Journal
ARABIAN JOURNAL OF CHEMISTRY
Volume 14, Issue 10, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.arabjc.2021.103385
Keywords
SARS-CoV-2; Pharmacokinetics; Pharmacodynamics; Remdesivir; Lopinavir; Hydroxychloroquine; Favipiravir
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This study examined the variable efficacy or limitations of Lopinavir/Ritonavir, Remdesivir, Hydroxychloroquine, and Favipiravir in clinical settings. It was found that the efficacy of antiviral drugs against COVID-19 depends on their ability to achieve therapeutic concentrations in lung and intestinal tissues.
Background: COVID-19 is an ongoing viral pandemic produced by SARS-CoV-2. In light of in vitro efficacy, several medications were repurposed for its management. During clinical use, many of these medications produced inconsistent results or had varying limitations. Objective: The purpose of this literature review is to explain the variable efficacy or limitations of Lopinavir/Ritonavir, Remdesivir, Hydroxychloroquine, and Favipiravir in clinical settings. Method: A study of the literature on the pharmacodynamics (PD), pharmacokinetics (PK), safety profile, and clinical trials through academic databases using relevant search terms. Results & discussion: The efficacy of an antiviral drug against COVID-19 is associated with its ability to achieve therapeutic concentration in the lung and intestinal tissues. This efficacy depends on the PK properties, particularly protein binding, volume of distribution, and half-life. The PK and PD of the model drugs need to be integrated to predict their limitations. Conclusion: Current antiviral drugs have varying pharmacological constraints that may associate with limited efficacy, especially in severe COVID-19 patients, or safety concerns. (C) 2021 The Authors. Published by Elsevier B.V. on behalf of King Saud University.
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