8452Southwestern Oklahoma State University College of Pharmacy, Weatherford, OK, USA.
J Pharm Pract. 2022 Dec;35(6):952-962. doi: 10.1177/08971900211000692. Epub 2021 Apr 16.
The extended lifespan of people living with human immunodeficiency (HIV) and acquired immune deficiency syndrome (AIDS) (PLWHA) has increased the potential for ICU admissions unrelated to HIV infection. The objective of this review is to guide continued management of antiretroviral therapy (ART) recommended by the United States Department of Health and Human Services Antiretroviral Guidelines in critically ill adult PLWHA admitted to the intensive care unit (ICU). Pharmacists are uniquely positioned to mitigate these concerns, including whether to continue ART in the ICU, drug interactions with common ICU drugs, renal and hepatic dosing considerations, and alternative methods of administration. Despite these concerns, the original ART regimen should be continued or modified in conjunction with an HIV specialist. Discontinuation greater than 2 weeks should be avoided due to potential resistance and future HIV treatment failure. Use of ART in critically ill patients presents challenges that pharmacists are best equipped to address to prevent adverse events, administration errors, and treatment failure.
随着感染人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合征（AIDS）（PLWHA）人群的寿命延长，与 HIV 感染无关的 ICU 入院人数也有所增加。本综述的目的是指导继续管理美国卫生与公众服务部抗逆转录病毒指南推荐的抗逆转录病毒疗法（ART），以治疗入住重症监护病房（ICU）的成年 PLWHA。药剂师具有独特的优势，可以减轻这些担忧，包括在 ICU 中是否继续进行 ART、与常见 ICU 药物的药物相互作用、肾和肝剂量考虑因素以及替代给药方法。尽管存在这些担忧，但应继续使用原始的 ART 方案，或与 HIV 专家一起进行调整。由于可能产生耐药性和未来 HIV 治疗失败，应避免停药超过 2 周。在危重病患者中使用 ART 带来了挑战，药剂师最适合解决这些问题，以防止不良事件、给药错误和治疗失败。
