RESUMEN
Objective: To update information about drug interactions in patients with HIV/AIDS. Methods: Comprehensive literature review in MEDLINE/PubMed database from May of 2009 to December of 2014, using the Mesh terms: Anti-retroviral agents and drug interactions or herb-drug interactions or food-drug interactions. Publications with drug interactions in humans, in English or Spanish, and with full text were retrieved. Additionally, citation lists from identified articles were reviewed. The study inclusion was assessed by three independent researchers and by consensus among them when was necessary. Clinical relevance of drug interaction was grouped into four levels according to seriously and probability of occurrence. Results: Global, 546 different references were retrieved and 243 were selected. In addition 11 further manuscripts were identified in the references of the included articles. Overall, 935 pairs of drug interactions were identified, 95.7% pharmacokinetic (823 by enzyme induction or inhibition and 67 by changes in bioavailability). Of the 935 pairs of drug interactions, 402(43%) were classified as levels 1 or 2. Conclusions: The most clinically relevant antiretroviral drug interactions are due to pharmacokinetic mechanism, mainly induction or enzyme inhibition, according to previous reviews, the protease inhibitors remain as the antiretrovirals with the highest number of clinical relevant interactions.
Objetivo: Actualizar información sobre interacciones medicamentosas en pacientes con VIH/SIDA. Métodos: Revisión estructurada en MEDLINE/PubMed utilizando los términos Mesh: Anti-retroviral agents and drug interactions or herb-drug interactions or food-drug interactions, entre mayo de 2009 y diciembre de 2014. Publicaciones sobre interacciones medicamentosas, en humanos, en inglés o español y con acceso a texto completo fueron seleccionadas. Además, se incluyeron referencias de artículos considerados relevantes. La inclusión de los artículos fue evaluada por tres investigadores independientes y, en caso de requerirlo, por consenso entre ellos. La relevancia clínica se estableció en cuatro niveles, acorde con la gravedad y probabilidad de ocurrencia de la interacción. Resultados: Se identificaron 546 artículos, de los cuales se seleccionaron 273; además, se incluyeron 11 referencias relevantes. Se identificaron 935 parejas de interacciones medicamentosas, 95,7% farmacocinéticas. De este grupo, 823 mediadas por inducción o inhibición enzimática y 67 por cambios en la biodisponibilidad. De las 935 parejas de interacciones, 402 (43%) fueron relevantes clínicamente (niveles 1 o 2). Conclusiones: Las interacciones medicamentosas con anti-retrovirales de mayor relevancia clínica se deben a mecanismos farmacocinéticos, principalmente inducción o inhibición enzimática. Acorde con revisiones previas, los inhibidores de proteasa continúan siendo los anti-retrovirales con mayor número de interacciones relevantes.
Asunto(s)
Humanos , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Antirretrovirales/farmacocinética , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/etiología , Inhibidores de Proteasas/farmacocinética , Factores de Riesgo , Interacciones FarmacológicasRESUMEN
OBJECTIVE: To update information about drug interactions in patients with HIV/AIDS. METHODS: Comprehensive literature review in MEDLINE/PubMed database from May of 2009 to December of 2014, using the Mesh terms: Anti-retroviral agents and drug interactions or herb-drug interactions or food-drug interactions. Publications with drug interactions in humans, in English or Spanish, and with full text were retrieved. Additionally, citation lists from identified articles were reviewed. The study inclusion was assessed by three independent researchers and by consensus among them when was necessary. Clinical relevance of drug interaction was grouped into four levels according to seriously and probability of occurrence. RESULTS: Global, 546 different references were retrieved and 243 were selected. In addition 11 further manuscripts were identified in the references of the included articles. Overall, 935 pairs of drug interactions were identified, 95.7% pharmacokinetic (823 by enzyme induction or inhibition and 67 by changes in bioavailability). Of the 935 pairs of drug interactions, 402(43%) were classified as levels 1 or 2. CONCLUSIONS: The most clinically relevant antiretroviral drug interactions are due to pharmacokinetic mechanism, mainly induction or enzyme inhibition, according to previous reviews, the protease inhibitors remain as the antiretrovirals with the highest number of clinical relevant interactions.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Antirretrovirales/farmacocinética , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/etiología , Interacciones Farmacológicas , Humanos , Inhibidores de Proteasas/farmacocinética , Factores de RiesgoRESUMEN
