ZIDOVUDINE

ZIDOVUDINE

ZIDOVUDINE=Azidothymidine (AZT)=Retrovir

CAS NUMBER:30516-87-1
EC NUMBER:623-849-4
Molecular Weight:267.24
Molecular Formula:C10H13N5O4

⯈ DEFINITION OF ZIDOVUDINE:
Zidovudine is a white to beige, odorless, crystalline solid with a molecular weight of 267.24 and a solubility of 20.1 mg per mL in water at 25°C.
The molecular formula is C10H13N5O4.
Zidovudine is a dideoxynucleoside used in the treatment of HIV infection
Zidovudine (ZDV), also known as azidothymidine (AZT), is an antiretroviral medication used to prevent and treat HIV/AIDS.
Zidovudine (ZDV) is generally recommended for use in combination with other antiretrovirals.
Zidovudine (ZDV) may be used to prevent mother-to-child spread during birth or after a needlestick injury or other potential exposure.
Zidovudine (ZDV) is sold both by itself and together as lamivudine/zidovudine and abacavir/lamivudine/zidovudine.
Zidovudine (ZDV) can be used by mouth or by slow injection into a vein.
Zidovudine (ZDV) is commonly used in pregnancy and appears to be safe for the baby.
Zidovudine (ZDV)  is of the nucleoside analog reverse-transcriptase inhibitor (NRTI) class.
Zidovudine (ZDV) works by inhibiting the enzyme reverse transcriptase that HIV uses to make DNA and therefore decreases replication of the virus.
Zidovudine was first described in 1964.
Zidovudine (ZDV) was approved in the United States in 1987 and was the first treatment for HIV.
Zidovudine (ZDV)  is on the World Health Organization's List of Essential Medicines.
Zidovudine (ZDV)  is available as a generic medication.
A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group.
This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains.

Drug Class: Nucleoside Reverse Transcriptase Inhibitor (NRTIs)

⯈ USES/BENEFITS OF ZIDOVUDINE:
Zidovudine is used with other HIV medications to help control HIV infection. 
Zidovudine helps to decrease the amount of HIV in your body so your immune system can work better.
This lowers your chance of getting HIV complications (such as new infections, cancer) and improves your quality of life.
Zidovudine belongs to a class of drugs known as nucleoside reverse transcriptase inhibitors-NRTIs.
Zidovudine is used in pregnant women to prevent passing the HIV virus to the unborn baby. 
Zidovudine is also used in newborns born to mothers infected with HIV to prevent infection in the newborns.
Zidovudine (ZDV) is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription.
Zidovudine (ZDV) improves immunologic function.
Zidovudine (ZDV) is used in combination with other antiretroviral agents for the treatment of human immunovirus (HIV) infections.
Zidovudine, a structural analog of thymidine, is a prodrug that must be phosphorylated to its active 5′-triphosphate metabolite, zidovudine triphosphate (ZDV-TP).
Zidovudineinhibits the activity of HIV-1 reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleotide analogue. 
Zidovudine competes with the natural substrate dGTP and incorporates itself into viral DNA.
Zidovudine is also a weak inhibitor of cellular DNA polymerase α and γ.

⯈ APPLICATIONS OF ZIDOVUDINE:
Medical uses
•HIV treatment
Azidothymidine is usually dosed twice a day in combination with other antiretroviral therapies.
This approach is referred to as Highly Active Antiretroviral Therapy (HAART) and is used to prevent the likelihood of HIV resistance.
•HIV prevention
Azidothymidine (AZT) has been used for post-exposure prophylaxis (PEP) in combination with another antiretroviral drug called lamivudine. 
Together they work to substantially reduce the risk of HIV infection following the first single exposure to the virus.
More recently, Azidothymidine (AZT) has been replaced by other antiretrovirals such as tenofovir to provide PEP.
Azidothymidine (AZT) is now a principal part of the clinical pathway for both pre-exposure prophylaxis and post-exposure treatment of mother-to-child transmission of HIV during pregnancy, labor, and delivery and has been proven to be integral to uninfected siblings' perinatal and neonatal development.
Without Azidothymidine (AZT), as many as 10 to 15% of fetuses with HIV-infected mothers will themselves become infected.
Azidothymidine (AZT) has been shown to reduce this risk to as little as 8% when given in a three-part regimen post-conception, delivery, and six weeks post-delivery. Consistent and proactive precautionary measures, such as the rigorous use of antiretroviral medications, cesarean section, face masks, heavy-duty rubber gloves, clinically segregated disposable diapers, and avoidance of mouth contact will further reduce child-attendant transmission of HIV to as little as 1–2%.
During 1994 to 1999, AZT was the primary form of prevention of mother-to-child HIV transmission.
Azidothymidine (AZT) prophylaxis prevented more than 1000 parental and infant deaths from AIDS in the United States.
In the U.S. at that time, the accepted standard of care for HIV-positive mothers was known as the 076 regimen and involved five daily doses of Azidothymidine (AZT) from the second trimester onwards, as well as Azidothymidine (AZT) intravenously administered during labour.
A number of studies were initiated in the late 1990s that sought to test the efficacy of a shorter, simpler regimen for use in 'resource-poor' countries.
•Antibacterial properties
Zidovudine also has antibacterial properties, though not routinely used in clinical settings.
Zidovudine (ZDV) acts on bacteria with a mechanism of action still not fully explained. 
Promising results from in vitro and in vivo studies showed the efficacy of Azidothymidine (AZT) also against multidrug-resistant gram-negative bacteria (including mcr-1 carrying and metallo-β-lactamase producing isolates), especially in combination with other active agents (e.g. fosfomycin, colistin, tigecycline)

