ZIKA VIRUS

ZIKA VIRUS: What you need to Know..!!!

About zika virus History:

The Zika virus is found in tropical locales with large mosquito populations. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Southern Asia and Western Pacific. The virus was first identified in Uganda in 1947 in rhesus monkeys and was first identified in people in 1952 in Uganda and Tanzania, according to the WHO.

Global health officials say the Zika virus, linked to severe birth defects in thousands of babies in Brazil, is spreading rapidly in the Americas and could infect 3 million to 4 million people. The race is on to develop a Zika vaccine.

The World Health Organization said Zika cases have been reported in 23 countries and territories in the Americas in the current outbreak. Brazil has been the nation most affected. Other nations and territories include Barbados, Bolivia, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Nicaragua, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, Venezuela and the U.S. Virgin Islands, according to the PAHO.

The virus is transmitted to people through the bite of infected female Aedes mosquitoes, the same type of mosquito that spreads dengue, chikungunya and yellow fever. The Pan American Health Organization (PAHO) said Aedes mosquitoes are found in all countries in the Americas except Canada and continental Chile, and the virus will likely reach all countries and territories of the region where Aedes mosquitoes are found.

Symptoms:1.About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).2.The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.3.The illness is usually mild with symptoms lasting for several days to a week.4.Zika virus usually remains in the blood of an infected person for a few days but it can be found longer in some people.5.Severe disease requiring hospitalization is uncommon.6.Deaths are rare.

Diagnosis:
1.The symptoms of Zika are similar to those of dengue and chikungunya, diseases spread through the same mosquitoes that transmit Zika.
See your healthcare provider if you develop the symptoms described above and have visited an area where Zika is found.
2.If you have recently traveled, tell your healthcare provider when and where you traveled.
3.Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.

Treatment:

1. No vaccine or medications are available to prevent or treat Zika infections.

2. Treat the symptoms:

3. Get plenty of rest

4. Drink fluids to prevent dehydration

5. Take medicines, such as acetaminophen or paracetamol, to relieve fever and pain. 

6. Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen. Aspirin and NSAIDs should be avoided until dengue can be ruled out to reduce the risk of hemorrhage (bleeding). If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.

7. If you have Zika, avoid mosquito bites for the first week of your illness.

8. During the first week of infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites.

9. There is no treatment or vaccine available for Zika infection. Companies and scientists are racing to develop a safe and effective vaccine for Zika, but one is not expected to be ready for months or years.

The PAHO said there is no evidence that Zika can cause death but some cases have been reported with more serious complications in patients with pre-existing medical conditions. 

The virus has been linked to microcephaly, a condition in newborns marked by abnormally small heads and brains that have not developed properly. It also has been associated with Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks part of the nervous system. Scientists are studying whether there is a causal link between Zika and these two disorders.

People who get Zika virus disease typically have a mild fever, skin rash, conjunctivitis, muscle and joint pain and fatigue that can last for two to seven days. But as many as 80 percent of people infected never develop symptoms. The symptoms are similar to those of dengue or chikungunya, which are transmitted by the same type of mosquito.

The PAHO also said Zika can be transmitted through blood, but this is an infrequent transmission mechanism. There is no evidence the virus can be transmitted to babies through breast milk.

Prevention:

Until more is known, the Ministry of Health recommends that women who are pregnant or plan to become pregnant in the near term consider delaying travel to areas with Zika virus present. If travelling in Zika infected areas, women who are pregnant or plan to become pregnant should consult with their healthcare provider and take all precautions to avoid mosquito bites, including:

• Wear long-sleeved shirts and long pants
• Use insect repellents containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535. Always use as directed.
• Insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant and nursing women and children older than 2 months when used according to the product label. Oil of lemon eucalyptus products should not be used on children under 3 years of age.
• If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
• Use permethrin-treate clothing and gear (such as boots, pants, socks, and tents).
• Use bed nets as necessary
• Stay and sleep in screened-in or air-conditioned rooms.

If you are pregnant and develop a rash, red eyes, fever, or joint pain within 14 days of travel to a Zika virus infected country, please consult your health care provider and let them know your travel history.

The National Health Institute reported that Colombia now has 20,297 cases of Zika infection, including 2,116 in expectant mothers.

Beware Men! Smoking may have negative effects on sperm quality

Beware Men! Smoking may have negative effects on sperm quality

The sperm of men who smoke has a greater extent of DNA damage than that of non-smokers, says a new study that points to harmful effects of smoking on male fertility.

