Pharmacology of Antiretroviral Agents An Emphasis on Drug ...

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Risk Factors for Drug Interactions AmongOlder Adults with HIV• Polypharmacy• ART Adverse effects more problematic in olderadults• Adding rx’s to manage side effects• Discomfort/Pain management• Other conditions: depression, erectiledysfunction, other conditions above• Use <strong>of</strong> natural and OTC products• Use <strong>of</strong> multiple pharmacies• Difficult to perform medication reconciliation• Adherence• Drug interaction screening challenging
Risk Factors for Drug Interactions AmongOlder Adults with HIV• Pharmacokinetic changes• Comorbidities• Cardiovascular disease, renal failure, diabetes, bone fractures aremore prevalent among HIV-infected individuals• Polypharmacy• Use <strong>of</strong> multiple pharmacies• Use <strong>of</strong> over-the-counter and natural products• Adherence Issues and concerns• Pill burden and fatigue• Hospital admissions
Page 1 and 2: PHARMACOLOGY OFANTIRETROVIRAL AGENT
Page 3 and 4: Introduction- Patient Case• SY is
Page 5 and 6: 1. Centers for Disease Control and
Page 7 and 8: 3. Luther VP, Wilken AL. HIV Infect
Page 9 and 10: Incident cases in 2009 approx 48,00
Page 11 and 12: ANTIRETROVIRALTHERAPYPharma
Page 13 and 14: 7. Pomerantz RJ and Horn DL. 20 Yea
Page 15 and 16: Step 1: Binding & Attachment9. AIDS
Page 17 and 18: Enfuvirtide- Mechanism of</
Page 19 and 20: NRTI Mechanism of
Page 21 and 22: Integration12. Pommier Y, Johnson A
Page 23 and 24: Protease Inhibitors11. Brunton, L.
Page 25 and 26: When to Start ART in Older Adults
Page 27 and 28: OLDER ADULTSPharmacokineticsAdverse
Page 29 and 30: Drug MetabolismCytochrome P450 Enzy
Page 31 and 32: P-glycoprotein• Efflux transporte
Page 33 and 34: Risk Factors for Drug Interactions
Page 39: 19. Marzolini C, Back D, Weber R, e
Page 45 and 46: 21. Rastegar DA, Knight AM, and Mon
Page 47 and 48: RECOGNIZINGPREVENTABLE ADVERSEEVENT
Page 49 and 50: Preventable Adverse Events:CCR5 Inh
Page 51 and 52: Preventable Adverse EventsNNRTIs•
Page 53 and 54: Pharmacoenhancers• Cobicistat•
Page 55 and 56: Drug Interactions Involving Proteas
Page 57 and 58: Pharmacokinetic Interactions withPr
Page 59 and 60: HMG-CoA Reductase Inhibitors andPro
Page 61 and 62: Lipid-Lowering Agents</stro
Page 63 and 64: Neuropsychiatric• An</str
Page 65 and 66: Other P450 interactions•
Page 67 and 68: PREVENTING DRUGINTERACTIONS
Page 69 and 70: Back to our patient case…• SY i
Page 71 and 72: Patient Case• Drug Interactions
Page 73 and 74: References1. Centers for Disease Co

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