Amfani da Haɗaɗɗa Zai iya Ƙara Rarraba Yankuna, Rage Ƙarƙashin Drug
Hanyoyin hulɗa da kwayoyi suna da mahimmanci a duk lokacin da aka tsara wani magani tare da wani. A mafi yawan lokuta, haɗuwa bazai buƙatar mutum ya dakatar da miyagun ƙwayoyi ɗaya ko wani. Sau da yawa ba haka ba, ana iya ƙara yawan ƙwayoyi, ragewa ko matsakaita don kauce wa cututtuka ko tabbatar da cewa kwayoyi sunyi aiki mai kyau. A wasu lokuta, za'a iya yin musanya tare da wakili daidai.
Duk da haka, idan yazo da kwayoyin cutar HIV (ARVs) , akwai wasu magungunan likita da za su iya magance matsalar miyagun ƙwayoyi. Suna yin haka ta hanyar musanya magungunan pharmacodynamics (yadda yarinyar ke aiki) ko pharmacokinetics (yadda miyagun ƙwayoyi ke motsa ta jiki) na daya ko fiye na ARV naka.
Wannan zai zama matsala mai tsanani. Lokacin da miyagun kwayoyi Magungunan pharmacodynamics suna canzawa, zasu iya ƙara ko rage ƙarfin daya ko duka magungunanka, ko kuma kara yawan tasirin da suke ciwuwa, har ma da haɗari, matakan.
A madadin haka, lokacin da ake magance magungunan pharmacokinetics, zasu iya rinjayar yadda lafiyayyen miyagun ƙwayoyi ke shafe ko ƙarfafa ta jiki. A wasu lokuta, kwayoyi guda ɗaya na iya tayar da wani enzyme wanda zai iya sauke nauyin wani ko rage karfin maganin ƙwayar magani don gina ta cikin kodan ko hanta.
Duk waɗannan abubuwa ne da za ku so ku guji idan akan cutar HIV .
Baya ga yawan tasirin da ake gani na maganin miyagun ƙwayoyi, sakamakon " ganuwa " na rage yawan miyagun ƙwayoyi yana iya zama zurfi. Idan wannan ya faru, kwayar cutar HIV ba zata iya rage cutar ba, wanda zai haifar da ci gaba da cigaba da maganin miyagun ƙwayoyi, kuma, ƙarshe, rashin cin nasara- kuma ba kawai ga wakili guda ba amma sau da yawa ga dukkanin kwayoyi.
Saboda haka, yana da mahimmanci a koya wa likitancinka na kwayar cutar HIV da kowace kwayoyi da za ka iya ɗauka, ko an umarce su ko a'a.
Magungunan ƙwayoyi da aka ƙaddara don amfani da kwayar cutar HIV
Anyi amfani da miyagun ƙwayoyi idan an cutar da shi idan ya iya cutar da shi. A cikin sassan cutar HIV, akwai wasu kwayoyi da cewa, idan aka dauki su tare da ARV, suna da yiwuwar wannan sakamako. Sun hada da magungunan yau da kullum da ake amfani dasu don magance babban cholesterol da yanayin zuciya, da kuma hanyoyin magance cutar da cutar ta HIV.
Za a iya rushe su, kamar haka:
Labaran ƙwaya-jijiya
Ana amfani da kwayoyi masu magunguna don rage matakan cholesterol kuma aiki ta hanyar hana hanta enzyme da ke da alhakin samar da cholesterol.
Duk da yake mafi yawan waɗannan magungunan magungunan ba su da alamar amfani dasu tare da ARV (ko kuma sun buƙaci daidaitawar sauƙin sauƙi), ya kamata a kauce wa abu guda biyu yayin da haɗin haɗarsu zai iya ƙara yawan illolin kwayoyi, ciki har da haɗarin ciwon tsoka da ƙwayar ƙwayoyi. rashin ƙarfi (myopathy) ko kuma mummunan rauni na tsoka nama ( rhabdomyolysis ).
- Magunguna contraraindicated: Altoprev (lovastatin), Mevacor (lovastatin), Zocor (simvastatin)
- Ba za a iya amfani dashi ba tare da ARV masu zuwa: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Magunguna na Cardiac
Wasu daga cikin kwayoyi da aka yi amfani da su a cikin ƙwaƙwalwar ajiya ( arrhythmia ) an hana su da amfani da wasu ARVs saboda suna iya ƙara yawan ƙwayar hanta ko lalacewa. Wadannan jami'o'i biyu mafi yawa sune:
- Magunguna masu ƙwayar cuta: Multaq (dronederone), Renexa (ranolazine)
- Ba za a iya amfani dasu ba tare da ARV masu zuwa: Abtivus, Invirase, Genvoya (Renexa kawai), Kaletra, Lexiva, Prezista, Reyataz, Stribild (Renexa uniquement), Vitekta (Renexa kawai)
Wasu magunguna masu kwakwalwa suna san cewa suna da wannan matsala kuma ya kamata a kauce masa idan aka yi amfani da su na ARV. Sun hada da maganin maganin maganin ƙwayoyin cuta Cordarone, Nexterone, Pacerone, Quinaglute, Quinidexm Rythmol, Tambocor, da Tikosyn, da kuma maganin lidocaine na anti-tachycardia.