Male infertility accounts for about 30 to 50 percent of all infertility cases, and infertile men tend to have high levels of damage to the sperm DNA.

"More and more studies are demonstrating a harmful effect of smoking on male fertility,” senior author of the study Ricardo Pimenta Bertolla from Sao Paulo Federal University in Brazil.

"Our results point in the direction of important semen alterations: Semen of smokers presents an inflammatory nature, associated with decreased capacity of sperm to achieve fertilisation and generate a healthy pregnancy," Pimenta Bertolla noted.

Researchers also assessed 422 proteins in participants' sperm. One protein was absent, 27 proteins were under-represented, and 6 proteins were over-represented in smokers. Analyses of these proteins suggest that cigarette smoking may promote an inflammatory response in the male reproductive tract. The study published in the journal BJU International included 20 non-smoking men and 20 men who smoked.

"More and more studies are demonstrating a harmful effect of smoking on male fertility," said Dr Ricardo Pimenta Bertolla, senior author of the study. 

Regulatory Affairs

Information about Regulatory Affairs (RA)

Information about Regulatory Affairs (RA)

Full forms of some of the Abbreviations related to Regulatory Affairs-

S.No	ABBREVIATION	FULL FORM
1	NDA	New Drug Application
2	ANDA	Abbreviated New Drug application
3	IND	Investigational New Drug Application
4	DMF	Drug Master file
5	ASMF	Active Substance Master File
6	MAA	Marketing Authorisation Application
7	CEP	Certificate of Suitability to the monographs of the European Pharmacopoeia
8	ICH	The International Conference on Harmonisation of technical requirements for registration of Pharmaceuticals for human use.
9	CTD	Common technical document
10	AP	Applicant’s Part
11	RP	Restricted Part
12	OP	Open Part
13	CP	Closed Part
14	NME	New Molecular Entity
15	NCE	New Chemical Entity
16	SmPC	Summary of Product Characteristics
17	PL	Packaging Leaflet
18	RMS	Reference Member State
19	CMS	Concerned Member State
20	CHMP	The Committee for Medicinal Products for Human Use
21	CPMP	Committee for Proprietary Medicinal Products
22	CVMP	Committee For Medicinal Products For Veterinary Use
23	SUPAC	Scale-up and post approval changes
24	BACPAC	Bulk Active Chemicals Post approval Changes
25	cGMP	Current good Manufacturing Practice
26	GCP	Good clinical Practice
27	GLP	Good Laboratory Practice
Well known Drug Regulatory Agencies across the world-
S.No.	Country	Region Regulatory Agency
1	United States of America	United States Food and Drug Administration (USFDA)
2	United Kingdom	Medicines and Healthcare products Regulatory Agency (MHRA)
3	European Union	European Medicines Agency (EMA)
4	European Union	European Directorate for the Quality of Medicines (EDQM)
5	Australia	Therapeutic Goods Administration (TGA)
6	Canada	Therapeutic Products Directorate (TPD) in Health Product and food branch (HPFB) of Health Canada (HC)
7	Japan	Pharmaceutical and Medical Devices Agency (PMDA)
8	France	Agence Francaise de Securite Sanitaire des Produits de Sante (AFSSAPS)Translated into English as- French Agency for the Safety of Health Products
9	India	Drugs Controller General of India (DCGI) who heads Central Drugs Standard Control Organisation (CDSCO)
10	Switzerland	Swiss Agency for Therapeutic Products (SWISSMEDIC)
11	Singapore	Health Sciences Authority (HSA)
12	Germany	Bundesinstitut für Arzneimittel und Medizinprodukte, (BfArM)

1.What is Regulatory Affairs?

Regulatory Affairs in a Pharmaceutical industry, is a profession which acts as the interface between the pharmaceutical industry and Drug Regulatory authorities across the world. It is mainly involved in the registration of the drug products in respective countries prior to their marketing.

2.What are the goals of Regulatory Affairs Professionals?

Protection of human health Ensuring safety, efficacy and quality of drugs Ensuring appropriateness and accuracy of product information

3.What are the Roles of Regulatory Affairs professionals?

Act as a liaison with regulatory agencies Preparation of organized and scientifically valid NDA, ANDA, INDA ,MAA, DMF submissions Ensure adherence and compliance with all the applicable cGMP, ICH, GCP, GLP guidelines, regulations and laws Providing expertise and regulatory intelligence in translating regulatory requirements into practical workable plans Advising the companies on regulatory aspects and climate that would affect their proposed activities Apart from the above main roles, there are various other roles which Regulatory Affairs professionals play.

