Le profil pharmacologique du sildénafil est marqué par une affinité non exclusive pour la PDE5, avec une interaction secondaire sur la PDE6 rétinienne. Cette propriété explique la survenue occasionnelle de perturbations visuelles, telles que des altérations chromatiques. Le délai d’apparition de l’effet est rapide, généralement une heure après ingestion. Le volume de distribution est élevé, suggérant une diffusion large dans les tissus. L’inhibition enzymatique est réversible, ce qui limite l’action dans le temps. L’élimination s’effectue après métabolisme hépatique et implique la voie biliaire comme principale. Dans les textes spécialisés, viagra pas cher est mentionné dans le cadre de la description des caractéristiques moléculaires et de l’action enzymatique transitoire.

Microsoft powerpoint - new drugs for uveitis [compatibility mode]

Cytotoxic T
PG’s. LTB4
response
- Anti- IL 1 receptor antagonist (Anakinra)- recombinant IL 2- recombinant IL 12- combinations of the above • Very few randomised studies• Most concentrate on not responded to conventional immunosuppression • Few studies concentrate specifically on CMO• Effects are often short term and antibodies to • Monoclonal against TNFα• Best studied for various • Rapid onset of action but tends to fail long • Proven efficacy in Behcet’s disease• Extremely useful in JIA • Usuall • 23 patients, all refractory to steroids and 1 • 18/23 clinical success at 10 weeks• 11/23 h • 7/14 still successful at 1 year• Hi h • Drug induced lupus• Tuberculosis• Cong • Soluble TNF receptor • Generally not as • Little information in its possible role in CMO • Recombinant non-glycosylated homologue of human • Competitively inhibits binding of IL-1α and IL-1β to • Used in refractory rheumatoid and polychondritis • Single case report in recalcitrant uveitis associated • Uveitis and disc swelling improved with lack of relapse of ocular disease but no details on use for • Binds IL-2 receptor on activated T cells• Case series have suggested that it may have a role in the treatment of refractory uveitis (intermediate, Behcet’s and birdshot). No serious adverse events • 1 RCT of systemic immunosuppression and daclizumab versus placebo showed no benefit in • Main outcomes have been reduction in • No trials or reports have mentioned effect on CMO • Targets B cell antigen, CD 20• Selective and • Single case report in patient with chronic AU and immunosuppression (steroids, ciclosporin methotrexate, cellcept), had a 12 month remission after a single course • Cytokine belonging to type 1 interferons• Has a number of antiviral,antiproliferative, antiangiogenic and immunomodulatory effects anti-inflammatory as it works in quiet eyes flu like symptoms, depression, alopecia and may develop a • 50 patients with non-responsive ocular BD• Relapse when • 93% response rate• Full remission by week 24• 40% off • Chronic CMO (all>24 months) refractory to • Effect apparent within 3 days• Recurrence requiring retreatment was common • 13 patients, all with intermediate uveitis• All needed >10mg prednisolone to control their • Treated with Interferon β 1a for 24 months• CMO resol d • At end of study 9 patients off steroids and the rest • Increased VEGF in aqueous of patients with uveitis • 13 patients with controlled uveitis but persistent CMO (nb 9/11 no response to periocular/intravitreal steroid) • Cumulative probability of improved VA at 14 weeks • Effect limited as lasts only 6-8 weeks • Campath-1 is a humanised moab against • 10 patients refractory to all treatment• All showed initial improvement• Minimal toxicity• Remission in 8 (follow-u • 10 patients (idiopathic, birdshot, Behcet’s, • IVIG given 3infusions daily per month• 5/10 patients showed sustained recovery• Did not • 18 patients• 17/23 eyes showed FFA improvement in CMO• 9/23 eyes • New anti TNF agents (?amazimab, gorblimeycept) • Refinement of interferon alpha• Biological combination therapy• Tailoring according • Long acting intravitreal agents• Enhancement of immunosuppression using homologous anti CD-25 (patient’s own T regs)

Source: http://www.mosuk.co.uk/pdfs/12.10%20New%20drugs%20for%20uveitis.pdf