Plant-based whole foods provide thousands of bioactive metabolites to the human diet that reduce the risk of developing chronic diseases. ß-Caryophyllene (CAR) is a common constituent of the essential oil of numerous plants, vegetables, fruits and medicinal herbs, and has been used as a flavouring agent since the 1930 s. Here, we report the antioxidant activity of CAR, its protective effect on liver fibrosis and its inhibitory capacity on hepatic stellate cell (HSC) activation. CAR was tested for the inhibition of lipid peroxidation and as a free radical scavenger. CAR had higher inhibitory capacity on lipid peroxidation than probucol, α-humulene and α-tocopherol. Also, CAR showed high scavenging activities against hydroxyl radical and superoxide anion. The activity of 5-lipoxygenase, an enzyme that actively participates in fibrogenesis, was significantly inhibited by CAR. Carbon tetrachloride-treated rats received CAR at 2, 20 and 200 mg/kg. CAR significantly improved liver structure, and reduced fibrosis and the expression of Col1a1, Tgfb1 and Timp1 genes. Oxidative stress was used to establish a model of HSC activation with overproduction of extracellular matrix proteins. CAR (1 and 10 µm) increased cell viability and significantly reduced the expression of fibrotic marker genes. CAR, a sesquiterpene present in numerous plants and foods, is as a natural antioxidant that reduces carbon tetrachloride-mediated liver fibrosis and inhibits hepatic cell activation.
Asunto(s)
Antioxidantes/uso terapéutico , Intoxicación por Tetracloruro de Carbono/prevención & control , Suplementos Dietéticos , Células Estrelladas Hepáticas/metabolismo , Hígado/metabolismo , Sesquiterpenos/uso terapéutico , Animales , Antioxidantes/administración & dosificación , Antioxidantes/metabolismo , Antioxidantes/farmacología , Araquidonato 5-Lipooxigenasa/química , Araquidonato 5-Lipooxigenasa/metabolismo , Intoxicación por Tetracloruro de Carbono/metabolismo , Intoxicación por Tetracloruro de Carbono/patología , Línea Celular , Supervivencia Celular/efectos de los fármacos , Femenino , Aromatizantes/administración & dosificación , Aromatizantes/metabolismo , Aromatizantes/uso terapéutico , Depuradores de Radicales Libres/administración & dosificación , Depuradores de Radicales Libres/metabolismo , Depuradores de Radicales Libres/uso terapéutico , Células Estrelladas Hepáticas/efectos de los fármacos , Células Estrelladas Hepáticas/enzimología , Peroxidación de Lípido/efectos de los fármacos , Inhibidores de la Lipooxigenasa/administración & dosificación , Inhibidores de la Lipooxigenasa/metabolismo , Inhibidores de la Lipooxigenasa/uso terapéutico , Hígado/efectos de los fármacos , Hígado/patología , Sesquiterpenos Monocíclicos , Estrés Oxidativo/efectos de los fármacos , Sesquiterpenos Policíclicos , Probucol/farmacología , Probucol/uso terapéutico , Distribución Aleatoria , Ratas , Ratas Wistar , Sesquiterpenos/administración & dosificación , Sesquiterpenos/metabolismo , alfa-Tocoferol/metabolismo , alfa-Tocoferol/uso terapéuticoRESUMEN
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Asunto(s)
Humanos , Anciano , Fototerapia/métodos , Luminiscencia , Trastornos del Inicio y del Mantenimiento del Sueño/terapiaRESUMEN
Para que el farmacéutico realice el seguimiento farmacoterapéutico, dentro de la atención farmacéutica, en el Consenso de Granada se desarrolló una clasificación de problemas relacionados con medicamentos (PRM). En esa reunión se dió una definición de PRM que puede haber estado provocando confusión entre los farmacéuticos que no diferenciaban causas, PRM y sus consecuencias. El presente trabajo propone una definición de PRM como fallos de la farmacoterapia, así como propone su inclusión en la Clasificación Internacional de Atención Primaria en una categoría diferenciada (AU)
A classification of drug-related problems (DRP), also named drug therapy problems, was developed after the Consensus of Granada so that the Pharmacists could carry out drug therapy follow-up within Pharmaceutical Care. in this meeting a definition of DRP was given which may have been producing confusion among the pharmacists that were not differentiating causes, DRP and their consequences. The present study proposes a definition of DRP as failures in drug therapy, and likewise its inclusion in the Primary Care International Classification in a differentiated category (AU)