Kushandiswa kwakasanganiswa Kunogona Kuwedzera Mitemo Yakasviba, Kuderedza Kubudirira Kwemishonga
Kurwisana kwezvinodhaka kunowanzojairika pose apo imwe mishonga inorayirwa pamwe chete neimwe. Muzviitiko zvakawanda, kushamwaridzana hazvirevi kuti munhu aise mishonga imwe kana imwe. Kazhinji pane kudarika, kuwedzera kunogona kuwedzerwa, kuderera kana kudengenyeka kuitira kuti urege kudzivirirwa kana kuti kuvimbisa kuti mishonga inoramba ichichengetedza. Pane dzimwe nguva, kushandiswa kunoitwa kunogona kuitwa neanomiridzi akaenzana.
Zvisinei, kana zvinosvika kuHIV antiretrovirals (ARVs) , kune mishonga yemishonga yakawanda inogona kupindira zvakananga nekuita zvinodhaka. Vanodaro nokuchinja ma pharmacodynamics (sei mushonga unoshanda) kana kuti pharmacokinetics (kuti mushonga unofamba sei mumuviri) weimwe kana kuti akawanda emaARV ako.
Izvozvo zvinogona kuva dambudziko rakakomba. Apo zvinodhaka pharmacodynamics inoshandurwa, inogona kuwedzera zvakanyanya kana kuderedza kushanda kweimwe kana mishonga yako yose, kana kuti kugadzirisa zvinokonzera zvinokonzera kusakanganisika, kunyange nengozi, maitiro.
Zvimwe, apo drug pharmacokinetics inopindira, inogona kukanganisa kushanda zvakanaka kwechirwere chinoshandiswa kana kushandiswa kwemitambo nemuviri. Mune dzimwe nguva, mishonga imwe inogona kukurudzira enzyme iyo inoparadza imwe yechiratidzo kana kuderedza kushandiswa kwemishonga kuitira kuti ivakwe muitsvo kana chiropa.
Zvose izvi zviitiko zvaunoda kudzivisa kana uri nehutachiona hweHIV .
Kunze kwezvinhu zvinowanikwa " zvinowanikwa " zvinokonzera zvinodhaka, " kusingaonekwi " kunokonzerwa nekuderedza mishonga yemishonga kunogona kunge kwakanyanya. Kana izvi zvikaitika, mishonga yako yeHIV ichave isina kukwanisa kuderedza hutachiona, iyo inogona kutungamirira kukura kwenguva isati yasvika yekutswa kwezvinodhaka uye, pakupedzisira, kukanganisa- uye kwete kungoita sendimi imwe chete asi kazhinji kukirasi yose yemishonga.
Sezvo zvakadaro, zvakakosha kugara uchiudza chiremba wako weHIV chero ipi zvayo yemishonga iwe unogona kunge uri kutora, pasinei nokuti inorayirwa kana kwete.
Zvinodhaka Zvinopindirana Kuti Ushandise neHIV Kurapa
Mishonga inonzi inopesana kana ichigona kukuvadza. Mukati rehutachiona hweHIV, kune mamwe marudzi emishonga iyo, kana inotorwa nema ARVs, inogona kuita izvi. Zvinosanganisira mishonga yemusi wega wega inoshandiswa kurapa yakakwirira yeholesterol nemamiriro emwoyo, pamwe chete nemishonga inoshandiswa kurapa zvirwere zvinokonzerwa neHIV.
Zvinogona kuputsika zvakashata, sezvinotevera:
Lipid-Kuderedza Zvinodhaka
Statin zvinodhaka zvinoshandiswa kuderedza cholesterol maitiro uye kushanda nekuvhara chiropa chekuropa chinokonzerwa nekubudisa cholesterol.
Kunyange zvazvo yakawanda yemishonga iyi yakakurumbira isinganzwisisiki kuti ishandiswe nema ARVs (kana kuti inoda kugadziriswa kwemazi nyore), mbiri inofanira kudziviswa sezvo kushandiswa kwavo pamwe chete kunogona kuwedzera zvinokonzera zvinokonzerwa nemishonga yemutemo, kusanganisira panjodzi yekurwa kwemishonga inosangana nemishonga kana kushayiwa simba (myopathy) kana kuparara kwakakomba kwemasumbu ( rhabdomyolysis ).
