Ukuncitshiswa okunciphisisiweyo kudibaniswe nezidakamizwa ezidumileyo kunye nezibonelelo
Ukusebenzisana kweziyobisi ngezidakamizwa kukuxhalabisayo ngokuqhelekileyo kubantu abane- HIV kunye noogqirha babo, kunyango ukuba umntu ubona iingcali ezininzi kwiinkalo ezinxulumene ne-HIV. Nangona ii-pharmacy zihlala zibona oku kuthethwa ngazo xa imimiselo izaliswe, kukho imveliso eqhelekileyo ekwazi ukuhamba ngokukhawuleza phantsi kwe-radar yekhemisti kwaye, ukuba ithathwa, iyanciphise kakhulu ukusetyenziswa kweziyobisi zakho ze- antiretroviral (ii-ARVs).
Bangakwazi ukwenza oko okanye ngokuphazamisa ukutshatyalaliswa kwee-ARV ezithile, ukuvimbela ama-enzyme okufunekayo ukulungelelanisa izidakamizwa, okanye kubangele ukwanda okungafunekiyo okanye ukunciphisa amanqanaba okugonywa kwamachiza e-ARV. Okumangalisa kukuba, ezinye zeemveliso zimihla ngemihla, izinto ezingaphezulu kwee-counter, kanti ezinye izigulane okanye izigulane ezingekho mthethweni awunakucinga kabini malunga nokuthatha phantsi kweemeko eziqhelekileyo.
Ukuba uqala ukuqala unyango lwe-antiretroviral , qiniseka ukuba ucebisa ugqirha wakho kwanaliphi na isicatshulwa okanye ukuxhaswa-kuquka ukuzaliswa kwemithi okanye ukuphelisa-ungathabatha. Ukuba sele usele kunyango kwaye uthatha nayiphi na imveliso elandelayo ingqinelwanga kwi-regimen yakho ethile, thetha nodokotela wakho. Unokuxubusha ngokuphinda uhlaziye ishedyuli ye-drug dosing schedule, ukumisa umkhiqizo onqatshelwe, okanye ukutshintsha ii-ARVs, ukuba kufuneka.
Iibhentshi ze-Antacids kunye nokuQiniswa
I-Magnesium kunye ne-aluminium ene-antacids (njengeMaalox, i-Mylanta, i-Milk yeMagnesia, i-Tums) inokunciphisa i-acids esiswini kwizinga elinjengokuba liphazamise ngokungathí sina ukutshatyalaliswa kwee-ARV ezithile.
Ama-antacids afana nalawa asebenzisa iipropati zabo ezingaphelelanga ixesha elifutshane kwaye ngokubanzi zilawulwa iiyure ezimbini ukuya kweyure ngaphambi okanye emva kwesazi.
Ama-ARVs amaninzi achaphazelekayo ngamachiza afaka:
- I-Aptivus (tipranavir) -yifake i-antiacacid iiyure ezintandathu ngaphambi kweeyure ezimbini okanye emva kweeyure ezimbini
- I-Edurant (rilpivirine) -yifake i-antiacacid iiyure ezimbini ngaphambi kweeyure ezine okanye emva kweeyure ezine
- I-Rescriptor (delavirdine) -yifake i-antiacacid ngeyure enye phambi kweyure okanye emva kweeyure ezimbini
- I-Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) -yifake i-antiacacid iiyure ezimbini ngaphambi okanye emva
- I-Tivicay (dolutegravir) -yifake i-antiacacid iiyure ezintandathu ngaphambi kweyure okanye emva kweeyure ezimbini
- I-Triumeq (dolutegravir + ziagen + i-epivir) -yifake i-antiacacid iiyure ezintandathu ngaphambi kweyure okanye ezimbini emva kweeyure
Ezinye izidakamizwa zokunciphisa i-acid ezifana neproton pump inhibitors (umz., I-Nexium, i-Prilosec, i-Losec, i-Prevacid) inomsebenzi omude kwaye inokunciphisa ukutyathwa kweReyataz (atazanavir) kunye ne-Edurant (rilpivirine) ngama-78 ekhulwini kunye no-40 pesenti, ngokulandelanayo. Ngaloo ndlela, ukusetyenziswa kweproton pump inhibitors kunqatshelwe ukusetyenziswa kwezi ARVs ezithile kunye nokunyamekela okhethekileyo kufuneka kuthathwe xa usebenzisa abaphikisi be-H2 njengeTagamet neZantac, kunye.
Qhagamshelana nogqirha wakho ukuba uxoxe ngokuguqulwa kwe-dosing kunye / okanye imithi xa usebenzisa nayiphi na enye yalezi zigaba zamachiza neReyataz okanye i-Edurant.