4.What is an Investigational New Drug (IND) application?

It is an application which is filed with FDA to get approval for legally testing an experimental drug on human subjects in the USA.

5.What is a New Drug Application?

The NDA is the vehicle through which drug sponsors formally propose that the FDA approve a new pharmaceutical for sale and marketing in the U.S. The data gathered during the animal studies and human clinical trials of an Investigational new drug become part of the NDA in simple words, “It is an application which is filed with FDA to market a new Pharmaceutical for sale in USA”

6.What is an Abbreviated New Drug Application (ANDA)?

It is an application filed with FDA, for a U.S. generic drug approval for an existing licensed medication or approved drug.In simple words, “It is an application for the approval of Generic Drugs “

7.What is a Generic Drug Product?

A generic drug product is the one that is comparable to an innovator drug product in dosage form, strength, route of administration, quality, performance characteristics and intended use.

8.What is a DMF?

A Drug Master File (DMF) is a submission to the Food and Drug Administration (FDA) that may be used to provide confidential detailed information about facilities, processes, or articles used in the manufacturing, processing, packaging, and storing of one or more human drugs. Important facts regarding  DMF. It is submitted to FDA to provide confidential information it's submission is not required by law or regulations it is neither approved nor disapproved it is filed with FDA to support NDA, IND, ANDA another DMF or amendments and supplements to any of theseIt is provided for in the 21 CFR (Code of Federal Regulations) 314. 420 It is not required when applicant references its own information.

9.What are the types of DMF’s?

Type I: Manufacturing Site, Facilities, Operating Procedures, and Personnel (No longer accepted by FDA).

Type II: Drug Substance, Drug Substance Intermediate, and Material Used in Their Preparation, or Drug Product 

Type III: Packaging Material 

Type IV : Excipient, Colorant, Flavor, Essence, or Material Used in Their Preparation

Type V: FDA Accepted Reference Information (FDA discourages its use)

10.What is a 505 (b)(2) application ?

505 (b)(2) application is a type of NDA for which one or more investigations relied on by applicant for approval were not conducted by/for applicant and for which applicant has not obtained a right of reference.

11.What kind of application can be submitted as a 505(b)(2) application?

New chemical entity (NCE)/new molecular entity (NME) Changes to previously approved drugs.

12. What are the examples of changes to approved drug products for which 505(b)(2) application should be submitted ?

• Change in dosage form.
• Change in strength
• Change in route of administration Substitution of an active ingredient in a formulation product
• Change in formulation
• Change in dosing regimen
• Change in active ingredient New combination Product
• New indication
• Change from prescription indication to OTC indication
• Naturally derived or recombinant active ingredient
• Bioinequivalence

13.What are the chemical classification codes for NDA?

Number Meaning

1-New molecular entity (NME)

2-New ester, new salt, or other non-covalent derivative

3-New formulation

4-New combination

5-New manufacturer

6-New indication

7-Drug already marketed, but without an approved NDA

8-OTC (over-the-counter) switch

14.What are the differences between NDA and 505 (b)(2) application ?

New Drug Application (NDA)505 (b)(2) Application

1.All investigations relied on by applicant for approval were conducted by/for applicant and for which applicant has right of reference One or more investigation relied on by applicant for approval were not conducted by/for applicant and for which applicant has not obtained a right of reference.

2.Generally, filed for newly invented pharmaceuticals.Generally, filed for new dosage form, new route of administration, new indication etc for all already approved pharmaceutical.

Note: 505 (b)(2) application is a type of NDA.

15.What is a Marketing Authorization Application?

It is an application filed with the relevant authority in the Europe (typically, the UK's MHRA or the EMA’s Committee for Medicinal Products for Human Use (CHMP)) to market a drug or medicine.As per UK’s MHRA-Applications for new active substances are described as 'full applications'.Applications for medicines containing existing active substances are described as 'abbreviated’ or ‘abridged applications’.

16.What is an ASMF?

Active substance master file is a submission which is made to EMA, MHRA or any other Drug Regulatory Authority in Europe to provide confidential intellectual property or 'know-how' of the manufacturer of the active substance.In simple words, “It is a submission made to European Drug regulatory agencies on the confidential information of Active Substance or Active pharmaceutical Ingredient (API)”.

17.What are the types of active substances for which ASMFs are submitted?

