Clinical management of drug interaction with antiretroviral agents

Pau, Alice

doi:10.1097/coh.0b013e3282f82c06

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…[300][301][302][303][304] Medications used to treat HIV infection, some anticonvulsants, immunosuppressive drugs, and some psychotropic medications (often used to treat children with autism spectrum disorder) may also produce clinically important drug-drug interactions. [305][306][307][308][309][310][311][312][313][314] Therefore, a careful drug history is a vital part of the safe sedation of children. The practitioner should consult various sources (a pharmacist, textbooks, online services, or handheld databases) for specific information on drug interactions.…”

Section: Use Of Immobilization Devices (Protective Stabilization)mentioning

confidence: 99%

Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

Coté¹,

Wilson²

2019

Pediatrics

522

241

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The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction, a clear understanding of the medication' s pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age-and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of appropriately trained staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions. This report was developed through a collaborative effort of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry to offer pediatric providers updated information and guidance in delivering safe sedation to children.

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Section: Use Of Immobilization Devices (Protective Stabilization)mentioning

confidence: 99%

Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

Coté¹,

Wilson²

2019

Pediatrics

522

241

View full text Add to dashboard Cite

show abstract

“…81 When adding a new drug, one should evaluate its potential interaction with the patient’s current list of medications, including those which are over-the-counter. If a potential drug-drug interaction is identified and the potential benefits of adding the new medication outweighs the risks, an alternative agent with less potential for drug interaction should be considered.…”

Section: Management Of Drug-drug Interactionsmentioning

confidence: 99%

Drug Interactions and Antiretroviral Drug Monitoring

et al. 2014

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Due to the improved longevity afforded by combination antiretroviral therapy (cART), HIV-infected individuals are developing several non-AIDS related comorbid conditions. Consequently, medical management of the HIV-infected population is increasingly complex, with a growing list of potential drug-drug interactions (DDIs). This article reviews some of the most relevant and emerging potential interactions between antiretroviral medications and other agents. The most common DDIs are those involving protease inhibitors or non-nucleoside reverse transcriptase inhibitors which alter the cytochrome P450 enzyme system and/or drug transporters such as p-glycoprotein. Of note are the new agents for the treatment of chronic hepatitis C virus infection. These new classes of drugs and others drugs which are increasingly used in this patient population represent a significant challenge with regard to achieving the goals of effective HIV suppression and minimization of drug-related toxicities. Awareness of DDIs and a multidisciplinary approach are imperative in reaching these goals.

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“…As patients live longer, the management of HIV infection extends to treatment of a wide spectrum of comorbid conditions. 1,2 Adverse effects have been reported with all antiretroviral (ARV) drugs and are among the most common reasons for switching or discontinuing therapy and for nonadherence. 3 Although some common adverse effects were identified during premarketing clinical trials, some less frequent toxicities (such as lactic acidosis with hepatic steatosis and progressive ascending neuromuscular weakness syndrome) and some long-term complications (such as dyslipidemia and fat maldistribution) were not recognized until after the drugs had been used in a larger population for a longer duration.…”

Section: Introductionmentioning

confidence: 99%