FARMAKOTERAPI HIV

FARMAKOLOGI 3
UTA, 04 DECEMBER 2017

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 OVERVIEW OF HIV INFECTION
AND ITS TREATMENT
1. CHRONIC COMBINATION ANTIRETROVIRAL THERAPY TO SUPPRESS HIV INFECTION
2. COMBINATION ANTIRETROVIRAL THERAPY:
1. PROLONGS LIFE
2. PREVENTS PROGRESS OF DISEASE CAUSED BY HIV
3. 24 ANTIRETROVIRAL DRUGS ARE AVAILABLE IN THE MARKET (US)
4. 3-DRUGS COMBINATIONS ARE THE MINIMUM STANDARD OF CARE FOR THIS INFECTION
5. SEVERAL THOUSAND POSSIBLE REGIMENS
6. LONGTERM USE OF ANTIRETROVIRALS
7. RATIONAL APPROACH:
1. ESSENTIAL FEATURES OF PATHOPHYSIOLOGY
2. HOW CHEMOTERAPEUTIC AFFECT THE VIRUS
3. HOW CHEMOTERAPEUTIC AFFECT THE HOST
8. CRITICAL FACTORS
1. UNIQUE FEATURES OF ANTIRETROVIRAL
2. LIFELONG ADIMINSTRATION
3. RAPID EMERGENCE OF PERMANENT DRUG RESISTANCE

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 TUGAS TERSTRUKTUR (3)

1. PEMBERIAN TERAPI KOMBINASI

ANTIRETROVIRAL JANGKA PANJANG
BERTUJUAN UNTUK MENEKAN INFEKSI HIV,
MENCEGAH PERKEMBANGAN PENYAKIT
DAN MEMPERPANJANG HARAPAN HIDUP
PASIEN AIDS. MINIMUM STANDAR
KOMBINASI TERDIRI DARI:
A. 2 ANTIRETROVIRAL
B. 3 ANTIRETROVIRAL
C. 4 ANTIRETROVIRAL
D. 5 ANTIRETROVIRAL
E. 6 ANTIRETROVIRAL

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 SITUATIONAL SHIFTING

CONVENIENCE
EFFICACY SAFETY
TOLERABILITY

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 OBJECTIVES

1. SINGLE TABLET FIXED-DOSE

COMBINATION OF DRUGS
2. ORALLY OD OR BID
3. POTENTIAL ADVERSE REACTIONS

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 PATHOGENESIS OF HIV – RELATED DISEASE

1. HUMAN IMMUNODEFICIENCY VIRUS (HIV)

2. LENTIVIRUS  MAMMALIAN RETROVIRUS
3. CHRONIC PERSISTENT INFETION
4. GRADUAL ONSET OF CLINICAL SYMPTOMS
REPLICATION IS CONSTANT FOLLOWING THE
INFECTION
5. HOSTS:
1. HUMAN
2. NONHUMAN PRIMATES

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 HIV FAMILIES

1. HIV - 1
2. HIV - 2
3. SIMILAR IN VITRO SENSITIVITY TO MOST
ANTIRETROVIRAL DRUGS
4. NON-NUCLEOSIDE REVERSE
TRANSCRIPTASE INHIBITORS (NNRTIs):
1. HIV-1 SPECIFIC
2. NO ACTIVITY AGAINST HIV-2

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 REPLICATIVE CYCLE OF HIV-1

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 REPLICATIVE CYCLE OF HIV-1

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 HOW THE VIRUS CAUSES DISEASE

1. SEXUAL TRANSMISSION
2. RAPID BURST REPLICATION PEAKING
3. CD4+T-LYMPHOSITES DECLINE
4. HIV-RNA CONCENTRATION RISE
5. CLINICAL IMMUNOSUPRESSION
6. AIDS – ACQUIRED IMMUNE
DEFICIENCY SYNDROME

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 HIV TRANSMISSION

1. SEXUAL
2. BLOOD TRANSFUSION
3. CONTAMINATED NEEDLE
4. PLACENTA

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 ANTIRETROVIRAL AGENTS (1)

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 ANTIRETROVIRAL AGENTS (2)

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 CLINICAL SUMMARY (1)

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 CLINICAL SUMMARY (2)

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 CLINICAL SUMMARY (3)

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 CLINICAL SUMMARY (4)

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 TUGAS TERSTRUKTUR (1)

1. PENGOBATAN HIV-AIDS BERSIFAT JANGKA

PANJANG DAN KOMPLEKS, KESALAHAN
PEMBERIAN ANTIRETROVIRAL JUGA DAPAT
MEMBERIKAN KONSEKUENSI YANG IREVERSIBEL,
OLEH KARENA ITU PEMBERIAN ANTIRETROVIRAL
HARUS MEMPERTIMBANGKAN FAKTOR BERIKUT:
1. PEMBERIAN ANTIRETROVIRAL SEBAIKNYA MERUPAKAN
KOMBINASI 3 ANTIRETROVIRAL
2. PEMBERIAN ANTIRETROVIRAL SETELAH DILAKUKAN PADA
SUBYEK DENGAN UJI SKRINING HIV POSITIF
3. DAPAT DITOLERASI DENGAN BAIK
4. RESISTENSI VIRUS HIV DAPAT DIATASI DENGAN PEMBERIAN
ANTIRETROVIRAL ZIDOVUDINE TUNGGAL

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 TUGAS TERSTRUKTUR (2)

1. PENGOBATAN HIV-AIDS BERSIFAT JANGKA

PANJANG OLEH KARENA ITU REGIMEN DOSIS
ANTIRETROVIRAL HARUS DITEKANKAN PADA
ASPEK BERIKUT:
1. ANTIRETROVIRAL DAPAT MENEKAN REPLIKASI VIRUS
HIV
2. REGIMEN DOSIS YANG NYAMAN
3. EFEK SAMPING DAPAT DITOLERASI DENGAN BAIK
4. BILA ANTIRETROVIRAL YANG DIGUNAKAN SAAT INI
TIDAK EFEKTIF, DAPAT DIGANTI DENGAN KOMBINASI
ANTIRETROVIRAL YANG BARU

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