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Understanding Ritonavir: Interactions, Side Effects, and its Role in HIV Therapy

This presentation by Peerakarn Banjerdkij explores the essential role of Ritonavir in HIV therapy, detailing its pharmacology, drug interactions, and potential side effects. HIV treatment often requires multiple therapies due to complex drug interactions, particularly with protease inhibitors. The presentation outlines the types of HIV drugs, how they work, and how Ritonavir interacts with other medications, emphasizing the importance of understanding these factors in effective HIV management.

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Understanding Ritonavir: Interactions, Side Effects, and its Role in HIV Therapy

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  1. RITONAVIR INTERACTIONS AND SIDE EFFECTS Present by PEERAKARN BANJERDKIJ

  2. OUTLINE • Introduction • HIV Therapy • Types of HIV-drugs • Protease Inhibitors work • Ritonavir • Pharmacology • Drug Interactions • Side effects • Conclusion

  3. INTRODUCTION Why is the “HIV Therapy” called “multiple therapies”? Ans. : Immune system What is the “medical problem”? Ans. : Drug interactions How many types of HIV-drugs? Ans. : 3 Types

  4. Types of HIV-drugs • 2 main groups • 1. Reverse Transcriptase • 1.1 Nucleoside Reverse Transcriptase • Inhibitors (NRTIs) • zidovudine (AZT) • didanosine (ddI) • 1.2 Non-nucleoside Reverse Transcriptase • Inhibitors (NNRTIs) • nevirapine • delaviridine • 2. Protease Inhibitors (PIs) • indinavir • ritonavir

  5. What is HIV protease?

  6. How do protease inhibitors work?

  7. How do protease inhibitors differ from other available anti-HIV drugs?

  8. OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects

  9. RITONAVIR Pharmacology • Block maturation of virus • By interfering • Act at the stage of HIV replication cycle • Produce resistance • Bound plasma 98-99% • Cross resistance • combine with NNRTIs or NRTIs • combine with PIs Cross resistance

  10. OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects

  11. RITONAVIR Combinations & Interactions What types of other medications can interact with PIs? Ans.1 : HIV-HIV drugs - Combination Therapy - Double-Drug ; PIs + PIs , PIs + NRTIs - Triple-Drug ; PIs+PIs+NNRTIs Ans.2 : HIV-Other drugs ; PIs+Antivirals

  12. RITONAVIR Drug Interactions • Metabolized by P450 at the liver • Combine with competition drugs ; can occur 1. Metabolism of these drugs 2. Concentration of Ritonavir and these drugs

  13. DRUG INTERACTION Between Other drugs and Ritonavir http://www.hivinsite.UCSF.edu/topics/research_advances/2098.339b.html

  14. DRUG INTERACTION Between Other drugs and PIs http://www.thebody.com/hivatis/agents1/table14.html

  15. DRUG COMBINATION Between PIs and PIs * Invirase or Fortovase , + Conducted with Invirase , # with Fortovase http://www.thebody.com/hivatis/agents1/table15.html

  16. OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects

  17. SIDE EFFECTS Adverse Drug Reaction http://www.utoledo.edu/pharmacy/clinical/aids.html http://www.iapac.org/clinmgt/avtherapies/patient/proinbk.html#top

  18. HIV Drugs -Toxicities SIDE EFFECTS http://www.thebody.com/hivatis/agents1/table16.html

  19. OUTLINE • Introduction • Ritonavir • Pharmacology • Drug Interactions • Side effects • Conclusion

  20. CONCLUSIONS Protease Inhibitors can cure or not! Combination ; more efficiency Side effects ; different ways Resistance Problems Cross resistance problems

  21. THE END THANK YOU • Dr. SUVIT • Dr. MARIA • Mr. SOMJERD • CRI OFFIER & OUR CLASS ……...

  22. SIDE EFFECTS Advantages & Disadvantages ofClass-Sparing Regimens http://www.thebody.com/hivatis/agents1/table7.html

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