Ukusetshenziswa Okuhlangene Kungakwandisa Imiphumela Yecala, Nciphisa Ukusebenza Kwezidakamizwa
Ukusebenzisana kwezidakamizwa kuvamile uma imithi eyodwa imisiwe eceleni komunye. Ezimweni eziningi, ukuxhumana akudingi ukuba umuntu ayeke umuthi owodwa noma omunye. Ngokuvamile kunalokho, amanani angakhuphuka, anciphise noma anciphise ukuze agweme izidakamizwa noma ukuqinisekisa ukuthi izidakamizwa zigcina amandla azo. Ngezinye izikhathi, ukufaka endaweni esikhundleni kungenziwa nge-ejenti elilinganayo.
Kodwa-ke, uma kuziwa kuma- ARVs (ama-ARV) , kunezinhlobo zemithi yokwelashwa engakwazi ukuphazamisa ngokuqondile isenzo semithi. Benza kanjalo ngokushintsha ama-pharmacodynamics (ukuthi umuthi usebenza kanjani) noma i-pharmacokinetics (ukuthi umuthi udlula kanjani emzimbeni) we-ARV eyodwa noma ngaphezulu.
Lokho kungaba inkinga enkulu. Lapho izidakamizwa i-pharmacodynamics ishintshiwe, ingahle ikhuphukise noma iyanciphise amandla okubodwa noma kokubili kwezidakamizwa zakho, noma ikhulise imiphumela yabo enobuthi ezingangeni ezingenakubekezeleleka, ngisho nezingozi.
Ngenye indlela, uma i-pharmacokinetics yezidakamizwa iphazamiseka, ingathinta kanjani ukuthi imithi idonswa kanjani noma ifakwe umzimba ngendlela efanele. Kwezinye izimo, esinye isidakamizwa singase sikhuthaze i-enzyme ephazamisa umphumela womunye noma inciphise ukuphuma kwesidakamizwa ukuze yakha ezinso noma isibindi.
Zonke lezi yizenzakalo ongathanda ukuzigwema uma ukwelapha nge-HIV .
Ngaphandle kwethonya elibonakalayo " lokubonakalayo " kwezidakamizwa ezidakamizwa, umthelela " ongabonakali " womsebenzi wezidakamizwa owehlisiwe ungaba nje ojulile. Uma kwenzeka lokhu, izidakamizwa zakho ze-HIV ngeke zikwazi ukuvimbela igciwane, okungaholela ekuthuthukiseni izidakamizwa ngaphambi kwesikhathi futhi, ekugcineni, ukwehluleka- hhayi nje kummeleli owodwa kodwa ngokuvamile kulesigaba sonke semithi.
Njengalokhu, kubalulekile ukuthi uhlale utshela udokotela wakho we-HIV nganoma imiphi imithi ongase uyithathe, kungakhathaliseki ukuthi imisiwe noma cha.
Izidakamizwa ezihlukunyezwayo zokusebenzisa nge-HIV Ukwelapha
Isidakamizwa kubhekwa njengokungahambisani uma kungabangela ukulimala. Phakathi nendawo yokwelashwa kwe-HIV, kunezinhlobo ezithile zezidakamizwa ukuthi, uma zithathwe ngama-ARV, zinekhono lomphumela. Zihlanganisa imishanguzo yansuku zonke esetshenziselwa ukwelapha izimo eziphakeme ze-cholesterol nezinhliziyo, kanye nemithi yokwelapha eqashwe ukuphatha izifo ezihambisana ne-HIV.
Zingahle ziphulwe phansi, ngendlela elandelayo:
Izidakamizwa zokunciphisa i-Lipid
Izidakamizwa ze-Statin zisetshenziselwa ukunciphisa amazinga e-cholesterol futhi zisebenza ngokuvimbela inzyme yesibindi eyabangela ukukhiqizwa kwe-cholesterol.
Nakuba iningi lala mithi ethandwayo alinqatshelwe ukuthi lisetshenziswe ngama-ARV (noma idinga ukulungiswa kwesisindo esilula), kufanele kugwenywe kokubili njengoba ukusetshenziswa kwabo okuhlangene kungakwandisa imiphumela enobuthi yezidakamizwa ze-statin, kubandakanya ingozi yokuhlunguphazwa kwemisipha yomzimba noma ubuthakathaka (myopathy) noma ukuwohloka okukhulu kwezicubu zomzimba ( rhabdomyolysis ).
- Izidakamizwa ezihlukile: i-Altoprev (lovastatin), i-Mevacor (i-lovastatin), i-Zocor (i-simvastatin)
- Ngeke isetshenziswe ngama-ARV alandelayo: I-Aptivus, i-Invirase, i-Genvoya, i-Kaletra, i-Lexiva, i-Prezista, iReyataz, i-Stribild, i-Vitekta
Imithi ye-Cardiac
Ezinye izidakamizwa ezisetshenziselwa ukushaya kwenhliziyo ( arrhythmia ) ziphikisana ukuze zisebenzise ngamanye ama-ARV njengoba zingandisa amathuba okuvuvukala kwesibindi noma umonakalo. La ma-agent amabili okuvame ukubandakanya:
- Izidakamizwa eziphikisanayo: Multaq (dronederone), Renexa (ranolazine)
- Ngeke isetshenziswe ngama-ARV alandelayo: I-Aptivus, Invirase, i-Genvoya (i-Renexa kuphela), i-Kaletra, iLexiva, i-Prezista, i-Reyataz, i-Stribild (i-Renexa kuphela), i-Vitekta (i-Renexa kuphela)
Ezinye izidakamizwa zenhliziyo ziyaziwa ukuthi zinamandla okufanayo futhi kufanele zigwenywe uma zisetshenziselwa ama-ARVs we-protease inhibitor-class. Zihlanganisa i-anti-arrhythmic Cordarone, i-Nexterone, i-Pacerone, i-Quinaglute, i-Quinidexm Rythmol, iTambocor, ne-Tikosyn, kanye ne-anti-tachycardial drug lidocaine.
