12.07.2015 Views

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

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

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

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A <strong>Clinical</strong> <strong>Guide</strong> <strong>to</strong> <strong>Supportive</strong> <strong>and</strong> <strong>Palliative</strong> <strong>Care</strong> <strong>for</strong> <strong>HIV</strong>/<strong>AIDS</strong> • Chapter 27: Pharmacologic Interactions of <strong>Clinical</strong> SignificanceTable 27-12:26 picasDISEASE Disease STATES States<strong>and</strong> MedicationsSildenafil (Viagra)Summary of Significant Drug-Drug Interactionsin <strong>Palliative</strong> <strong>Care</strong> of <strong>HIV</strong> Disease (continued)Non-nucleoside NON-NUCLEOSIDE REVERSE ReverseTranscriptase TRANSCRIPTASE INHIBITORS Inhibi<strong>to</strong>rsDelavirdine Efavirenz Nevirapine(Rescrip<strong>to</strong>r) (Sustiva) (Viramune)Significantly ↑plasma conc. ofdrug due <strong>to</strong> a ↓ inits clearance ∴results in ↑ effectsSignificantly ↑plasma conc. ofdrug due <strong>to</strong> a ↓ inits clearance ∴results in ↑ effectsSignificantly ↑plasma conc. ofdrug due <strong>to</strong> a ↓ inits clearance ∴results in ↑ effectsChemotherapy Agents↑ risk <strong>for</strong> <strong>to</strong>xicitywith e<strong>to</strong>poside &paclitaxelILLEGAL DRUGSEcstasyCocaineLSDMost dangerouseffects due <strong>to</strong> thebreak down of thedrugLess dangerouseffectsLess dangerouseffectsAvoid in patients with family or personal his<strong>to</strong>ry of depressionor anxiety disorders because the drug damages the sero<strong>to</strong>ninneurons.Doubles the speed at which the virus reproduces∴ increases the progression of the diseaseNo knowninteractionsNo knowninteractionsNo knowninteractionsDISEASE Disease STATES States<strong>and</strong> MedicationsGASTROINTESTINALAntacids, Pro<strong>to</strong>n PumpInhibi<strong>to</strong>rs <strong>and</strong> H 2AntagonistsNucleoside NUCLEOSIDE REVERSE ReverseTranscriptase TRANSCRIPTASE INHIBITORS Inhibi<strong>to</strong>rsZidovudine Didanosine Abacavir(Retrovir) (Videx) (Ziagen)↑ the absorption ofARTCENTRAL NERVOUS SYSTEMAntipsychotics↑ serum conc. ofthorazine & chloralhydrateXXVIIU.S. Department of Health <strong>and</strong> Human Services • Health Resources <strong>and</strong> Services Administration • <strong>HIV</strong>/<strong>AIDS</strong> Bureau 581

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