AIDS Clinical Trials Group Pharmacology Specialty Laboratory, New York State Center of Excellence in Bioinformatics and Life Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA.
Center for Human Experimental Therapeutics, University of Rochester, Rochester, NY, USA.
Clin Pharmacol Drug Dev. 2017 Mar;6(2):135-139. doi: 10.1002/cpdd.313.
There are many factors that can affect the pharmacokinetics (PK) of drugs. Pathophysiological changes from disease states can alter the mechanisms that control the PK of antiretrovirals (ARVs), direct-acting antivirals (DAAs), and addiction treatment medications. Drug-drug interaction pathways of certain ARVs and DAAs can be very complex, with agents being substrates, inhibitors, or inducers of multiple metabolic and transporter pathways. Buprenorphine and methadone may be used in HIV- and hepatitis C virus (HCV)-infected patients and may also be affected by drug interactions. Current research is focused on novel PK analyses, which aim to describe the PK of agents within organs that host the infection of interest, such as within hepatocytes during treatment for HCV. Modeling techniques allow for the prediction of drug PK in specific organs and the plasma compartment. This review will provide a summary of these areas while exploring PK considerations for ARVs, DAAs, and addiction treatment medications.
有许多因素会影响药物的药代动力学(PK)。疾病状态引起的病理生理变化会改变控制抗逆转录病毒(ARV)、直接作用抗病毒药物(DAA)和成瘾治疗药物 PK 的机制。某些 ARV 和 DAA 的药物-药物相互作用途径可能非常复杂,药物可能是多种代谢和转运途径的底物、抑制剂或诱导剂。丁丙诺啡和美沙酮可用于感染 HIV 和丙型肝炎病毒(HCV)的患者,也可能受到药物相互作用的影响。目前的研究重点是新型 PK 分析,旨在描述在感染相关器官(如在治疗 HCV 期间的肝细胞内)中药物的 PK。建模技术可用于预测特定器官和血浆隔室中的药物 PK。本综述将在探讨 ARV、DAA 和成瘾治疗药物 PK 注意事项的同时,对这些领域进行总结。