Imithi Yokulwa Ne-Epilepsy
Ngokuvamile, izidakamizwa ezisetshenziselwa ukwelapha isithuthwane zibhekwa ziphephile ukusetshenziswa nemithi yakho ye-HIV. Nokho, bambalwa abathinteka ngqo yi-Intelence (etravirine) yezidakamizwa ngokuncintisana nezindlela ezifanayo zezinto eziphilayo lapho belawulwa ngokufanayo. Ngokwenza kanjalo, kunganciphisa kakhulu ukuhlushwa kwe-Intelence egazini, ukunciphisa ukusebenza kwayo.
- Izidakamizwa ezihlukile: i-carbamazepine, i-phenobarbital, i-phenytoin
- Ngeke isetshenziswe ngama-ARV alandelayo: Intelence
Izidakamizwa nezinye izidakamizwa ze-neurologic
Eziningana zezidakamizwa ezivamile-kanye nezidakamizwa ezimbili ezilawulwayo ezisetshenziselwa ukwelapha isifo socansi kanye ne-Tourette's syndrome-nazo ziyaziwa ukuthi zithinta amazinga okuhlushwa ama-ARV athile.
- Izidakamizwa ezihlukile: Latuda (lurasidone), Versed (midazolam), Orap (pimozide), Halcion (iriazolam)
- Ngeke isetshenziswe ngama-ARV alandelayo: I-Aptivus, i-Invirase, i-Genvoya, i-Kaletra, i-Lexiva, i-Prezista, iReyataz, i-Stribild, i-Vitekta
I-Hepatitis C Izidakamizwa
Izinga lokutheleleka kwe-hepatitis C kubantu abanesandulela ngculazi lingakwazi ukugijimela phezulu ku-20-30% ezingxenyeni zaseNyakatho Melika naseYurophu. Njengoba izidakamizwa ezishaya izifo ze-hepatitis C ezishaya phambili (ezibizwa ngokuthi i- anti-virus, noma i-DAA ) ezithembisa ukuphulukiswa kwamazinga angaphezu kwamaphesenti angaphezu kuka-90 kwezinye izindawo, kunakekelwa okukhulu nakakhulu abantu abathintekayo kanye nangaphezulu kunomnyaka odlule.
Kodwa-ke, iningi lala ma-DAA alinakusetshenziswa ngama-ARV athile, ikakhulukazi ngenxa yezenzo zemithi ezinokuncintisana ezingaba nokwandisa noma ukunciphisa i-pharmacokinetics yezidakamizwa.
- Izidakamizwa ezihlukile: Olysio, Victrelis, Viekira Pak
- Ayikwazi ukusetshenziswa ngama-ARV alandelayo: i-Aptivus, i-Edurant (i-Viekira Pak kuphela) i-Intelence, i-Invirase, i-Genvoya, i-Kaletra, i-Lexiva, i-Prezista, i-Reyataz (i-Olysio ne-Victrelis kuphela), i-Selzentry (i-Viekira Pak kuphela), i-Stribild, i-Sustiva, i-Viramune, i-Vitekta
Ngaphezu kwalokho, izidakamizwa eHarvoni naseSolvadi, ama-DAA azinqunyelwe kakhulu emakethe, azikwazi ukulawulwa nge-Aptivus.
Imithi yesifo sofuba
Ezingxenyeni ezithile zomhlaba, isifo sofuba sifana nokutheleleka phakathi kwabantu abane-HIV. Ngisho ne-US neYurophu, izinga le-TB liphakeme nakakhulu kubantu abane-HIV futhi isici esivamile kwisifo se-HIV esithuthukisiwe. Izidakamizwa ezimbili ezivame ukusetshenziselwa ukwelapha ukutheleleka nge-TB ziyaziwa nangokunciphisa ukuxilongwa kwezidakamizwa zama-ARV athile lapho kulawulwa ngokuvumelana.
- Izidakamizwa ezihlukile: i-rifampin, i-rifapentine
- Ngeke isetshenziswe ngama-ARV alandelayo: I-Aptivus, i-Invirase, i-Genvoya, i-Kaletra, i-Lexiva, i-Nevirapine (i-rifapentine kuphela), i-Prezista, i-Reyataz, iSelzentry (i-rifapentine kuphela), i-Stocrin (i-rifapentine kuphela), i-Stribild, iTivicay (i-rifapentine kuphela), i-Triumeq ( i-rifapentine kuphela), i-Vitekta
Ezimweni zokutheleleka kwe-HIV / TB, i-rifabutin yezidakamizwa ngokuvamile ishintshiwe uma kunoma iyiphi i-ARV ebonakalayo ekhonjisiwe.
Imithombo:
Izikhungo Zempilo Zikazwelonke (NIH). "Imihlahlandlela yokusetshenziswa kwama-Antiretroviral Agents ku-HIV-1-Adult Adult and Adolescents." I-Rockville, e-Maryland.