractionsContraindicationsPrecautionsAdult
20-40 mg PO qhs or 20 mg IV q12h

Pediatric
0.5 mg/kg PO/IV qh; not to exceed 40 mg/d

DosingInteractionsContraindicationsPrecautionsMay decrease efficacy of ketoconazole, itraconazole, cefpodoxime, delavirdine, digestive enzymes, and iron salts

DosingInteractionsContraindicationsPrecautionsDocumented hypersensitivity; phenylketonuria; impaired renal function

DosingInteractionsContraindicationsPrecautionsPregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions
If changes in renal function occur during therapy, adjust dose or discontinue treatment; serious reactions include thrombocytopenia, leukopenia, pancytopenia, and cholestatic jaundice

Nizatidine (Axid)
Competitively inhibits histamine at the H2 receptor of gastric parietal cells, resulting in reduced gastric acid secretion, gastric volume, and reduced hydrogen concentrations.

DosingInteractionsContraindicationsPrecautionsAdult
300 mg PO hs or 150 mg bid

Pediatric
<6 months: Not established
6-10 mg/kg PO qd (for 6 months to 12 years, divide dose bid)
>12 years: Administer as in adults

DosingInteractionsContraindicationsPrecautionsMay reduce efficacy of cefpodoxime, delavirdine, digestive enzymes, iron salts, and ketoconazole

DosingInteractionsContraindicationsPrecautionsDocumented hypersensitivity; impaired renal function

DosingInteractionsContraindicationsPrecautionsPregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions
If changes in renal function occur during therapy, adjust dose or discontinue treatment; serious reactions include thrombocytopenia, leukopenia, pancytopenia, and cholestatic jaundice

Ranitidine (Zantac)
Competitively inhibits histamine at H2 receptor of gastric parietal cells, resulting in reduced gastric acid secretion, gastric volume, and reduced hydrogen concentrations.

DosingInteractionsContraindicationsPrecautionsAdult
150 mg PO bid or 300 mg PO qhs; alternately, 50 mg/dose IV/IM q6-8h

Pediatric
<2 weeks: 2 mg/kg PO divided bid ; alternately, 1.5 mg/kg IV initial, then 1.5 mg/kg IV divided bid
Infusion: 0.04 mg/kg/h IV
Children: 4-5 mg/kg PO IV/IM divided bid/tid; alternately, 2-4 mg/kg IV/IM divided tid/qid; infusion 0.1-0.125 mg/kg/h

DosingInteractionsContraindicationsPrecautionsMay decrease effects of ketoconazole, itraconazole, cefpodoxime, delavirdine, and digestive enzymes; may alter serum levels of ferrous sulfate, nondepolarizing muscle relaxants, diazepam, and oxaprozin

DosingInteractionsContraindicationsPrecautionsDocumented hypersensitivity; porphyria; impaired liver and renal function

DosingInteractionsContraindicationsPrecautionsPregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions
Caution in renal or liver impairment; if changes in renal function occur during therapy, consider adjusting dosage or discontinuing treatment; may cause thrombocytopenia and hepatotoxicity

Antipyretics
Treatment of yellow fever is symptomatic and supportive. Bed rest and mild analgesic-antipyretic therapy often help relieve associated lethargy, malaise, and fever.

Acetaminophen (Tylenol, Aspirin-Free Anacin, Feverall)
Inhibits action of endogenous pyrogens on heat-regulating centers; reduces fever by direct action on the hypothalamic heat-regulating centers, which, in turn, increase dissipation of body heat via sweating and vasodilation.

