Psychopharmacologic Treatment Issues in AIDS Psychiatry

2010 ◽  
Author(s):  
Kelly L. Cozza ◽  
Harold W. Goforth
Keyword(s):  
Drug Interactions ◽  
Receptor Site ◽  
Metabolic Enzymes ◽  
Hiv And Aids ◽  
Pharmacodynamic Interactions ◽  
Introductory Overview ◽  
Full Explanation ◽  
Metabolic Interactions ◽  
The Subject ◽  
Hiv Aids

Persons with HIV and AIDS are often prescribed a plethora of medications, all of which require special attention and are based on well-defined principles. In the first part of this chapter, Drug Interaction Principles, we provide a short but essential review of these principles in order to prepare the reader to critically weigh the potential for drug interactions between psychotropics and antiretroviral therapy (ART) and those between ART and other medications. In the second part, Psychotropics and HIV, a brief review of the available literature on the effectiveness of psychotropics in treating patients with HIV is provided, followed by an overview of issues relating to drug interactions for each psychotropic or class of psychotropic. The third part of the chapter, Antiretrovirals, provides an introductory overview of currently available antiretrovirals and of medications prescribed in treating HIV/AIDS. Readers are referred to an excellent review of pharmacological treatment for persons with addictions and HIV/AIDS, by Wynn and colleagues (2005), and to Chapters 2, 6, 8, and 10 of this handbook for more information on treating substance abuse and dependence. Understanding drug–drug interactions in the care of HIV patients is essential. For a full explanation of psychotropic pharmacology and drug interactions, the reader is referred to additional texts on the subject (Cohen and Gorman, 2008; Schatzberg and Nemeroff, 2009; Wynn et al., 2009). Pharmacodynamic interactions are those that occur at the intended receptor site of a medication and involve absorption, distribution, metabolism, and excretion. ART drugs may be affected by timing with food or buffers, which is relatively predictable. Metabolic interactions are a bit more complex, as they are affected by metabolic inhibition, induction, and pharmacogenetics (the particular metabolic enzymes that a patient is born with). Metabolic interactions may occur in either phase I or II metabolic enzymes and also may include the cell membrane transporter enzymes (also known as p-glycoproteins). For a complete explanation of pharmacokinetic interactions, the reader is referred to the text by Wynn et al. (2009).

Factors associated to first line antiretroviral therapy (ART) failure among HIV/AIDS patients at Sanglah Hospital, Bali

2017 ◽  
pp. 4
Author(s):  
Cok Istri Sri Dharma Astiti ◽  
A.A Sagung Sawitri ◽  
Tuti Parwati
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Clinical Stage ◽  
Hiv And Aids ◽  
First Line ◽  
Aids Patients ◽  
Factors Associated ◽  
Art Initiation ◽  
Risk Of Treatment ◽  
Hiv Aids

Background and purpose: The incidence of first line ART failure is increasing in the South East Asia region. The main referral hospital in Bali has recorded an increased use of second line ART due to the first line ART failure. This study aims to explore risk factors associated to first line ART failure.Methods: A case control study was conducted among people living with HIV and AIDS at Sanglah Hospital Denpasar who started first line ART between 2004 and 2013. Cases were those who diagnosed as having clinical treatment failure and still on treatment in 2015. Controls were those with no treatment failure. Sex and year of ART initiation were matched between case and control. Data were obtained from medical records that include initial regiments, HIV mode of transmission, the WHO HIV clinical stage, CD4 count, opportunistic infections, body mass index, hemoglobin level, and drug substitution at the beginning and during treatment. Risk factors were analysed using logistic regression.Results: Out of 68 HIV/AIDS patients with clinical ART failure, 72.1% were confirmed with immunological and 36.8% were confirmed with virological failure. Median time before treatment failure was 3.5 years. Factors associated to ART failure were HIV clinical stage IV with (AOR=3.43; 95%CI=1.65-7.13) and being widow/widower (AOR=4.85; 95%CI=1.52-15.53). Patients with TB co-infection have a lower risk for treatment failure due to early diagnosis and treatment through TB-HIV program with (AOR=0.32; 95%CI=0.14-0.70).Conclusions: Higher HIV clinical stage at ART initiation increases the risk of treatment failure. HIV-TB co-infection indirectly reduces the risk of treatment failure.

