Ukuncipha okunciphise kuhlanganiswe nemithi ethandwayo kanye nezithako
Ukusebenzisana kwezidakamizwa yizinto ezivame ukukhathazeka kubantu ababili abane- HIV kanye nodokotela babo, ikakhulukazi uma umuntu ebona ochwepheshe abaningi kwabanye, izinkinga ezingezona i-HIV. Ngenkathi ama-pharmacy engakwazi ukubona lezi zinkampani lapho kugcwaliswa imiyalelo, kunezinto eziningi ezivame ukuhamba ngaphansi kwe-radar yemithi futhi, uma kuthathwe, kunciphisa kakhulu ukuphumelela kwemithi yakho ye- antiretroviral (ama-ARV).
Bangenza kanjalo noma ngokuphazamisa ukungena kwemithi ethile yama-ARV, ukuvimbela ama-enzyme okudingekayo ukuze kusetshenziswe izidakamizwa, noma kubangele ukwanda okungadingeki noma ukunciphisa amazinga okuhlushwa ngama-ARV. Okumangalisa ukuthi ezinye zale mikhiqizo ziyizinsuku zonke, izinto ezingaphezu kwezinto, kanti ezinye izidakamizwa noma izidakamizwa ezingavunyelwe ungacabangi kabili ngokuthatha ngaphansi kwezimo ezijwayelekile.
Uma usuzoqala ukwelashwa kwe-antiretroviral , ngaso sonke isikhathi qiniseka ukuthi ucebisa udokotela wakho nganoma imuphi umuthi noma isilwane-okubandakanya izithako zemithi noma okuphelele-ungase uthathe. Uma usuvele ukwelashwa futhi uthatha noma iyiphi yale mikhiqizo elandelayo iphikisana nemithi yakho ye-ARV ethize, khuluma nodokotela wakho. Ungabe uxoxisana noma ubuyekeze isimiso sakho sokulinda izidakamizwa, ubeke umkhiqizo ophikisanayo, noma ushintshe ama-ARV akho, uma kudingeka.
I-Antacids Tablets and Suspensions
Ama-antacids (i-Maalox, i-Mylanta, i-Milk of Magnesia, i-Tums) ingakwazi ukunciphisa umzimba we-acids ngezinga elithile lokuphazamiseka ngokungathí sina nokutholwa kwama-ARV athile.
Ama-antacids afana nalawa asebenzisa izakhiwo zabo zokungasebenzi kalula nje isikhathi esifushane futhi ngokuvamile angenziwa amahora amabili kuya kwanguyisithupha ngaphambi noma ngemuva kwesilinganiso.
I-ARVs ethinteka kakhulu kulezi zidakamizwa ihlanganisa:
- I-Aptivus (tipranavir) -fake ama-antacid amahora ayisithupha ngaphambi noma ngemva kwamahora amabili
- I-edurant (rilpivirine) -fake ama-antiacidid amahora amabili ngaphambi noma amahora amane emva kwalokho
- I-rescriptor (delavirdine) -fake i-antacid ihora elilodwa ngaphambi noma ngemva kwamahora amabili
- I-Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) -fake ama-antiaciday amahora amabili ngaphambi noma ngemuva
- I-Tivicay (i-dolutegravir) -fake ama-antacid amahora ayisithupha ngaphambi noma amahora amabili ngemuva
- I-Triumeq (dolutegravir + ziagen + epivir) -fake ama-antacid amahora ayisithupha ngaphambi kokuqala noma amahora amabili
Ezinye izidakamizwa ezinciphisa i-asidi njengeproton pump inhibitors (isib. I-Nexium, i-Prilosec, i-Losec, i-Prevacid) inomphumela wokubamba isikhathi eside futhi inganciphisa ukumunwa kokubili uReyataz (atazanavir) no-Edurant (rilpivirine) ngamaphesenti angu-78 no-40 amaphesenti, ngokulandelana. Ngakho-ke, ukusebenzisa i-proton pump inhibitors kunqatshelwe ukusetshenziswa kwala ma-ARVs kanye nokunakekelwa okukhethekile okufanele kuthathwe uma usebenzisa abaphikisi be-H2 njengeTagamet noZantac, kanye.
Xhumana nodokotela wakho ukuze uxoxe ngokuguqulwa kokuhlolwa kanye / noma imithi uma usebenzisa noma yikuphi kulawa makilasi okudakamizwa noReyataz noma u-Edurant.