DosingInteractionsContraindicationsPrecautionsAdult
325-1000 mg PO/PR q4-6h; not to exceed 4 g/d
Alternatively, administer 1000 mg tid/qid; not to exceed 4 g/d

Pediatric
<12 years: 10-15 mg/kg/dose PO/PR q4-6h prn; not to exceed 2.6 g/d
>12 years: 325-650 mg PO/PR q4h; not to exceed 4 g/d

DosingInteractionsContraindicationsPrecautionsBecause of induction of microsomal enzymes by barbiturates, carbamazepine, hydantoins, isoniazid, rifampin, and sulfinpyrazone, long-term administration of these agents or large doses of acetaminophen may increase acetaminophen hepatotoxicity (therapeutic effects of acetaminophen also may decrease)

DosingInteractionsContraindicationsPrecautionsDocumented hypersensitivity; G-6-PD deficiency, phenylketonuria, impaired liver and renal function, and long-term alcohol use

DosingInteractionsContraindicationsPrecautionsPregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions
Hepatotoxicity possible in patients with chronic alcoholism following various dose levels; severe or recurrent pain or high or continued fever may indicate serious illness; acetaminophen is contained in many OTC products and combined use with these products may result in cumulative acetaminophen doses exceeding recommended maximum dose

Aspirin (Anacin, Bufferin, Ecotrin)
Lowers elevated body temperature by vasodilating peripheral vessels, thereby enhancing dissipation of excess heat. Also acts on the heat-regulating center of hypothalamus to reduce fever.

DosingInteractionsContraindicationsPrecautionsAdult
325-650 mg PO/PR q4h

Pediatric
10-15 mg/kg PO/PR q4-6h; not to exceed 60-80 mg/kg/d

DosingInteractionsContraindicationsPrecautionsEffects may decrease with antacids and urinary alkalinizers; corticosteroids decrease salicylate serum levels; additive hypoprothrombinemic effects and increased bleeding time may occur with coadministration of anticoagulants, antiplatelets, COX-2 inhibitors, sulfinpyrazone, thrombolytics, and valproic acid derivatives; may antagonize uricosuric effects of probenecid and increase toxicity of phenytoin and valproic acid; doses >2 g/d may potentiate glucose-lowering effect of sulfonylurea drugs and insulin; mesalamine may increase aspirin toxicity; combo therapy may increase methotrexate toxicity

DosingInteractionsContraindicationsPrecautionsDocumented hypersensitivity; liver damage, GERD, G-6-PD deficiency, hypoprothrombinemia, TTP, vitamin K deficiency, bleeding disorders, asthma; because of association of aspirin with Reye syndrome, do not use in children (<16 y) with flu

DosingInteractionsContraindicationsPrecautionsPregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions
May cause transient decrease in renal function and aggravate chronic kidney disease; avoid use in patients with severe anemia, with history of blood coagulation defects, or taking anticoagulants

Ibuprofen (Motrin, Advil, Nuprin)
NSAID with analgesic and antipyretic activities. Although exact mode of action not known, appears to inhibit cyclooxygenase activity and prostaglandin synthesis. May inhibit lipoxygenase, leukotriene synthesis, lysosomal enzyme release, neutrophil aggregation, and various cell-membrane functions.

DosingInteractionsContraindicationsPrecautionsAdult
200-400 mg PO q4-6h prn; not to exceed 3.2 g/d; take with food

Pediatric
4-10 mg/kg PO q6-8h, not to exceed 50 mg/kg/d; take with food

DosingInteractionsContraindicationsPrecautionsCoadministration with aspirin, probenecid, and leflunomide increases risk of inducing serious NSAID-related adverse effects; anticoagulants, antiplatelets, corticosteroids, COX-2 inhibitors, thrombolytics, valproic acid derivatives, and aspirins may increase risk of bleeding; probenecid may increase concentrations and, possibly, toxicity of NSAIDs; may decrease effect of hydralazine, ACE inhibitors, angiotensin II receptor blockers, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; may increase lithium toxicity, phenytoin levels may be increased when administered concurrently, acetaminophen, cyclosporin, may increase risk of nephrotoxicity, all quinolones may increase risk of CNS stimulation

DosingInteractionsContraindicationsPrecautionsDocumented hypersensitivity; peptic ulcer disease; recent GI bleeding or perforation; renal insufficiency; high risk of bleeding; CHF

DosingInteractionsContraindicationsPrecautionsPregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions
Caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in anticoagulation abnormalities or during anticoagulant therapy

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