scholarly journals Knowledge and attitude regarding HIV/AIDS among patients attending medicine outpatient department in C. C. M. Medical College and Hospital, Durg

2019 ◽  
Vol 6 (12) ◽  
pp. 5095
Author(s):  
Suresh C. Gupta ◽  
Karan J. Jain ◽  
Anjana Tiwari ◽  
Indu Padmey ◽  
Nandkishor J. Bankar ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Modern Medicine ◽  
Unprotected Sex ◽  
Hiv And Aids ◽  
Outpatient Department ◽  
Cross Sectional ◽  
Medical College ◽  
Modes Of Transmission ◽  
Hiv Aids

Background: Acquired immunodeficiency syndrome (AIDS) is one of the deadliest diseases that modern medicine has ever had to tackle. Understanding the knowledge about HIV/AIDS in general populations will help in formulating strategy for prevention and treatment. With this background, this study was conducted to assess the knowledge and awareness about HIV/AIDS among general population.Methods: A cross sectional study was conducted at C.C.M. Medical College and Hospital, Durg during December 2018 to January 2019. The data was collected from 450 patients attending the medicine outpatient department. Study subjects were selected using convenient sampling technique. Patients giving consent and willing to participate were included in the study. The data was collected in predesigned and pretested questionnaire.Results: 77.11% study participants were aware that unprotected sex can lead to transmission of HIV, 73.78% knew that shaking hands will not transmit the disease. 79.8% knew that use of condom can prevent transmission of HIV/AIDS. Overall males had better knowledge than females. 76.85% said they would behave friendly with people having HIV/AIDS and 69.78% were willing to take care of relatives with HIV.Conclusions: This study indicates that majority participants have good knowledge about difference between HIV and AIDS, modes of transmission and prevention though they were not completely aware of it. The proportion of those with lack of correct knowledge though comparatively less, needs to be taken as a challenge and addressed through well planned health educational activities at various platforms including teaching hospital premises.

scholarly journals Knowledge Level of Grade XII Senior High School Students Regarding HIV/AIDS

2021 ◽  
Vol 3 (1) ◽  
pp. 20-28
Author(s):  
Stanley Lesmana ◽  
Riyadh Ikhsan ◽  
Azriya Azka
Keyword(s):  
High School ◽  
High School Students ◽  
Senior High School ◽  
Hiv And Aids ◽  
The Body ◽  
Sample Population ◽  
Knowledge Level ◽  
School Students ◽  
Senior High School Students ◽  
Hiv Aids

Background: AIDS (Acquired Immunodeficiency Syndrome) is a collection of symptoms or diseases caused by a decrease in the immune system from the body due to infection from the HIV (Human Immunodeficiency Virus) which belongs to the retroviridae family. Teenagers themselves are vulnerable to HIV/AIDS. The right and precise knowledge of HIV and AIDS is important in HIV prevention efforts in adolescents. Method: This research is a descriptive research with cross-sectional design. The sample population of this study was grade XII senior high school students of the 2020/2021 at Methodist – 2 Medan by sampling total sampling. This study was analyzed univariately to look at the descriptive images. Result: From the results of this study, it has obtained that the knowledge level of students grade XII Methodist - 2 Medan had good knowledge about HIV / AIDS with the number of 144 people (70.6%). Conclusion: From this study, it was found that the level of knowledge about HIV/AIDS was mostly in a good category.  

scholarly journals Pencegahan HIV/AIDS melalui Collaborative Governance antara Pemerintah, Lembaga Swadaya Masyarakat, dan Masyarakat

2019 ◽  
Vol 10 (1) ◽  
pp. 14-31
Author(s):  
Agung Rheza Fauzi ◽  
Amy Yayuk Sri Rahayu
Keyword(s):  
Collaborative Governance ◽  
Aids Prevention ◽  
Hiv And Aids ◽  
Capital City ◽  
Collaborative Process ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Working Groups ◽  
The Government ◽  
Hiv Aids

