scholarly journals Polypharmacy Leading to Priapism in HIV Patient with Schizoaffective Disorder: A CYP450 Cascade

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Vinod Sharma ◽  
Aditi Sharma
Keyword(s):  
Reuptake Inhibitor ◽  
Highly Active Antiretroviral Therapy ◽  
Psychiatric Patients ◽  
Medication History ◽  
Medical Problems ◽  
Highly Active ◽  
Sexual Side Effects ◽  
Increasing Trend ◽  
Dopamine Reuptake Inhibitor ◽  
Cyp450 Enzyme

With increasing trend of polypharmacy, there are higher chances of drug-drug interactions leading to adverse effects, especially in psychiatric patients with co-morbid chronic medical problems. This case demonstrates a schizoaffective 30-year-old male on highly active antiretroviral therapy (HAART) who reported an incident of priapism potentially caused by an interaction between previously prescribed atypical antipsychotic, trazodone, norepinephrine dopamine reuptake inhibitor (NDRI), HAART, and newly added selective serotonin reuptake inhibitor (SSRI). This case emphasizes obtaining careful medication history, understanding cytochrome P450 (CYP450) enzyme and its subtypes, and discouraging polypharmacy. Clinicians must educate their patients about different sexual side effects as these can be socially stigmatizing and can further deteriorate mental health symptoms.

SPECTRUM OF DISEASE, MANAGEMENT, EFFICIENCY, CLINICAL PROFILE AND OUTCOMES OF RETROVIRAL DISEASE PATIENTS

INDIAN DRUGS ◽  
2021 ◽  
Vol 58 (09) ◽  
pp. 47-51
Author(s):  
Narmada Talasila ◽  
Amith S. Papatla ◽  
Ragini Thummanapally ◽  
Vasudha Bakshi ◽  
Hemanth Kumar B ◽  
...  
Keyword(s):  
Viral Load ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Integrase Inhibitor ◽  
Undetectable Viral Load ◽  
Disease Stage ◽  
Care Hospital ◽  
Medication History ◽  
Highly Active

HIV is a virus that targets and alters the immune system, increasing the risk and impact of other infections and diseases. Without treatment, the infection might progress to an advanced disease stage called AIDS. A prospective study was conducted for a period of 6 months in a tertiary care hospital with the sample size of 102 patients. A data collection form was taken, which includes the details of demographics date of visit to the hospital, diagnosis, past and current medication history. 102 Inpatients and Outpatients diagnosed with HIV were considered. For the management of HIV, 52 % of 2 NRTI and 1 NNRTI combination and 35 % of 2 NRTI and 1 integrase inhibitor combination were used. The drug usage pattern was found to be tenofovir 74.5 %, lamivudine 83.3 % and Efavirenz 50.9 %. The percentage of subjects with opportunistic infections was 66.6 % and, among these opportunistic infections, tuberculosis was found to be 47.05 %. The viral load after 6 months of ART was found to be undetectable in 95.09 % patients. The levels of CD4 counts were raised after initiation of the ART in 6 months of duration. The death rate was found to be 4.90 %. Due to highly active antiretroviral therapy and effi cient opportunistic infection management, the patients had elevated CD4 levels and undetectable viral load. Hence HAART is highly effi cient in management of HIV which ultimately improves the quality of life of patients.

Chris Hani Baragwanath Hospital (CHB) Neuropsychiatric unit: HIV Positive Psychiatric Patients on Antiretrovirals

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Jonsson ◽  
M. Moosa ◽  
F. Jeenah
Keyword(s):  
Mentally Ill ◽  
Highly Active Antiretroviral Therapy ◽  
Psychiatric Patients ◽  
First Episode ◽  
Hiv Positive ◽  
Psychiatric Unit ◽  
Eligibility Criteria ◽  
Female Ratio ◽  
Viral Loads ◽  
Highly Active

Aim:To describe the characteristics of a group of HIV positive psychiatric patients on highly active antiretroviral therapy (HAART).Method:All mentally ill patients admitted to the psychiatric unit at CHB that were HIV positive where included in the audit. Patients that met the following criteria where initiated on HAART: CD4 of 200 or less cells/mm3; diagnosis of a WHO Stage 4 condition.Results:Since the inception of the service, the hospital admitted 573 mentally ill patients of which a group of 42 (7.3%) where confirmed as HIV positive. The mean age of the group was 39.2 years with a male: female ratio of 1:4.3. 42.9% of the patients presented with maniform symptoms. For 20 patients this was their first episode of mental illness. Only 11 (26.2%) patients were subjected to a CT scan and 18 (42.9%) to a lumbar puncture. In this group of HIV positive patients, 30 met the eligibility criteria and were commenced on HAART: 28 were treated with regimen 1b and 2 with regimen 1a. 16 patients had subsequent CD4 counts and 14 follow up viral loads performed. The viral loads of 13 patients had reached the required decrease in Log value at six weeks of HAART.Conclusion:A significant percent of all mentally ill patients admitted to the psychiatric unit at CHB are found to be HIV positive despite the fact that HIV screening is not done routinely on all patients. The majority of these patients have advanced disease and are eligible for HAART.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

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