Clinical pharmacokinetics of antiretroviral drugs in older persons.
Clinical pharmacokinetics of antiretroviral drugs in older persons.
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DOI：
10.1517/17425255.2013.781153
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发表时间：
2013-05
影响因子：
4.3
通讯作者：
Anderson PL
中科院分区：
文献类型：
--
作者：
Schoen JC;Erlandson KM;Anderson PL
Combination antiretroviral therapy has enabled HIV infected persons to reach older ages in high numbers. Hepatic and renal changes that normally occur with advancing age occur earlier and with higher incidence in HIV-infected individuals. A limited number of prospective controlled studies have demonstrated small reductions (17% to 41%) in lopinavir, atazanavir, and lamivudine clearance in older versus younger adults. A much larger number of retrospective studies in adults (age range ~20 to 60 years), including all antiretroviral drugs, have evaluated age as a covariate for pharmacokinetics. Most studies did not detect substantial associations between drug exposures and age. This review summarizes antiretroviral drug pharmacokinetics in older persons. The authors review articles from PubMed (search terms: elderly, antiretroviral, pharmacokinetics) in addition to the bibliographies of those selected. The evidence to date does not support major pharmacokinetic changes in adults between ~20 and 60 years of age. However, additional prospective, well-controlled studies are needed in more persons > 60 years, including those with frailty and comorbidities, with assessment of unbound drug clearance, and incorporation of adherence, pharmacogenetics, and concomitant medications. Until then, guidelines for drug-drug interactions and dosing in renal and hepatic impairment should be followed in older HIV infected individuals.
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影响因子：
3.4
作者：
Burger, D;van der Heiden, I;van Schaik, R
通讯作者：
van Schaik, R
影响因子：
1.5
作者：
Crawford, Keith W.;Spritzler, John;Flexner, Charles
通讯作者：
Flexner, Charles
影响因子：
3.4
作者：
Crommentuyn, KML;Kappelhoff, BS;Beijnen, JH
通讯作者：
Beijnen, JH
影响因子：
2.9
作者：
Bertrand, Julie;Treluyer, Jean-Marc;Mentre, France
通讯作者：
Mentre, France
影响因子：
4.9
作者：
Adams, JM;Shelton, MJ;Morse, GD
通讯作者：
Morse, GD