Kugwiritsa Ntchito Pamodzi Kungapangitse Mavuto Otsatira, kuchepetsa Kugwiritsa Ntchito Mankhwala Osokoneza Bongo
Kugwiritsa ntchito mankhwala osokoneza bongo n'kofala nthawi iliyonse pamene mankhwala amauzidwa pambali pa wina. Nthaŵi zambiri, kugwirizana sikutanthauza munthu kuti asiye mankhwala amodzi kapena ena. Kawiri kawiri, mlingo ukhoza kuwonjezeka, kuchepa kapena kusokonezeka pofuna kupeŵa toxicities kapena kuonetsetsa kuti mankhwalawa amasunga potency. Panthawi zina, m'malo osinthidwa angapangidwe ndi wothandizira ofanana.
Komabe, pankhani yokhudzana ndi ma ARV (ARVs) , pali mankhwala ambiri omwe amalepheretsa kusokoneza mankhwala. Iwo amachititsa zimenezi mwa kusintha mankhwala osokoneza bongo (momwe mankhwala amagwiritsira ntchito) kapena pharmacokinetics (momwe mankhwala amapitilira kudutsa thupi) la limodzi kapena ambiri mwa ma ARV.
Izi zingakhale vuto lalikulu. Pamene mankhwala pharmacodynamics amasinthidwa, akhoza kuwonjezera kapena kuchepetsa mphamvu ya mankhwala amodzi kapena onse awiri, kapena kuonjezera zotsatira zawo zoopsa kuti zisasokonezeke, ngakhale zoopsa.
Momwemo, pamene mankhwala a drug pharmacokinetics amathyola, amatha kusintha momwe mankhwala amathandizira kapena kugwiritsiridwa ntchito kake ndi thupi. Nthawi zina, mankhwala ena amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda kapena chiwindi.
Zonsezi ndizochitika zomwe mungafune kupewa ngati mutachiza HIV .
Pambuyo pa zotsatira zowonekeratu za mankhwala osokoneza bongo, zotsatira za " zosawoneka " za mankhwala osokoneza bongo zingakhale zovuta kwambiri. Ngati izi zikuchitika, mankhwala anu a kachilombo ka HIV sangathe kuthetsa kachilombo ka HIV, zomwe zingachititse kuti musamangokhalira kumwa mankhwala, ndipo pamapeto pake, kulephereka- osati kwa wothandizila koma nthawi zambiri ku mankhwala osokoneza bongo.
Choncho, ndi kofunika nthawi zonse kudziwitsa dokotala wanu kachilombo ka mankhwala aliwonse omwe mungakhale nawo, kaya atumizidwa kapena ayi.
Mankhwala Ogwiritsira Ntchito Mankhwala Ogwiritsira Ntchito Mankhwala Ogwiritsira Ntchito Mankhwala Osokoneza Bongo Kuti Agwiritsidwe Ntchito ndi HIV
Mankhwala amaganiziridwa mosiyana ngati angapweteke. M'malo mwa chithandizo cha kachilombo ka HIV, pali mitundu yambiri ya mankhwala omwe, atatengedwa ndi ma ARV, amakhala ndi zotsatira zake. Amaphatikizapo mankhwala amtsiku ndi tsiku omwe amachititsa kuti thupi likhale ndi cholesterol komanso mtima, komanso mankhwala omwe amagwiritsidwa ntchito pochiza matenda okhudzana ndi HIV.
Iwo akhoza kuthyoledwa moyenera, motere:
Lipid-Mankhwala Ochepetsa
Mankhwala otchedwa Statin amagwiritsidwa ntchito kuchepetsa ma cholesterol ndipo amagwira ntchito poletsa chiwindi cha chiwindi chomwe chimayambitsa cholesterol.
Ngakhale kuti mankhwala ambiri otchuka samatsutsana kuti agwiritsidwe ntchito ndi ma ARV (kapena kuti mukhale ndi kusintha kosavuta kwa mlingo), ziwiri ziyenera kupeŵedwa pamene ntchito zawo zowonjezera zingathe kuonjezera zotsatira zoopsa za mankhwala osokoneza bongo, kuphatikizapo chiopsezo cha ululu wa minofu zofooka (myopathy) kapena kuwonongeka kwakukulu kwa minofu ( rhabdomyolysis ).
