Significant Interactions with New Antiretrovirals and Psychotropic Drugs
Significant Interactions with New Antiretrovirals and Psychotropic Drugs
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与新型抗逆转录病毒药物和精神药物的显着相互作用
DOI：
10.1345/aph.18240
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发表时间：
1999
影响因子：
3
通讯作者：
M. Foisy
中科院分区：
文献类型：
--
作者：
A. Tseng;M. Foisy
目的：为管理复杂的艾滋病毒相关药物治疗的医疗保健从业人员提供有关抗逆转录病毒相互作用和精神药物的最新信息。数据来源：通过 MEDLINE 搜索（1966 年 1 月至 1998 年 9 月）检索信息，使用 MeSH 标题人类免疫缺陷病毒、药物相互作用、精神病学、精神药物、精神疾病以及治疗 HIV 感染的常用药物名称。还检索了国际和国内会议的摘要（截至 1999 年 2 月）、评论文章、教科书以及所有文章的参考文献。研究选择和数据提取：考虑纳入有关药代动力学相互作用的文献。选择并总结了相关信息以供讨论。在缺乏具体数据的情况下，考虑药代动力学和药效学特性，以预测潜在药物相互作用的可能性。数据综合：所有蛋白酶抑制剂和非核苷逆转录酶抑制剂都是细胞色素P450系统的底物，并具有酶抑制和/或诱导特性。精神药物也具有类似的代谢特征，并且可能与抗逆转录病毒药物相互作用。可能需要修改药物选择、剂量或给药方案，以确保足够的抗逆转录病毒浓度，从而最大限度地降低病毒抑制不完全和/或产生耐药性的风险。在缺乏具体数据的情况下，考虑代谢特征可能有助于从业者预测可能发生相互作用的可能性。结果：回顾了抗逆转录病毒药物相互作用的发生率和影响。还讨论了实用的管理策略。提供了与抗逆转录病毒组合和精神药物的临床显着相互作用的综合表格。结论：鉴于多种药物治疗的使用越来越多，药物相互作用的可能性非常高。药物相互作用可能会导致不良后果，包括低于治疗药物浓度和抗逆转录病毒耐药性风险。在管理与复杂的抗逆转录病毒疗法的相互作用时，从业者需要考虑药代动力学、药理学、治疗和依从性因素。
OBJECTIVE: To provide an update on relevant antiretroviral interactions and psychotropic medications for healthcare practitioners managing complex HIV-related pharmacotherapy. DATA SOURCES: Information was retrieved via a MEDLINE search (January 1966–September 1998) using MeSH headings human immunodeficiency virus, drug interactions, psychiatry, psychotropics, psychiatric illness, and names of medications commonly prescribed for the management of HIV infection. Abstracts of international and national conferences (until February 1999), review articles, textbooks, and references of all articles also were searched. STUDY SELECTION AND DATA EXTRACTION: Literature on pharmacokinetic interactions was considered for inclusion. Pertinent information was selected and summarized for discussion. In the absence of specific data, pharmacokinetic and pharmacodynamic properties were considered in order to predict the likelihood of potential drug interactions. DATA SYNTHESIS: All protease inhibitors and nonnucleoside reverse transcriptase inhibitors are substrates of the cytochrome P450 system and possess enzyme-inhibiting and/or -inducing properties. Psychotropic medications also possess similar metabolic characteristics and may interact with antiretrovirals. Modifications in drug selection, dose, or dosing regimen may be needed to ensure adequate antiretroviral concentrations and thus minimize the risk of incomplete viral suppression and/or development of drug resistance. In the absence of specific data, consideration of metabolic characteristics may assist practitioners in predicting the likelihood of possible interactions. RESULTS: The incidence and implications of antiretroviral drug interactions are reviewed. Practical management strategies are also discussed. Comprehensive tables on clinically significant interactions with antiretroviral combinations and with psychiatric medications are provided. CONCLUSIONS: Given the increasing use of multiple-drug therapy, the potential for drug interactions is extremely high. Drug interactions may lead to undesirable outcomes including subtherapeutic drug concentrations and risk of antiretroviral resistance. Practitioners need to consider pharmacokinetic, pharmacologic, therapeutic, and adherence factors when managing interactions with complex antiretroviral therapy.
影响因子：
--
作者：
Rabkin,JG;Ferrando,S
通讯作者：
Ferrando,S