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RITONAVIR INTERACTIONS AND SIDE EFFECTS. Present by PEERAKARN BANJERDKIJ. OUTLINE. Introduction HIV Therapy Types of HIV-drugs Protease Inhibitors work Ritonavir Pharmacology Drug Interactions Side effects Conclusion. INTRODUCTION.
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RITONAVIR INTERACTIONS AND SIDE EFFECTS Present by PEERAKARN BANJERDKIJ
OUTLINE • Introduction • HIV Therapy • Types of HIV-drugs • Protease Inhibitors work • Ritonavir • Pharmacology • Drug Interactions • Side effects • Conclusion
INTRODUCTION Why is the “HIV Therapy” called “multiple therapies”? Ans. : Immune system What is the “medical problem”? Ans. : Drug interactions How many types of HIV-drugs? Ans. : 3 Types
Types of HIV-drugs • 2 main groups • 1. Reverse Transcriptase • 1.1 Nucleoside Reverse Transcriptase • Inhibitors (NRTIs) • zidovudine (AZT) • didanosine (ddI) • 1.2 Non-nucleoside Reverse Transcriptase • Inhibitors (NNRTIs) • nevirapine • delaviridine • 2. Protease Inhibitors (PIs) • indinavir • ritonavir
How do protease inhibitors differ from other available anti-HIV drugs?
OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects
RITONAVIR Pharmacology • Block maturation of virus • By interfering • Act at the stage of HIV replication cycle • Produce resistance • Bound plasma 98-99% • Cross resistance • combine with NNRTIs or NRTIs • combine with PIs Cross resistance
OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects
RITONAVIR Combinations & Interactions What types of other medications can interact with PIs? Ans.1 : HIV-HIV drugs - Combination Therapy - Double-Drug ; PIs + PIs , PIs + NRTIs - Triple-Drug ; PIs+PIs+NNRTIs Ans.2 : HIV-Other drugs ; PIs+Antivirals
RITONAVIR Drug Interactions • Metabolized by P450 at the liver • Combine with competition drugs ; can occur 1. Metabolism of these drugs 2. Concentration of Ritonavir and these drugs
DRUG INTERACTION Between Other drugs and Ritonavir http://www.hivinsite.UCSF.edu/topics/research_advances/2098.339b.html
DRUG INTERACTION Between Other drugs and PIs http://www.thebody.com/hivatis/agents1/table14.html
DRUG COMBINATION Between PIs and PIs * Invirase or Fortovase , + Conducted with Invirase , # with Fortovase http://www.thebody.com/hivatis/agents1/table15.html
OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects
SIDE EFFECTS Adverse Drug Reaction http://www.utoledo.edu/pharmacy/clinical/aids.html http://www.iapac.org/clinmgt/avtherapies/patient/proinbk.html#top
HIV Drugs -Toxicities SIDE EFFECTS http://www.thebody.com/hivatis/agents1/table16.html
OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects • Conclusion
CONCLUSIONS Protease Inhibitors can cure or not! Combination ; more efficiency Side effects ; different ways Resistance Problems Cross resistance problems
THE END THANK YOU • Dr. SUVIT • Dr. MARIA • Mr. SOMJERD • CRI OFFIER & OUR CLASS ……...
SIDE EFFECTS Advantages & Disadvantages ofClass-Sparing Regimens http://www.thebody.com/hivatis/agents1/table7.html