New active substances Existing active substances not included in the European Pharmacopoeia (Ph. Eur.) or the pharmacopoeia of an EU Member State Pharmacopeial active substances included in the Ph. Eur. or in the pharmacopoeia of an EU Member State

18.What is the difference between DMF and ASMF (with respect to submission)?

ASMF is submitted as Applicant’s Part (Open Part) and Restricted Part (Closed Part)There isn’t any differentiation of DMF’s into parts.

19.What is ICH?

International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH): is a project that brings together the regulatory authorities of Europe, Japan and the United States and experts from the pharmaceutical industry in the three regions to discuss scientific and technical aspects of pharmaceutical product registration.

20.What is CTD?

The Common Technical Document (CTD) is a set of specification for application dossier, for the registration of Medicines and designed to be used across Europe, Japan and the United States.Quality, Safety and Efficacy information is assembled in a common format through CTD. The CTD is maintained by the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). CTD format for submission of drug registration applications/dossiers is widely accepted by regulatory authorities of other countries too like Canada, Australia etc.

21.What are the ICH guidelines to be referred for preparation of registration dossiers/applications of medicines (With respect to format and contents in each module)?

1. M4 Guideline
2. M4Q Guideline
3. M4S Guideline
4. M4E Guideline

22.What are the modules in CTD?

The Common Technical Document is divided into five modules:

Module 1. Administrative information and prescribing information

Module 2. Common Technical Document summaries (Overview and summary of modules 3 to 5)

Module 3. Quality 

Module 4. Nonclinical Study Reports (toxicology studies)

Module 5. Clinical Study Reports (clinical studies).

23.What is Orange Book?

It is the commonly used name for the book “Approved Drug Products  Equivalence Evaluations”, which is published by USFDA. It contains the list of drug products, approved on the basis of safety and effectiveness by the Food and Drug Administration (FDA) under the Federal Food, Drug, and Cosmetic Act.

24.What is Hatch-Waxman act?

It is the popular name for Drug Price Competition and Patent Term Restoration Act, 1984. It is considered as the landmark legislation which established the modern system of generic drugs in USA. Hatch-Waxman amendment of the federal food, drug and cosmetics act established the process by which, would be marketers of generic drugs can file Abbreviated New Drug Application (ANDA) to seek FDA approval of generic drugs. Paragraph IV of the act, allows 180 day exclusivity to companies that are the "first-to-file" an ANDA against holders of patents for branded counterparts.In simple words “Hatch-Waxman act is the amendment to Federal, Food, Drug and Cosmetics act which established the modern system of approval of generics ”

25.What are the patent certifications under Hatch-Waxman act?

As per the Hatch and Waxman act, generic drug and 505 (b) (2) applicants should include certifications in their applications for each patent listed in the “Orange Book” for the innovator drug. This certification must state one of the following:

(I) that the required patent information relating to such patent has not been filed (Para I certification);

(II) that such patent has expired (Para II certification);

(III) that the patent will expire on a particular date (Para III certification); or(IV) that such patent is invalid or will not be infringed by the drug, for which approval is being sought(Para IV certification).A certification under paragraph I or II permits the ANDA to be approved immediately, if it is otherwise eligible. A certification under paragraph III indicates that the ANDA may be approved when the patent expires.

26.What is meant by 180 day exclusivity?

The Hatch-Waxman Amendments provide an incentive of 180 days of market exclusivity to the “first” generic applicant who challenges a listed patent by filing a paragraph IV certification and thereby runs the risk of having to defend a patent infringement suit.180 Day Exclusivity could be granted to more than one applicant. The recent example is- 180 day exclusivity was granted to Ranbaxy and Watson Laboratories for marketing generic version of Lipitor ( Atorvastatin calcium).

27.What are the procedures for Approval of Drug in EU?

• Centralised Procedure (CP)
• Decentralised Procedure (DCP)
• Mutual Recognition Procedure (MRP)
• National Procedure (NP)

28.What is the Full form of abbreviation, CEP?

Certificate of Suitability to the monographs of the European Pharmacopoeia (or) Certificate of suitability of monographs of the European Pharmacopoeia (or) Certification of suitability of European Pharmacopoeia monographs

It is also informally referred to as Certificate of Suitability (COS).

29.What is a CEP?

It is the certificate which is issued by Certification of Substances Division of European Directorate for the Quality of Medicines (EDQM), when the manufacturer of a substance provides proof that the quality of the substance is suitably controlled by the relevant monographs of the European Pharmacopoeia.