Kuchepetsa kuchepetsa kugwirizanitsa ndi mankhwala ambiri ndi zowonjezera
Kugwiritsa ntchito mankhwala osokoneza bongo ndizovuta kwa anthu onse omwe ali ndi kachirombo ka HIV ndi madokotala awo, makamaka ngati munthu akuwona akatswiri osiyanasiyana, omwe alibe kachilombo ka HIV. Ngakhale kuti ma pharmayi amatha kuwonana kuti machitidwewa akwaniritsidwe, pali zinthu zambiri zomwe zimagwira ntchito mosavuta pa radar ya mankhwala, ndipo ngati zitengedwa, zimachepetsanso mphamvu za mankhwala opatsirana pogonana.
Angathe kuchita zimenezi mwa kulepheretsa kumwa ma ARV ena, kuteteza mavitamini omwe amayenera kuwonjezera mankhwalawa, kapena kuwonjezera kuwonjezeka kapena kuchepa kwa ma ARV. N'zosadabwitsa kuti zina mwa mankhwalawa ndi tsiku lililonse, pa-counter-counter-mankhwala, pamene zina ndizo mankhwala kapena mankhwala osagwiritsidwa ntchito omwe simungaziganizire mobwerezabwereza.
Ngati mukufuna kuyamba mankhwala ochepetsa kachilombo ka HIV , nthawi zonse muzitsatira dokotala wanu mankhwala alionse kapena othandizirapo-kuphatikizapo zitsamba kapena zowonjezereka. Ngati mwakhala mukuchiritsidwa kale ndipo mutengapo mankhwala aliwonsewa akutsutsana ndi ma ARV anu, lankhulani ndi dokotala wanu. Mungathe kukambirana kapena kubwereza ndondomeko yanu ya mankhwala osokoneza bongo, kuletsa mankhwala osokoneza bongo, kapena kusintha ma ARV, ngati kuli kofunikira.
Antacids Mapepala ndi Kusamalitsa
Mankhwala a Magnesium ndi aluminium (monga Maalox, Mylanta, Milk of Magnesia, Tums) amatha kuchepetsa ziwalo za m'mimba kuti asokoneze kwambiri kumwa ma ARV.
Ma antiacid monga awa amatha kuperewera kwa nthawi yochepa chabe ndipo amatha kupatsidwa maola awiri kapena asanu asanafike kapena pambuyo pake.
Ma ARV omwe amapezeka kwambiri ndi mankhwalawa ndi awa:
- Aptivus (tipranavir) -chitani mavitamini asanu ndi limodzi musanafike kapena maola awiri atapita
- Edurant (rilpivirine) -pangani mankhwalawa maola awiri kapena maola anayi asanafike
- Rescriptor (delavirdine) -gwiritsani antacid ora limodzi kapena maola awiri atapita
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) -pangani mankhwalawa maola awiri musanafike kapena pambuyo pake
- Tivicay (dolutegravir) -chitani ma antiacid maola sikisi asanayambe kapena maola awiri
- Triumeq (dolutegravir + ziagen + epivir) -pangani mankhwala osokoneza maola sikisi kapena maola awiri
Mankhwala ena oterewa monga proton pump inhibitors (mwachitsanzo, Nexium, Prilosec, Losec, Prevacid) amakhala ndi mphamvu zowonjezera ndipo angathe kuchepetsa kuyamwa kwa Reyataz (atazanavir) ndi Edurant (rilpivirine) ndi 78 peresenti ndi 40 peresenti, motsatira. Momwemonso, kugwiritsa ntchito proton pump inhibitors kumatsutsana ndi kugwiritsidwa ntchito ndi ma ARV omwewa komanso chisamaliro chapadera chiyenera kutengedwa pogwiritsa ntchito antchito omwe amatsutsa H2 monga Tagamet ndi Zantac.
Lankhulani ndi dokotala wanu kuti mukambirane kusintha kwa mankhwala ndi mankhwala ngati mukugwiritsa ntchito mankhwala kapena Reyataz kapena Edurant.
