Tseng A L, Foisy M M
Toronto Hospital, Ontario, Canada.
Ann Pharmacother. 1997 Sep;31(9):1040-58. doi: 10.1177/106002809703100915.
To provide a complication of relevant information on drug interactions to assist healthcare practitioners in managing complex HIV-related pharmacotherapy.
Information was retrieved via a MEDLINE search (January 1966-December 1996) using MeSH headings "human immunodeficiency virus," "drug interactions," and names of medications commonly prescribed for the management of HIV infection and related opportunistic infections. Abstracts of international and national conferences, review articles, textbooks, and references of all articles were also searched.
All literature on pharmacokinetic or pharmacodynamic interactions was considered for inclusion. Pertinent information, as assessed by the authors, was selected and summarized for discussion.
Drug disposition and/or pharmacologic effect may be affected either by HIV-related physiologic changes or by the presence of concomitant drug therapy. Modifications in drug selection, dosage, dosing regimen, or route of administration may be needed to avoid or manage drug-disease, drug-drug, or drug-food interactions. Management options may depend on the mechanism and the clinical significance of the interaction, the availability of therapeutic alternatives, patient convenience, and cost restrictions. In the absence of specific data, consideration of pharmacokinetic and pharmacodynamic characteristics to assist practitioners in predicting the likelihood of possible interactions was included.
A comprehensive table of clinically significant drug interactions is provided. Drug interaction principles and practical management strategies are also discussed.
The potential for drug interactions is extremely common, given the increasing complexity of managing patients infected with HIV. To avoid compromising therapeutic efficacy or increasing drug toxicity, practitioners need to be aware of potential interactions and are encouraged to use a systematic approach when managing patient drug therapy.
提供有关药物相互作用的相关信息，以协助医疗保健从业者管理复杂的与人类免疫缺陷病毒（HIV）相关的药物治疗。
通过医学文献数据库（MEDLINE）检索（1966年1月至1996年12月），使用医学主题词“人类免疫缺陷病毒”、“药物相互作用”以及常用于治疗HIV感染和相关机会性感染的药物名称。还检索了国际和国内会议的摘要、综述文章、教科书以及所有文章的参考文献。
纳入所有关于药代动力学或药效学相互作用的文献。作者评估的相关信息被挑选并总结用于讨论。
HIV相关的生理变化或同时进行的药物治疗可能会影响药物的处置和/或药理作用。可能需要调整药物选择、剂量、给药方案或给药途径，以避免或处理药物 - 疾病、药物 - 药物或药物 - 食物相互作用。管理方案可能取决于相互作用的机制和临床意义、治疗替代方案的可用性、患者便利性以及成本限制。在缺乏具体数据的情况下，考虑药代动力学和药效学特征以帮助从业者预测可能相互作用的可能性。
提供了一份具有临床意义的药物相互作用综合表格。还讨论了药物相互作用的原则和实际管理策略。
鉴于管理HIV感染患者的复杂性不断增加，药物相互作用的可能性极为常见。为避免损害治疗效果或增加药物毒性，从业者需要意识到潜在的相互作用，并在管理患者药物治疗时采用系统的方法。