- Contraindicated madawa: Altoprev (lovastatin), Mevacor (lovastatin), Zocor (simvastatin)
- Haikwanise kushandiswa neiyo ma ARVs: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Cardiac Mishonga
Mimwe yemishonga inoshandiswa kushaya mwoyo ( arrhythmia ) inopesana kuti ishandiswe nemamwe maARV sezvo inogona kuwedzera mukana wekuputika kwechiropa kana kukuvara. Izvo zvipfeko zviviri zvinowanzobatanidzwa ndezvi:
- Contraindicated madawa: Multaq (dronederone), Renexa (ranolazine)
- Hazvikwanisi kushandiswa nema ARVs anotevera: Aptivus, Invirase, Genvoya (Renexa chete), Kaletra, Lexiva, Prezista, Reyataz, Stribild (Renexa chete), Vitekta (Renexa chete)
Mamwe mishonga yemwoyo inozivikanwa kuti ine simba rakadaro uye inofanira kudziviswa kana yakashandiswa neprotease inhibitor-class ARVs. Dzinosanganisira anti-arrhythmics Cordarone, Nexterone, Pacerone, Quinaglute, Quinidexm Rythmol, Tambocor, uye Tikosyn, pamwe chete ne-anti-tachycardial drug lidocaine.
Anti-Epilepsy Mishonga
Kazhinji kutaura, zvinodhaka zvinoshandiswa pakurapa kamufa inonzi yakachengeteka kushandiswa nemishonga yako yeHIV. Asi vashomanana, zvisinei, vanokonzera zvakananga mushonga weIndelence (etravirine) nokukwikwidzana nemigwagwa imwechete yezvinyorwa kana iyo inobatanidzwa. Mukuita kudaro, inogona kuderedza zvakanyanya kufungisisa kweIndelence muropa, nekuderedza kushanda kwayo.
- Contraindicated madawa: carbamazepine, phenobarbital, phenytoin
- Hazvikwanisi kushandiswa nema ARVs anotevera: Intelence
Sedatives uye Dzimwe Neurologic Zvinodhaka
Nhamba dzakawanda dzinowanzoitwa sedatives-pamwe chete nemishonga inodzorwa inoshandiswa kurapa schizophrenia uye Tourette's syndrome-inozivikanwawo kuti inokanganisa kuongororwa kwevamwe maARV.
- Contraindicated madawa: Latuda (lurasidone), Versed (midazolam), Orap (pimozide), Halcion (iriazolam)
- Haikwanise kushandiswa neiyo ma ARVs: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Hepatitis C Zvinodhaka
Chirwere chehutachipatachi C hwehutachiona hwehutachiona hwevanhu vane HIV vanogona kukwira zvakakwirira se20-30% muzvikamu zveNorth America neEurope. Nekuwedzera kwechikwata che hepatitis C zvinodhaka (zvinonzi zvakananga kuita maitiro antivirals, kana maDAA ) zvinopikira zvirwere zvinopfuurika zvinopfuura 90% mune vamwe vanhu, kunyanya kuwedzerwa kuiswa n kurapa vanhu vane hutachiwana hwekare pamwe nekurwisana kupfuura makore apfuura.
Zvisinei, huwandu hweDAAs hahugoni kushandiswa nemamwe maARV, zvichida kunyanya kukwikwidzana kwezviito zvinodhaka zvinogona kuwedzera kana kuderedza kushandiswa kwemishonga yemasikirineti.
- Contraindicated drugs: Olysio, Victrelis, Viekira Pak
- Hazvikwanisi kushandiswa nemishonga inotevera maARV: Aptivus, Edurant (Viekira Pak chete) Intelence, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz (Olysio uye Victrelis chete), Selzentry (Viekira Pak chete), Stribild, Sustiva, Viramune, Vitekta
Mukuwedzera, mishonga iyi Harvoni naSolvadi, mbiri dzeDAA dzakanyanyozivikanwa mumusika, haigoni kubatanidzwa pamwe neAptivus.
Tuberculosis Medication
Mune zvimwe zvikamu zvenyika, tuberculosis co-infection inowanikwa pakati pevanhu vane HIV. Kunyangwe US uye Europe, mutengo weTB uripamusoro zvikuru muhutachiona hweHIV uye inowanzoonekwa mune hutachiona hweHIV hwakapfuura. Zvimwe zvinodhaka zvinowanzoshandiswa kurapa utachiona hweHIV zvinowanzonziwo kuderedza kushandiswa kwemishonga yemishonga yemamwe maARV kana ishandiswa.
- Contraindicated madawa: rifampin, rifapentine
- Hazvikwanisi kushandiswa nemishonga inotevera maARV: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Nevirapine (rifapentine chete), Prezista, Reyataz, Selzentry (rifapentine chete), Stocrin (rifapentine chete), Stribild, Tivicay (rifapentine chete), Triumeq ( rifapentine chete), Vitekta
Muzviitiko zvehutachiwana hweHIV / TB, mutachiri rifabutin inowanzosimbiswa apo chero ipi zvayo yeAIDS inoratidzirwa inoratidzwa.
Sources:
National Institutes of Health (NIH). "Mirayiridzo yeKushandiswa kweAntiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vari Kuyaruka." Rockville, Maryland.