Anti-Epilepsy Magunguna
Kullum magana, ana amfani da kwayoyi da ake amfani dasu don maganin cutar cututtuka lafiya don amfani da magungunan ku na HIV. Wasu, duk da haka, suna tasiri maganin miyagun ƙwayoyi (etravirine) ta hanyar yin gwagwarmaya tare da irin hanyoyin da kwayoyin halitta suke ciki lokacin da aka gudanar da su. A yin haka, zai iya rage yawan ƙaddamarwa mai kyau a cikin jini, da rage yawan tasirinsa.
- Magunguna masu ƙwayar cuta: carbamazepine, phenobarbital, phenytoin
- Ba za a iya amfani dashi ba tare da ARV masu biyowa: Dama
Sida da sauran Magungunan Neurologic
Yawancin magungunan na yau da kullum - da magungunan sarrafawa guda biyu da ake amfani dasu don magance schizophrenia da ciwo na Tourette - wadanda aka sani sun shafi tasiri na wasu ma'aikatan ARV.
- Magunguna masu rikitarwa: Latuda (lurasidone), Juyin (midazolam), Orap (pimozide), Halcion (iriazolam)
- Ba za a iya amfani dashi ba tare da ARV masu zuwa: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz, Stribild, Vitekta
Hepatitis C Magunguna
Ciwon haɗari na cutar hepatitis C a cikin mutanen da ke dauke da kwayar cutar HIV zai iya tafiya har zuwa 20-30% a sassa na Arewacin Amirka da Turai. Tare da sababbin kwayoyin cutar hepatitis C (wanda ake kira cibiyoyin maganganu na yau da kullum, ko DAAs ) yana da alamun maganin magani fiye da 90% a wasu al'ummomi, an sanya karin hankali ga zalunta da kamuwa da cutar a baya kuma mafi tsanani fiye da shekarun baya.
Duk da haka, yawancin wadannan DAA ba za'a iya amfani da su ba tare da wasu ARVs, saboda yawancin maganin miyagun ƙwayoyi wanda zai iya ƙara ko rage ƙwayar magungunan ƙwayoyi.
- Contraindicated kwayoyi: Olysio, Victrelis, Viekira Pak
- Ba za a iya amfani dashi ba tare da ARV masu zuwa: Abtivus, Edurant (Viekira Pak kawai) Halin kirki, Invirase, Genvoya, Kaletra, Lexiva, Prezista, Reyataz (Olysio da Victrelis kawai), Selzentry (Viekira Pak kawai), Stribild, Sustiva, Viramune, Vitekta
Bugu da kari, Harvoni da Solvadi, biyu daga cikin mafi kyawun DAA a kasuwa, ba za a iya hade tare da Aptivus ba.
Magunguna tarin fuka
A wasu sassan duniya, ƙwaƙwalwar kamuwa da tarin fuka a cikin mutanen da ke dauke da HIV. Har ma Amurka da Turai, yawancin TB ya fi girma a cikin yawan kwayar cutar HIV kuma yana da alamun da ke cikin cutar HIV. Biyu daga cikin magungunan da aka saba amfani dasu don kamuwa da cutar TB sun kasance sanannun ƙwayar magungunan miyagun kwayoyi na wasu ARV lokacin da aka gudanar da su.
- Contraindicated kwayoyi: rifampin, rifapentine
- Ba za a iya amfani dashi ba tare da fasinjoji na ARV: Aptivus, Invirase, Genvoya, Kaletra, Lexiva, Nevirapine (rifapentine kawai), Prezista, Reyataz, Selzentry (rifapentine kawai), Stocrin (rifapentine kawai), Stribild, Tivicay (rifapentine kawai), Triumeq ( rifapentine kawai), Vitekta
A lokuta na kamuwa da cutar HIV / TB, ana amfani da rifabutin miyagun ƙwayoyi a yayin da aka nuna fasinjoji na ARV.
Sources:
Cibiyar Kula da Lafiya ta Duniya (NIH). "Sharuɗɗa don Amfani da Ma'aikata marasa lafiya a HIV-1-Infected Adults and Adolescents." Rockville, Maryland.