HIV / AIDS cases in Indonesia continue to increase and have spread to all provinces in Indonesia. As the province with the highest number of HIV cases, DKI Jakarta through the Provincial AIDS Commission (KPAP) seeks to prevent the increase of HIV / AIDS cases through collaborative governance between the Government, Non-Governmental Organizations (NGOs), and the public. This collaborative governance is reinforced through Governor Regulation No. 231 of 2015 concerning the Organization and Work Procedure of the Jakarta Capital City Provincial AIDS Commission and the DKI Jakarta Provincial Regulation Number 5 of 2008 concerning HIV and AIDS Prevention. This research was conducted to analyze the process of collaboration between the Government, NGOs and Communities in the DKI Jakarta Province. In addition, this study aimed to provide strategic recommendations for effective collaborative governance in the context of HIV / AIDS prevention in DKI Jakarta Province. This study used descriptive qualitative research methods that described the collaborative process of preventing HIV / AIDS in DKI Jakarta Province. Therefore, this study used a collaborative governance theory that focused on the collaborative process. Based on the research, it was known that collaborative governance has been established between KPAP, Health Office, NGOs, Working Groups (Pokja), and the Community. However, it was still not effective because of the lack of roles of working groups and NGOs that were still dependent on donor agencies in carrying out their activities.

scholarly journals Impact of HIV and AIDS on Surgical Practice

2007 ◽  
Vol 89 (4) ◽  
pp. 354-358 ◽  
Author(s):  
RS Dua ◽  
SA Wajed ◽  
MC Winslet
Keyword(s):  
Complication Rate ◽  
Surgical Intervention ◽  
Medical Problem ◽  
Hiv And Aids ◽  
Tertiary Referral Centre ◽  
Common Component ◽  
Surgical Practice ◽  
Emergency Procedures ◽  
The Impact ◽  
Hiv Aids

INTRODUCTION Surgical intervention has become a common component in the management of patients infected with the human immunodeficiency virus (HIV) or suffering from the clinical consequences of acquired immunodeficiency syndrome (AIDS). We investigated the evolution of this involvement at a tertiary referral centre for this condition over a 16-year period. PATIENTS AND METHODS Detailed retrospective examination of the medical records of HIV-positive patients treated at the Royal Free Hospital between 1986 and 2002 was undertaken. Clinical, pathological and operative details of those patients who underwent surgical intervention were recorded. RESULTS Of the 2100 cases reviewed, 477 patients underwent a combined total of 772 surgical procedures. Of the 772 operations, 95 (12.3%) were performed as emergencies. Anorectal surgery represented the highest group with a total of 195 procedures (25.26%) being undertaken. The majority of patients (59%) had AIDS at the time of surgery, and 27.04% had a significant co-existing medical problem. Overall postoperative complication rate was 10.1%, with the risk being significantly greater in those undergoing intra-abdominal surgery and emergency procedures. CONCLUSIONS This is the largest study to audit the impact of HIV/AIDS in general surgical practice in the UK retrospectively. Surgery for HIV patients can be safely conducted with a low complication rate for the diagnostic and anorectal procedures that comprise the vast majority of surgery in HIV/AIDS patients. Medical treatment for patients with HIV/AIDS has developed dramatically over the last two decades. In parallel, this has resulted in a heavy, new and varied workload for general surgeons, who have also had to adapt in order to deal with the challenging spectrum of this disease.

Prevention of Hiv/Aids-Associated Opportunistic Infections Through Housing and Municipal Services

2008 ◽  
Vol 33 (4) ◽  
pp. 43-52
Author(s):  
Richard Tomlinson
Keyword(s):  
Hiv Prevention ◽  
Opportunistic Infections ◽  
Labour Force ◽  
Hiv And Aids ◽  
World Health ◽  
Clinical Staging ◽  
Municipal Services ◽  
Home Based ◽  
Home Based Care ◽  
Hiv Aids

