Ukusetyenziswa okudibeneyo kunokunyusa imiPhumela ecaleni, ukunciphisa ukuphumelela kweziyobisi
Ukusebenzisana kwezidakamizwa kuyaqhelekileyo xa kunamanye amayeza anqunywe eceleni kwelinye. Kwiimeko ezininzi, ukusebenzisana akudingi ukuba umntu amise esinye isilwanyana okanye esinye. Ngokuphindaphindiweyo, ama-dosage anganyuswa, ayancipha okanye ahlasele ukuze aphephe ukutywala okanye ukuqinisekisa ukuba iziyobisi zigcina ubuchule bazo. Ngamanye amaxesha, indawo engafakelwayo ingenziwa kunye ne-ejenti elinganayo.
Nangona kunjalo, xa kuziwa kwii- antiretrovirals ze-HIV (ii-ARVs) , kukho inamba yemithi yonyango engakwazi ukuphazamisa ngokuthe ngqo isenzo seziyobisi. Benza oko ngokuguqula i-pharmacodynamics (ukuba isilwanyana sisebenza njani) okanye i-pharmacokinetics (ukuba isilwanyana sidlula njani emzimbeni) enye okanye ngaphezulu kwe-ARVs yakho.
Oku kunokuba yingxaki enkulu. Xa izidakamizwa i-pharmacodynamics iguqulwa, inokunyusa okanye iyanciphise umbane omnye okanye zombini iziyobisi zakho, okanye ukwandisa iziphumo ezinobungozi ezingenakubekezeleka, nokuba ziyingozi, amanqanaba.
Ngenye indlela, xa izidakamizwa ze-drug pharmacokinetics ziphazamiseka, zinokuchaphazela ngendlela eyiyo ngayo isicatshulwa esikhatywayo okanye sisetyenziswe ngumzimba. Kwezinye iimeko, esinye isilwanyana singashukumisa i-enzyme ephazamisa omnye umphumo okanye ukunciphisa ukugqithiswa kwesilwanyana ukwenzela ukuba yakha ezintsheni okanye esibindi.
Zonke ezi ziganeko onokufuna ukuziphepha ukuba unyango lwe-HIV .
Ngaphandle kwefuthe " elibonakalayo " lezinto ezinobuthi beziyobisi, umphumo " ongabonakaliyo " wempembelelo yomsebenzi weziyobisi ungancinci nje. Ukuba oko kwenzeka, isilwanyana sakho se-HIV siya kuba nzima kakhulu ukukhusela intsholongwane, oko kungakhokelela ekuphuhlisweni kwexesha lamandulo, kwaye ekugqibeleni, ukungaphumeleli- kwaye kungekhona nje kwi-arhente enye kodwa ngokuqhelekileyo kwiklasi elipheleleyo leziyobisi.
Ngaloo nto, kubalulekile ukuba uhlale unika ugqirha wakho we-HIV kwanoma yiyiphi imichiza onokuyithatha, nokuba ingaba iyalelwe okanye ayikho.
Iziyobisi ezichasene nokusetyenziswa kweNtsholongwane kaGawulayo
Isicatshulwa sithathwa ngokungqiniswanga ukuba sinokulimaza. Kwiindawo zonyango lwe-HIV, kukho iindidi ezithile zamachiza apho, xa zithathwa ngama-ARVs, zinokukwazi ukwenza oku. Ziquka imishanguzo yemihla ngemihla esetyenziselwa ukuphatha i-cholesterol ephezulu kunye neemeko zentliziyo, kunye nezokwelapha eziqeshwe ukuphatha izifo ezihambisana ne-HIV.
Ziyakwazi ukuphulwa ngokukhawuleza, ngale ndlela:
Izidakamizwa zokuLawula i-Lipid
Izidakamizwa zeStatin zisetyenziselwa ukunciphisa amazinga e-cholesterol kwaye zisebenza ngokuthintela i-enzyme yesibindi ejongene nokuvelisa i-cholesterol.
Nangona uninzi lwamayeza athandwayo alunqatshelwe ukuba lusebenziswe ngama-ARVs (okanye lufuna ukulungiswa kwesazi elula), ezimbini kufuneka zikhunjulwe njengoko ukusetyenziswa kwazo kudibeneyo kunokunyusa iziphumo ezinobungozi bezidakamizwa ze-statin, kubandakanywa umngcipheko weentlungu zesifo se-muscle okanye ubuthathaka (imopathy) okanye ukuphazamiseka okukhulu kwezicubu zomzimba ( rhabdomyolysis ).
