The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 27: Pharmacologic Interactions of Clinical SignificanceTable 27-12:Summary of Significant Drug-Drug Interactionsin Palliative Care of HIV Disease (continued)Disease Statesand MedicationsProtease InhibitorsRitonavir Indinavir Nelfinavir(Norvir) (Crixivan) (Viracept)CENTRAL NERVOUS SYSTEMAntipsychoticsAntidepressantsBenzodiazepines↑ plasma conc. ofpimozide↑ plasma conc. ofbuproprion,nefazodone, SSRIs,& tricyclics↑ plasma conc. ofdiazepam &flurazepam↑↓ metabolism ofalprazolamExtreme sedation &respiratorydepression withclorazepate,estazolam &zolpidemProlong sedation ofmidazolam &triazolam due tonarrow therapeuticindexProlong sedation ofmidazolam &triazolam due tonarrow therapeuticindexANTIEPILEPTIC AND NEUROLEPTIC AGENTSCarbamazepine,phenytoin, &phenobarbital*ClozapineDivalproex andlamotrigine↓ plasma conc. ofthese drugs andmonitor blood levelsto assure therapeuticgoals↑ plasma conc.∴results in serioustoxicities such asrespiratorydepression, ortachycardia↓ plasma conc. ofthese drugs↓ plasma conc. ofphenytoin &phenobarbital ∴results in anineffectiveness ofthe drugs574U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau
A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 27: Pharmacologic Interactions of Clinical SignificanceTable 27-12:26 picasDisease Statesand MedicationsClonazepam, perphenazine,risperidone, andthioridazineSummary of Significant Drug-Drug Interactionsin Palliative Care of HIV Disease (continued)Protease InhibitorsRitonavir Indinavir Nelfinavir(Norvir) (Crixivan) (Viracept)↑ plasma conc. ofthese drugs*Inducers such as phenytoin, phenobarbital, and carbamazepines cancause a reduction in plasma conc. of PIsANALGESICSNSAIDSOpiatesErgotamines↑ plasma conc. ofPiroxicam↑ plasma conc. ofmeperidine,propoxyphene,fentanyl, &tramadol ∴↓ dose↑ in plasma conc.∴results in seriousor life-threateningarrhythmias↑ in plasma conc.∴results in seriousor life-threateningarrhythmias↑ in plasma conc.∴results in seriousor life-threateningarrhythmiasMethadone↑ plasma conc. dueto a ↓ in itsmetabolism↑ plasma conc. dueto a ↓ in itsmetabolism↑ plasma conc. dueto a ↓ in itsmetabolism↓ plasma conc. dueto displacementfrom PPB and ↑ inits metabolismOTHER MEDICATIONSRifampin and rifabutinRifampin ↓ plasmaconc. of PIsSignificantly ↑ theplasma conc. ofrifabutinSignificantly ↑ theplasma conc. ofrifabutinSignificantly ↑ theplasma conc. ofrifabutin↓ clearance ofrifabutin↓ clearance ofrifabutinRifampin ↓ plasmaconc. of PIsRifampin ↓ plasmaconc. of PIsKetoconazole anditraconazole↑ plasma conc. ofPIs↑ plasma conc. ofPIs↑ plasma conc. ofPIsXXVIIU.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 575
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DedicationA Clinical Guide to Suppo
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Lynn A Jansen, RN, PhDAssistant Res
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TABLE OF CONTENTSPart IChapter 1Cha
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IChapter 1.26 picasHIV and Palliati
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IA Clinical Guide to Supportive and
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A Clinical Guide to Supportive and
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IIIChapter 3.Assessment of Physical
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Chapter 6.26 picasPulmonary Symptom
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Chapter 8.26 picasOral ProblemsDavi
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Chapter 9.26 picasDermatologic Prob
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Chapter 10.26 picasPsychiatric Prob
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Chapter 11.26 picas Substance Use P
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Chapter 14.26 picasCulture and Care
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Chapter 15.26 picasSpecial Populati
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Chapter 17.26 picasEthical IssuesLy
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Chapter 18.26 picasLegal and Financ
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Chapter 19.Palliative 26 picas Care
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Chapter 21.26 picas Patient-Clinici
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Chapter 25.26 picas Prevention of S
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Chapter 26.26 picasResourcesMagda B
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