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PubMed2001

Quick reference guide to antiretrovirals.

Antiretroviral therapy continues to rapidly evolve and complex drug interactions are common. The quick reference guide is an attempt to summarize the following aspects of highly active antiretroviral treatment in concise tables: dosing of antiretroviral agents; drug-drug interactions between antiretroviral agents; antiretroviral resistance mutations and interactions of antiretroviral agents with TB-medications, oral contraceptives and methadone. Dosing and drug interaction data has been collected from manufacturers' dosing information, peer reviewed medical journals and scientific meetings. References are inserted directly in the tables referring to conferences or publication the information is derived from. In order to remain clinically relevant, regular updates to this publication are posted on the Medscape Web site at http://hiv.medscape.com/updates/quickguide - Please check regularly to ensure you are using the most recent edition. It is available as an HTML document; a PDF document; and for downloading to your Palm organizer.

Antiviral Agents↗
PubMed2001

[Value of saquinavir in antiretroviral treatment of adult HIV-1 infection in 2001].

Saquinavir is an HIV protease inhibitor (PI) which, formulated as a hard-gel capsule (HCG), was the first drug of its class to become available for the treatment of patients with HIV infection. The limited bioavailability of this drug was responsible for a reduced number of prescriptions when new PI were available. Since 1997, combination therapy with ritonavir has improved the pharmacokinetics parameters resulting in a better clinical benefit. Saquinavir (HGC) monotherapy is not yet recommended. Soft gel capsule (SGC) has improved biodisponibility. Efficacy of SQV has been shown in clinical studies in first and second line of treatment with PI. Resistance profile is favorable considering the low level of cross resistance with other PI. Better knowledge of saquinavir could help giving back a place to this drug in the anti HIV arsenal.

Adult↗
PubMed2002

Linezolid: its role in the treatment of gram-positive, drug-resistant bacterial infections.

While the choices available for the management of gram-positive, drug-resistant bacterial infections are becoming limited, antimicrobial resistance is becoming increasingly problematic because of the widespread overuse of antibiotics. Linezolid is a synthetic antibiotic belonging to a new class of antimicrobials called the oxazolidinones. Linezolid disrupts bacterial growth by inhibiting the initiation process of protein synthesis--a mechanism of action that is unique to this class of drugs. It is well absorbed with high bioavailability that allows conversion to oral therapy as soon as the patient is clinically stable. It has been approved for certain gram-positive infections including certain drug-resistant enterococcus, staphylococcus, and pneumococcus strains. It is generally well tolerated, with myelosuppression being the most serious adverse effect. As a nonselective inhibitor of monoamine oxidase, caution is recommended when used with adrenergic or serotonergic agents (e.g., tyramine, dopamine, pseudoephedrine, and selective serotonin reuptake inhibitors). Judicious use of this medication should help physicians treat patients with multidrug-resistant infections.

Acetamides↗
PubMedDate not supplied

In vitro antimicrobial interactions of arthemeter with some 4-quinolones.

Bacterial infections often co-exist with acute malarial attacks. The effect of combining arthemeter (a new antimalarial) with some commonly used 4-quinolones (ciprofloxacin, pefloxacin, norfloxacin and nalidixic acid) was investigated in-vitro with a view to providing data for the design of drug regimens for the treatment of such infections. While arthemeter demonstrated no antibacterial activity whatsoever against any of the test microorganisms (E. coli and Staph. aereus), the 4-quinolones shared marked activity. Comparative analyses of the activity of each quinolone alone and in combination with arthemeter showed 0% 43.8%, 44.9% and -12.2% change in the minimum inhibitory concentration (MIC) of nalidixic acid pefloxacin, ciprofloxacin and norfloxacin respectively against E. coli and -17.5%, 22.3% 35.8% and 50.9% change in the MICs of the same respective drugs against Staph. aureus. These changes in MIC were statistically significant (Pf0.05). With respect to infections caused by E. coli and E. coli, the combination of artemether with ciprofloxacin or pefloxacin proves to be a rational chemotherapeutic regimen when such infection co-exist with malaria.

4-Quinolones↗
PubMed1992

Neutrophil stimulation and priming by direct contact with activated human T lymphocytes.

The concept that T lymphocytes regulate neutrophil function has an important implication in the understanding of the role of these cells in immunity against infection and in inflammatory diseases, but evidence for this concept is primarily derived from the effects of lymphokines on neutrophils. We now present evidence to show that living or paraformaldehyde-fixed mitogen-activated T lymphocytes, as well as an activated T cell line (HUT-78), induce by cell-cell contact, an oxygen-dependent respiratory burst measured by both the lucigenin-dependent chemiluminescence assay and superoxide production. Neutrophils reacted with purified human T lymphocytes which had been activated by culture in the presence of PHA and PMA for 72 h showed a marked and significant respiratory burst compared with neutrophils treated with T lymphocytes cultured in the absence of these mitogens. Similar results were observed with the paraformaldehyde-fixed T cell line (HUT-78). The ability to stimulate neutrophils required intact paraformaldehyde-fixed T cells, and neutrophil stimulation failed to occur if the T cells and neutrophils were separated by membrane filters. mAb to TNF-alpha, and TNF-beta blocked the ability of rTNF-alpha and TNF-beta to stimulate neutrophils but did not block the neutrophil response induced by activated T cells. Pretreatment of neutrophils with the activated T lymphocytes enhanced the response to the tripeptide, FMLP. It is therefore conceivable that activated T lymphocytes attracted at sites of inflammation influence neutrophil activity by direct plasma membrane interaction which clearly represents an efficient microbial defence mechanism, minimizing tissue damage during inflammation.

Cell Communication↗