- Iziyobisi ezingqinelanayo: Altoprev (lovastatin), iMevacor (lovastatin), iZocor (simvastatin)
- Ayinakusetyenziswa ngama-ARVs alandelayo: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Iipilisi zeCardia
Ezinye zezilwanyana ezisetyenziselwa ukunyaniseka kwentliziyo ( arrhythmia ) zichasene ukuze zisebenzise ngee-ARVs ezithile njengoko zinokunyusa amathuba okuvuvukala kwesibindi okanye umonakalo. Ezi zimbini ezichaphazelekayo ngokubanzi zibandakanya:
- Iziyobisi ezingqinelanayo: i-Multaq (dronederone), iRenexa (ranolazine)
- Ayinakusetyenziswa ngala ma ARVs alandelayo: Aptivus, Invirase, Genvoya (Renexa kuphela), Kaletra, Lexiva, Prezista, Reyataz, Stribild (Renexa kuphela), Vitekta (Renexa kuphela)
Ezinye iimichiza zonyango ziyaziwa ukuba zinokufanayo kwaye zifanele zigwenywe xa zisetyenziswe nge-ARVs ye-protease inhibitor-class. Ziquka i-Cordarone, i-Nexterone, i-Pacerone, i-Quinaglute, i-Quinidexm Rythmol, i-Tambocor, ne-Tikosyn, kunye ne-anti-tachycardial drug lidocaine.
I-Anti-Epilepsy
Ngokuqhelekileyo, iziyobisi ezisetyenziselwa ukwelapha isithuthwane zibhekwa zikhuselekile ukusetyenziswa kunye neyeza zakho zonyango. Kodwa ke ezimbalwa zichaphazela ngqo izilwanyana ze-Intelence (etravirine) ngokukhuphisana neendlela ezifanayo ze-biochemical when co-administered. Ngokwenza njalo, kunokunciphisa kakhulu i-Intelence kwigazi, ukunciphisa ukusebenza kwayo.
- Iziyobisi eziphambeneyo: i-carbamazepine, phenobarbital, phenytoin
- Ayikwazi ukusetyenziswa kwezi ARVs ezilandelayo: Intelence
Izidakamizwa kunye nezinye izidakamizwa ze-Neurologic
Inani lezinto eziqhelekileyo-kunye nezidakamizwa ezilawulwayo ezimbini ezisetyenziselwa ukhathaza i-schizophrenia kunye ne-Tourette's syndrome-nayo iyaziwa ukuba ithintela amanqanaba okugxininisa ama-ARV athile.
- Iziyobisi ezingqinelanayo: iLatuda (lurasidone), i-Versed (midazolam), i-Orap (i-pimozide), i-Halcion (iriazolam)
- Ayinakusetyenziswa ngama-ARVs alandelayo: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
I-Hepatitis C Iziyobisi
Izinga lokutheleleka nge-hepatitis C kubantu abanentsholongwane ye-HIV banokugijima ngokuphakamileyo njenge-20-30% kwiindawo zaseMntla Melika naseYurophu. Ngezidakamizwa ze-hepatitis C ezitsha (ezibizwa ngokuba yi- anti-virus, okanye ii-DAA ) ezithembisa ukunyanga kwamazinga angaphezu kwe-90% kwezinye iindawo, kunikwa ingqwalasela enkulu kubantu abachaphazelekayo ngaphambili nangaphezulu nangaphezulu kwiminyaka edlulileyo.
Nangona kunjalo, inani le-DAA alinakusetyenziswa ngama-ARVs athile, ngenxa yezona zinto zikhuphisana nezenzo zeziyobisi ezinokunyusa okanye ukunciphisa i-drug pharmacokinetics.
- Amachiza angqinelanayo: Olysio, Victrelis, Viekira Pak
- Ayinakusetyenziswa ngala ma ARVs alandelayo: Aptivus, Edurant (Viekira Pak kuphela) Intelence, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz (i-Olysio kunye ne-Victrelis kuphela), i-Selzentry (i-Viekira Pak kuphela), i-Stribild, i-Sustiva, i-Viramune, iVitekta
Ukongezelela, iziyobisi iHarvoni neSolvadi, ezimbini zeDAA ezimiselweyo kwiimarike, azikwazi ukulawulwa kunye ne-Aptivus.
Isifo seTyhuseki
Kwimimandla ethile yehlabathi, isifo sofuba sisifo esifanayo phakathi kwabantu abane-HIV. Ngaphandle kwe-US kunye ne-Yurophu, izinga le-TB liphezulu kakhulu kubantu abane-HIV kunye nesimo esifanayo kwisifo se-HIV esiphezulu. Izibini zamachiza eziqhelekileyo ezisetyenziselwa ukunyanga ukusuleleka kwe-TB nazo ziyaziwa ngokunciphisa ukuxilongwa kweziyobisi ezithile ze-ARV xa zilawulwa ngokufanelekileyo.
- Iziyobisi ezingqinelanayo: i-rifampin, i-rifapentine
- Ayinakusetyenziswa ngala ma ARVs alandelayo: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Nevirapine (rifapentine kuphela), Prezista, Reyataz, Selfententry (rifapentine kuphela), Stocrin (rifapentine kuphela), Stribild, Tivicay (rifapentine kuphela), Triumeq ( i-rifapentine kuphela), iVitekta
Kwiimeko ze-HIV kunye ne-TB, usuhlobo lwe-rifabutin lugqithiselwa ngokutsha xa kukho nayiphi na i-ARVs engabonakaliyo.
Imithombo:
Iziko zeSizwe zezeMpilo (NIH). "Izikhokelo zokusetyenziswa kwee-Antiretroviral Agents kwi-HIV-1-abadala nabachaphazelekayo." Rockville, Maryland.