- Mankhwala osakaniza: Altoprev (lovastatin), Mevacor (lovastatin), Zocor (simvastatin)
- Sungagwiritsidwe ntchito ndi ma ARV awa: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Mankhwala a mtima
Zina mwa mankhwala omwe amagwiritsidwa ntchito mobwerezabwereza ( arrhythmia ) amatsutsana kuti agwiritsidwe ntchito ndi ma ARV ena pamene angapangitse kuti chiwindi kapena kutayika kwa chiwindi kuwonjezeke. Atumiki awiri omwe amawoneka kuti ndi awa:
- Mankhwala osokoneza bongo: Multaq (dronederone), Renexa (ranolazine)
- Sungagwiritsidwe ntchito ndi ma ARVs otsatirawa: Aptivus, Invirase, Genvoya (Okhaokha), Kaletra, Lexiva, Prezista, Reyataz, Stribild (Renexa yekha), Vitekta (Renexa yekha)
Mankhwala ena a mtima amadziwika kuti ali ndi mphamvu zomwezo ndipo ayenera kupeŵa pamene agwiritsidwa ntchito ndi anti-ARV inhibitor-classs. Zimaphatikizapo anti-arrhythmics Cordarone, Nexterone, Pacerone, Quinaglute, Quinidexm Rythmol, Tambocor, ndi Tikosyn, komanso mankhwala odana ndi tachycardial lidocaine.
Mankhwala Oletsa Khunyu
Nthawi zambiri, mankhwala osokoneza bongo amaonedwa kuti ndi otetezeka kuti agwiritsidwe ntchito ndi mankhwala anu. Ochepa, komabe, amagwira mwatsatanetsatane mankhwala a Intelence (etravirine) pochita mpikisano ndi njira zomwe zimagwiritsidwa ntchito poyang'anira. Pochita izi, zikhoza kuchepetsa kuchepa kwa ubwino m'magazi, kuchepetsa mphamvu zake.
- Mankhwala osakaniza: carbamazepine, phenobarbital, phenytoin
- Sungagwiritsidwe ntchito ndi ARV zotsatirazi: Intelence
Zomwe Zimayambitsa Mankhwala Osokoneza Bongo
Mankhwala ambiri omwe amagwiritsidwa ntchito pochizira matenda a schizophrenia ndi matenda a Tourette amadziwikiranso kuti amachititsa anthu ena kukhala ndi kachilombo ka HIV.
- Mankhwala osokoneza bongo: Latuda (lurasidone), Versed (midazolam), Orap (pimozide), Halcion (iriazolam)
- Sungagwiritsidwe ntchito ndi ma ARV awa: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Hepatitis C Mankhwala osokoneza bongo
Mliri wa matenda a hepatitis C mwa anthu omwe ali ndi kachilombo ka HIV angathe kuthamanga kufika 20-30% m'madera ena a North America ndi Europe. Ndi mankhwala atsopano a chiwindi a hepatitis C (otchedwa antiviral, kapena a DAA ) omwe amawathandiza kuti athe kuchiritsa anthu oposa 90% mwa anthu ena, amachititsa chidwi kwambiri kuti athe kuchiza anthu omwe ali ndi kachilombo ka HIV m'mbuyomu komanso mozunza kuposa zaka zapitazo.
Komabe, ma DAA ambiri sangagwiritsidwe ntchito ndi ma ARV ena, makamaka chifukwa cha zochitika zothandizira mankhwala omwe angathe kuwonjezera kapena kuchepetsa mankhwala osokoneza bongo.
- Mankhwala osokoneza bongo: Olysio, Victrelis, Viekira Pak
- Sizingagwiritsidwe ntchito ndi ma ARVs otsatirawa: Aptivus, Edurant (Viekira Pak okha) Intelence, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz (Olysio ndi Victrelis okha), Selzentry (Viekira Pak okha), Stribild, Sustiva, Viramune, Vitekta
Kuonjezera apo, mankhwala osokoneza bongo Harvoni ndi Solvadi, ma DAA omwe amalembedwa kwambiri pamsika, sangathe kugwirizanitsidwa ndi Aptivus.
Chifuwa cha TB
M'madera ena a dziko lapansi, kachilombo ka HIV kamagwirizanitsa pakati pa anthu omwe ali ndi HIV. Ngakhale US ndi Europe, mlingo wa TB ndi wapamwamba kwambiri kwa anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi ndipo ndiwodziwika bwino pa matenda akuluakulu a HIV. Mankhwala awiri omwe amagwiritsidwa ntchito pochizira matenda a TB amadziwika kuti kuchepetsa mankhwala osokoneza bongo a ARV ena akamagwiritsidwa ntchito.
- Mankhwala osokoneza bongo: rifampin, rifapentine
- Sizingagwiritsidwe ntchito ndi ma ARV: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Nevirapine (rifapentine okha), Prezista, Reyataz, Selzentry (rifapentine yekha), Stocrin (rifapentine yekha), Stribild, Tivicay (rifapentine yekha), Triumeq ( rifapentine kokha), Vitekta
Pakati pa kachilombo koyambitsa matenda a HIV / TB, rifabutin imayimilira nthawi yomwe ma ARV alionse amasonyezedwa.
Zotsatira:
National Institutes of Health (NIH). "Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Rockville, Maryland.