The background to this paper is the increasing interest in the relationship between housing and municipal services and HIV/AIDS. The purpose of this paper is to clarify what, precisely, one has in mind when thinking that housing and municipal services might prevent HIV infection and associated opportunistic infections. The focus is not on the socioeconomic dimensions but on the modes of transmission associated with specific opportunistic infections. That is, the paper first disputes the relevance of housing and services to HIV prevention, but then demonstrates that housing and municipal services are important for (a) the prevention of certain opportunistic infections to which people affected by HIV/AIDS are particularly vulnerable, and (b) for the provision of home-based care. In addition to the medical focus of the paper, there is attention to the empirical backdrop on the relation between housing, municipal services and HIV/AIDS, analysing survey findings regarding among whom and where HIV prevalence is highest, and projections regarding the extent of HIV infections and AIDS based on the World Health Organization clinical staging system. Using Johannesburg as a case study, it is demonstrated that the number of persons having AIDS is smaller than one might expect and also that the number is already declining, which has implications for the provision of home-based care. However, it is also shown that the number of households that lost one or several members is increasing rapidly. In this context, labour force surveys are employed to identify the impacts on specific categories of households. At this stage, a defining unknown is the scale, nature and location of these reconstituted households and what this means for housing policy. Finally, a feature of the research was the extent to which medical practitioners viewed housing as a quixotic sideline within the broader struggle for HIV prevention and the provision of treatment. In sum, the paper provides an argument for incorporating housing and municipal services into both HIV and AIDS prevention and treatment programmes.

Language and Representation: Framing of HIV/AIDS Discourse in Gikuyu “Mukingo” Songs and Common-Talk by Public Transport Operators in Nyeri Town

2019 ◽  
Vol 1 (2) ◽  
pp. 78-94
Author(s):  
Mary Kamunyu; Phylis Bartoo
Keyword(s):  
Critical Discourse Analysis ◽  
Public Transport ◽  
Hiv And Aids ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Group Discussions ◽  
Social Phenomena ◽  
African Languages ◽  
Collection Data ◽  
Hiv Aids

This paper aims to uncover representations and framings of the HIV/AIDS phenomenon. The paper asks: What are the representations and framings of the HIV/AIDS phenomenon in HIV/AIDS discourse in Gikuyu AIDS "Mukingo" songs and common-talk by public transport operators in Nyeri town? Although HIV and AIDS are biomedical and social phenomena that affect Kenyan society to the core, HIV/AIDS discourse has not been investigated adequately, especially with regard to how its discourse is represented in the African languages. The language and topics of research on HIV/AIDS, based on Western perceptions of reality, continue to exclude and marginalize the Third World’s own perceptions of reality and what counts as knowledge in the fight against HIV/AIDS. The paper is hinged within the frameworks of Critical Discourse Analysis (CDA) and Systemic Functional Linguistics Theory (SFL) as the theoretical orientations to the study of HIV/AIDS discourse. To get the needed data, the paper used purposive, and snowball sampling was used due to the mobile nature of public transport operators. Structured interviews and Focus Group Discussions (FGD) was also used for data collection. Data analysis was done using a traditional thematic analysis. Unpacking the social constructions of HIV/AIDS in this paper sheds light on the ways in which laypeople construct “common sense assumptions”, of the epidemic in the public realm.

Drug–drug interactions

ESC CardioMed ◽  
2018 ◽  
pp. 226-233
Author(s):  
Jeffrey K. Aronson
Keyword(s):  
Drug Interaction ◽  
Protein Binding ◽  
Drug Interactions ◽  
Adverse Reactions ◽  
Mechanisms Of Action ◽  
Intravenous Drug ◽  
Cellular Distribution ◽  
Drug Infusion ◽  
Pharmacodynamic Interactions ◽  
Site Of Action

A drug interaction occurs when the effects of a drug are altered by the effects of another drug, a vaccine, herb, foodstuff, or device. In drug–drug interactions, a precipitant drug increases or reduces the effects of an object drug by pharmaceutical, pharmacokinetic, or pharmacodynamic mechanisms. Pharmaceutical interactions occur during intravenous drug infusion; they are avoidable by infusing drugs separately. Pharmacokinetic interactions can arise from altered absorption, protein binding, cellular distribution, metabolism, or excretion of an object drug. The last two mechanisms are the most important. Pharmacodynamic interactions can be direct (antagonism or synergism at the same site of action, or summation or synergism of similar effects at different sites) or indirect (when an outcome of an action of a precipitant drug alters the effects of an object drug). Some drug–drug interactions are beneficial, through combining drugs with different beneficial mechanisms of action or using drugs to reverse or prevent adverse reactions.

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