•Mechanism of action
Azidothymidine (AZT) is a thymidine analogue.
Azidothymidine (AZT) works by selectively inhibiting HIV's reverse transcriptase, the enzyme that the virus uses to make a DNA copy of its RNA.
Reverse transcription is necessary for production of HIV's double-stranded DNA, which would be subsequently integrated into the genetic material of the infected cell (where it is called a provirus).
Cellular enzymes convert Azidothymidine (AZT) into the effective 5'-triphosphate form. 
Studies have shown that the termination of HIV's forming DNA chains is the specific factor in the inhibitory effect.
At very high doses, AZT's triphosphate form may also inhibit DNA polymerase used by human cells to undergo cell division, but regardless of dosage AZT has an approximately 100-fold greater affinity for HIV's reverse transcriptase.
The selectivity has been suggested to be due to the cell's ability to quickly repair its own DNA chain if it is disrupted by Azidothymidine (AZT) during its formation, whereas the HIV virus lacks that ability.
Thus Azidothymidine (AZT) inhibits HIV replication without affecting the function of uninfected cells.
At sufficiently high dosages, Azidothymidine (AZT) begins to inhibit the cellular DNA polymerase used by mitochondria to replicate, accounting for its potentially toxic but reversible effects on cardiac and skeletal muscles, causing myositis.

•Chemistry
Azidothymidine (AZT) crystallizes into an asymmetric nucleated monoclinic salt structure, forming an equalized hydrogen-nitrogen-oxygen bonded network of base-paired dimers; its multiscaled crystallized lattice superstructure and surfactant headgroup electrostatic bond polarity was reported in 1987 and 1988.

⯈ SAFETY MEASURES:
First aid measures:
After inhalation: Supply fresh air; consult doctor in case of complaints.
After skin contact: Generally the product does not irritate the skin.
After eye contact: Rinse opened eye for several minutes under running water.
After swallowing: If symptoms persist consult doctor
Firefighting Measures:
Suitable extinguishing agents:Use fire fighting measures that suit the environment.
A solid water stream may be inefficient

Handling and storage:
Ensure good ventilation/exhaustion at the workplace

⯈ PHYSICAL PROPERTIES OF ZIDOVUDINE:
Form: Solid
Odor: Characteristic
SOLUBILITY: DMF 30 mg/ml,
DMSO: 30 mg/ml,
Ethanol: 10 mg/ml,
PBS (pH 7.2): 10 mg/ml.

⯈ SYNONYMS OF ZIDOVUDINE:
azidothymidine (AZT)
zidovudine
Azidothymidine
30516-87-1
3'-Azido-3'-deoxythymidine
Retrovir
AZT
Thymidine, 3'-azido-3'-deoxy-
Zidovudinum
ZIDOVUDINE [AZT]
Combivir,
Trizivir

ADDITIONAL INFORMATION ON ZIDOVUDINE
(FREQUENTLY ASKED QUESTIONS)
⯈What is zidovudine?
Zidovudine is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the following uses:
To treat HIV infection in adults, children, and infants. When zidovudine is used to treat HIV infection, the medicine is always used in combination with other HIV medicines.
To prevent mother-to-child transmission (perinatal transmission) of HIV.
When used to prevent mother-to-child transmission, zidovudine is given to women with HIV during pregnancy and childbirth and to their infants after birth. 

⯈How to use Zidovudine
Take Zidovudine by mouth with or without food as directed by your doctor, usually 2 to 3 times daily.
Take Zidovudine with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.
If you are using the liquid form of Zidovudine, carefully measure the dose using a special measuring device/spoon.
Do not use a household spoon because you may not get the correct dose.
The dosage is based on your medical condition and response to treatment.
For children, the dosage is also based on weight.
Pregnant women may need to take this medication 5 times a day.
Newborns are usually given the liquid form every 6 hours for 6 weeks after birth to prevent infection.
Take Zidovudine 2 hours before or after taking clarithromycin. 
Clarithromycin may prevent your body from fully absorbing zidovudine.
For the best effect, take Zidovudine at evenly spaced times. 
To help you remember, take Zidovudineat the same times every day.
It is very important to continue taking Zidovudine (and other HIV medications) exactly as prescribed by your doctor.
Do not skip any doses. Refill your medication before you run out.
Do not take more or less of this drug than prescribed or stop taking it (or other HIV medicines) even for a short time unless directed to do so by your doctor.
Skipping or changing your dose without approval from your doctor may cause the amount of virus to increase, make the infection more difficult to treat (resistant), or worsen side effects.

⯈How should I use zidovudine?
Zidovudine (brand name: Retrovir) comes in the following forms and strengths:
300-mg tablets
100-mg capsules
10-mg/mL oral solution
200-mg/20-mL single-use vials for intravenous (IV) injection
Use zidovudine according to your health care provider’s instructions.
Take zidovudine tablets, capsules, or oral solution by mouth with or without food.
If giving zidovudine oral solution to a newborn baby, make sure to use the correct-sized syringe to measure the dose accurately. 
Zidovudine injection is given by IV infusion. Use zidovudine injection exactly as your health care provider has instructed.
If you do not understand how to use zidovudine injection, ask your health care provider.