ISt John's Wort
I-Hypericum perforatum , eyaziwa ngokugqithiseleyo kwiSt John's Wort, isityalo esivumbileyo sithandwa ngabanye ukuba sine-anti-inflammatory, antitiviral, anti-depressant, kunye ne-antioxidant. Nangona olunye uhlalutyo oluphezulu lwe-meta olwenziwa ngo-2008 lucebise ukuba imveliso yamachiza inemisebenzi kwonyango lokudakumba okukhulu, ezinye iipropati ezibikwayo zihlala zingqubuzana nobungqina obuncinci bokuxhasa amaninzi amabango.
Xa isetyenziselwa ukuncoma kwi-antiretroviral therapy, iSt. John's Wort inokuchaphazela umsebenzi we-enzyme CYP450 3A4, esebenza ngama-molecules amachiza e-oxidizing ukuze anqunywe emzimbeni. Ukuba oko kwenzeka, ukuxilongwa kweziyobisi ze-serum ye-HIV protease inhibitors (i-PIs) kunye ne- non-nucleoside reverse transcriptase inhibitors (i-NNRTIs) inokuncitshiswa kakhulu, ngamanye amaxesha ibe ngama-82 ekhulwini. Ngaloo ndlela, iSt. John's Wort akufanele ithathelwe ngama-ARVs alandelayo:
- Aptivus (tipranavir)
- I-Crixivan (indinavir)
- Edurant (rilpivirine)
- Intelence (etravirine)
- Invirase (saquinavir)
- Kaletra (lopinavir + ritonavir)
- Lexiva (fosamprenavir)
- Norvir (ritonavir)
- Prezista (darunavir)
- Umbhalisi (delavirdine)
- Reyataz (atazanavir)
- Stribild (echaphazela i-elvitegravir kunye neyobisi ngamacilisi enhlanganisela)
- Sustiva (efavirenz) okanye i-Atripla (inkunkuma edibeneyo ene efavirenz)
- IViracept (nelfinavir)
- I-Viramune (i-nevirapine)
Igalikhi
Iigrafu zikholelwa ukuba ezinye iipropati ezinokuthi zithinte okanye ziphathe isibalo sezifo, ezibandayo kunye nokunyuswa kwengcinezelo yegazi kwi-coronary disease and cancer. Ezinye izigunyazi zibonisa ukuba ezi zakhiwo ziyimichiza elinegalikhi ebizwa ngokuba yi-allicin.
Nangona uphando luye lwabonisa iingenelo ezinokwenzeka zokuxhaswa kwegalikhi-mhlawumbi kwipowder, ukukhupha, i-capsule, okanye ifomati-kungabikho iingxaki ezinkulu xa kulawulwa ngokubambisana neprotease-inhibitor-class class drug Invirase (saquinavir). Ngokuphazamisa i-CYP450 3A4 emanzini, isongezelelo segilisi sinokunciphisa uxinzelelo lwe-Invirase serum nge-54 ekhulwini. Nangona emva kokuphelisa ukusetyenziswa kwegalikhi, uphando lubonise ukuba iimpembelelo ezinokunyanzelisa zingaqhubeka iintsuku kunye neveki emva koko.
Olunye uphando luye lwaphakamisa ukuba igalikhi inokuchaphazela ukungafumaneki kwamanye ama-PIs kunye nee-NNRTI, nangona kungekho zichaso ezithile zokusetyenziswa kwaye akukho ziphakamiso malunga nokuba zininzi okanye ziphi iindidi zegalikhi (kubandakanywa i-eluhlaza) zifanelekile okanye zingalunganga. Ngaloo ndlela, ukuba uthatha igallic nangaluphi na uhlobo njengesongezelelo sempilo, ucebise ukuba uvumele ugqirha wakho olaphayo.
> Imithombo:
> Isebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu (DHHS). "Izikhokelo zokusetyenziswa kwee-Antiretroviral Agents kwi-HIV-1-abadala nabachaphazelekayo." EWashington, DC; NgoJanuwari 19, 2015.
> Linde, K .; Berner, M; kunye noKriston, uL. "Intsimbi yaseSt John yokudakumba okukhulu." I-Cochrane Database yeeNkqubo eziPhezulu . Oktobha 8, 2008; (4): CD000448. i-doi: 10.1002 / 14651858.CD000448.pub3.
> Piscitelli, S .; Burstein, A .; Welden, N .; okqhubekayo. "Impembelelo yee-garlic supplements kwi-pharmacokinetics ye-saquinavir." Izifo ezithathelwanayo zonyango; 34 (2): 234-238.