Wotchedwa St. John's Wort
Hypericum perforatum , yomwe imadziwika kwambiri ku St John's Wort, ndi zomera zomwe amakhulupirira kuti ena amadana ndi zotupa, tizilombo toyambitsa matenda, tizilombo toyambitsa matenda komanso antioxidant. Ngakhale kuti meta yaikulu yofufuza mchaka cha 2008 inanena kuti mankhwala a zitsamba amapindula pa chithandizo chachikulu cha kupsinjika maganizo, zida zake zina zimakhalabe zotsutsana ndi umboni wosatsutsika kuti zitsimikizire zambiri.
Pogwiritsidwa ntchito poyamikira mankhwala opatsirana pogonana, St. John's Wort ingakhudzire ntchito ya enzyme CYP450 3A4, yomwe imagwira ntchito ndi mamolekyu owononga mankhwala kuti athe kuchotsedwa m'thupi. Ngati izi zikuchitika, ndondomeko ya mankhwala a serum (HIV protease inhibitors (PIs) komanso osakhala nucleoside reverse transcriptase inhibitors (NNRTIs) akhoza kuchepetsedwa kwambiri, nthawi zina ndi 82 peresenti. Zoterezi, St. John's Wort sayenera kutengedwa ndi ARV zotsatirazi:
- Aptivus (tipranavir)
- Crixivan (indinavir)
- Edurant (rilpivirine)
- Intelence (etravirine)
- Invirase (saquinavir)
- Kaletra (lopinavir + ritonavir)
- Lexiva (fosamprenavir)
- Norvir (ritonavir)
- Prezista (darunavir)
- Kubwezeretsa (delavirdine)
- Reyataz (atazanavir)
- Stribild (yomwe imakhudza elvitegravir ndi mankhwala opangira mankhwala m'philo limodzi)
- Sustiva (efavirenz) kapena Atripla (mankhwala osakaniza omwe ali ndi efavirenz)
- Viracept (nelfinavir)
- Viramune (nevirapine)
Adyo
Ena amakhulupirira kuti garlic ili ndi katundu omwe angathe kupewa kapena kuchiza matenda ambiri, chimfine ndi kuthamanga kwa magazi ku matenda a mtima ndi khansa. Akuluakulu ena amanena kuti mankhwalawa ndi mankhwala a adlicin.
Ngakhale kuti kafukufuku wasonyeza kuti phindu la adyolo supplementation- mwina mu ufa, kutulutsa, capsule, kapena piritsi-pangakhale zovuta kwambiri pamene akugwirizanitsa ndi protease inhibitor-class drug drug Invirase (saquinavir). Polepheretsa CYP450 3A4 m'matumbo, adyo yowonjezerapo akhoza kuchepetsa ndondomeko ya mankhwala a Invirase ndi 54 peresenti. Ngakhale atasiya kumwa adyo, kafukufuku wasonyeza kuti zotsatira zowonjezera zingapitirize masiku kapena masabata pambuyo pake.
Kafukufuku wina wasonyeza kuti adyo ingasokoneze kuwonjezereka kwa mitundu ina ya ma ARV ndi NNRTI, ngakhale kuti palibe ndondomeko yotsatila yogwiritsira ntchito ndipo palibe ndondomeko yochuluka ya mtundu wa adyo (kuphatikizapo yaiwisi) yomwe ingakhale yoyenera kapena yosayenera. Momwemo, ngati mukudya adyo mwa njira iliyonse yothandizira, mumalangizidwa kuti mulole adokotala wanu adziwe.
> Zotsatira:
> Dipatimenti ya US Health and Human Services (DHHS). "Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Washington, DC; January 19, 2015.
> Linde, K .; Berner, M ;; ndi Kriston, L. "Wort St John chifukwa chovutika maganizo." Dongosolo la Cochrane la Zosintha Zogwirizana . October 8, 2008; (4): CD000448. lembani: 10.1002 / 14651858.CD000448.pub3.
> Piscitelli, S .; Burstein, A .; Welden, N .; et al. "Zotsatira za adyo zimaphatikizapo pa pharmacokinetics ya saquinavir." Matenda opatsirana pogonana; 34 (2): 234-238.