Wort St. John's Wort
I-Hypericum perforatum , eyaziwa kakhulu e-St John's Wort, isitshalo sezimbali esibakholelwa abanye ukuthi banezinto eziphikisana nokuvuvukala, i-antiviral, anti-depressant, ne-antioxidant. Ngenkathi u-meta-analysis omkhulu owenziwe ngo-2008 uphakamise ukuthi ukwelashwa kwamakhemikhali kunenzuzo ekwelapheni ukucindezeleka okukhulu, ezinye izakhiwo ezibikiwe zihlala zingqubuzana nobufakazi obuncane obusekelwe ekusekeleni izimangalo eziningi.
Uma isetshenziswe ekunconyeni ukwelashwa kwama-antiretroviral, iSt John's Wort ingathinta umsebenzi we-enzyme CYP450 3A4, esebenza ngamakhemikhali e-oxidizing izidakamizwa ukuze zisuswe emzimbeni. Uma lokhu kwenzeka, ukuxilongwa kwezidakamizwa ze-serum ye-HIV protease inhibitors (i-PIs) kanye ne- non-nucleoside reverse transcriptase inhibitors (i-NNRTIs) inganciphisa kakhulu, ngezinye izikhathi ibe ngamaphesenti angu-82. Ngenxa yalokho, iSt John's Wort akufanele ithathwe ngama-ARV alandelayo:
- I-Aptivus (tipranavir)
- I-Crixivan (indinavir)
- I-Edurant (rilpivirine)
- Intelence (etravirine)
- Invirase (saquinavir)
- I-Kaletra (lopinavir + ritonavir)
- I-Lexiva (i-fosamprenavir)
- I-Norvir (i-ritonavir)
- I-Prezista (i-darunavir)
- I-Rescriptor (delavirdine)
- I-Reyataz (atazanavir)
- Stribild (okuthinta i-elvitegravir ne-cobicistat izidakamizwa kuphilisi elihlanganisiwe)
- Sustiva (efavirenz) noma i-Atripla (inhlanganisela yemithi equkethe i-efavirenz)
- I-Viracept (nelfinavir)
- I-Viramune (i-nevirapine)
Ugaliki
I-garlic ikholelwa ukuthi abanye banezindawo ezingavimbela noma ziphathe izifo eziningana, ezibandayo kanye nokucindezelwa kwegazi okuphezulu kuya kwesifo senhliziyo nesifo somdlavuza. Ezinye iziphathimandla zithi lezi zakhiwo zibe yikhemikhali elinegalikhi okuthiwa i-allicin.
Ngenkathi izifundo zibonise izinzuzo ezingase zibe khona ze- garlic supplementation- mhlawumbe nge powder, extract, capsule, noma ithebulethi-kungaba khona ukungathinteki okukhulu lapho kulawulwa ngokuhambisana nomuthi we-protease inhibitor-class Invirase (saquinavir). Ngokuphazamisa i-CYP450 3A4 emathunjini, izithako ze-garlic zinganciphisa ukuhlushwa kwe-Invirase serum ngamaphesenti angama-54. Ngisho nangemva kokuqeda ukusebenzisa i-garlic, ucwaningo luye lwabonisa ukuthi imiphumela ecindezelayo ingaqhubeka izinsuku nezinyanga ezimbalwa.
Ezinye izifundo ziphakamise ukuthi igalikhi ingathinta nokutholakala kokunye kwamanye ama-PIs kanye nama-NNRTI, nakuba kungekho ukuphikisana okuqondile okusetshenziselwa futhi akukho izincomo zokuthi mangakanani noma yiziphi izinhlobo zegalikhi (kufaka phakathi okuluhlaza) okungenzeka kube kufanele noma kungalungile. Uma kunjalo, uma uthatha ugarlic nganoma yiluphi uhlobo njengesengezo sezempilo, kunelulekwa ukuthi uvumele udokotela wakho wokuphatha wazi.
> Imithombo:
> UMnyango WezeMpilo waseMelika kanye Nezinsizakalo Zabantu (DHHS). "Imihlahlandlela yokusetshenziswa kwama-Antiretroviral Agents ku-HIV-1-Adult Adult and Adolescents." Washington, DC; NgoJanuwari 19, 2015.
> Linde, K .; UBerner, uM .; noKriston, L. "I-St John's wort yokucindezeleka okukhulu." I-Cochrane Database yezibuyekezo ezihleliwe . Okthoba 8, 2008; (4): i-CD000448. i-doi: 10.1002 / 14651858.CD000448.pub3.
> Piscitelli, S .; IBurstein, A .; Welden, N .; et al. "Umphumela we-supplementary garlic kwi-pharmacokinetics ye-saquinavir." Izifo Ezithathelwanayo Emitholampilo; 34 (2): 234-238.