For the Pharmacist

[ituryu]

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Hello,
I am hoping that you guys could enlighten me hum should I describe it as the mechanism by which antretroviral drugs cause their associated ocular effects such as vitritis, iritis, hypotony and others not mentioned.
Thank you all for your enlightenment

 

[ZpackSux]

hmmm....I don't know.

 

[ituryu]

hmmm....I don't know.

I believe you are a student of Pharmacy, and I think you would know, let me just give you my own idea, there should be a chemical agent in these antiretroviral drugs that is capable of eliciting this iatrogenic changes, and if so what would be the therapeutic management?
Thank you, and I believe you can ration this out one way or the other, you are the professional here and I am asking for your help. 🙂 👍

 

[VCU07]

Of course there is a chemical agent in the drug, but are you speaking of a specific drug? Is is a NRTI, NNRTI, PI, prophylaxis for HIV infections? Also, is the patient on other drugs? There are many specific P450 reactions involved with antiretrovirals, especially ritonavir. Each of these drugs has a different MOA.

I believe you are a student of Pharmacy, and I think you would know, let me just give you my own idea, there should be a chemical agent in these antiretroviral drugs that is capable of eliciting this iatrogenic changes, and if so what would be the therapeutic management?
Thank you, and I believe you can ration this out one way or the other, you are the professional here and I am asking for your help. 🙂 👍

 

[ZpackSux]

I believe you are a student of Pharmacy, and I think you would know, let me just give you my own idea, there should be a chemical agent in these antiretroviral drugs that is capable of eliciting this iatrogenic changes, and if so what would be the therapeutic management?
Thank you, and I believe you can ration this out one way or the other, you are the professional here and I am asking for your help. 🙂 👍

Ok..if you insist. btw, I'm not a student of Pharmacy.

You are perhaps wanting to discuss the Ocular CMV management in HIV patients. This can be done with either oral or IV Ganciclovir for systemic and ocular CMV infection. But direct Ocular management using the new Antisense drug - Fomivirsen which is an Intravitreal Injection is an option. Ouch..

Common side effect of course...intraocular pressure, inflammation, ititis, and vitreitis.. what would cause this? perhaps it's not so "chemical"...but rather from the direct injection into the vitreal chamber?

Thses side effects can be rather transient and resolve...or ocular corticosteroid can be effective.

Or.. just use Ganciclovir PO or IV... and if resistance is an issue.. Fomivirsen is the way to go..I guess.

 

[28657]

Hello,
I am hoping that you guys could enlighten me hum should I describe it as the mechanism by which antretroviral drugs cause their associated ocular effects such as vitritis, iritis, hypotony and others not mentioned.
Thank you all for your enlightenment

Because of the vast therapeutic possibilities, associated opportunistic infections of HIV resulting in AIDS, and the simple fact that antiretroviral therapies are relatively new, leads to the conclusion that a pharmacist is NOT going to be able to answer this question without researching it. If you really want the actual mechanism of action answer to your question, you'll need to ask a PhD in antiretroviral pharmacology or the drug company researchers.

That being said I looked in Goodman Gilman, Koda Kimble, and Dipiro - the "Bibles of Pharmacy" and I found nothing relating to your question. But the internet can be your friend and you can find the same things that I found: The ocular side effects of antiretrovirals aren't very common. Viracept, a protease inhibitor, can cause irititis in less than 2% of users. And like Zpacksux said, Fomiversin can cause eye dysfunction because it is injected intraocularly.

Therefore, it seems as that the majority of retinopathy aren't iatrogenically derived, rather it's due to the disease complications. Again like Zpacksux says - cytomegalovirus is probably the cause of most retinopathy.

 

[bananaface]

http://67.43.153.76/showthread.php?t=164713

Check out this thread. Perhaps JR can share some resources with you.

 

[ZpackSux]

Bad internet manner...to post a topic.. and when answered...he doesn't come back to reply..

 

[bananaface]

That doesn't mean he hasn't read the advice, though.

 

[ZpackSux]

That doesn't mean he hasn't read the advice, though.

I want a "thank you sir." Dang it!!

 

[bananaface]

I want a "thank you sir." Dang it!!

Thank you, sir. 😛

 

[ZpackSux]

Thank you, sir. 😛

Not from you !!!!!! 😛

 

[bananaface]

Not from you !!!!!! 😛

😡 😡 😡




😉

 

[ZpackSux]

😡 😡 😡




😉

Ok... I'm sorry... go ahead and say "Thank you sir" again...

 

[bananaface]

Ok... I'm sorry... go ahead and say "Thank you sir" again...

Thank you, sir. 🙄

 

[ituryu]

Bad internet manner...to post a topic.. and when answered...he doesn't come back to reply..

I am really sorry about that I had to prepare for my seminar presentation on the effect of dissociation and phoria measurement. I had to help my course mate handle this post, no access and wasn't willing to get into the registration thing. My Bad, and I hope you can forgive me please I am soory for my bad manner.

 

[ituryu]

😡 😡 😡




😉

Thank you for the cover up, I think you will both make good team players and I do hope to know you guys better, and less I forget thank you Zpacksux, you have been a really humongus help. 👍

 

[bananaface]

No problem. I think Zpak was just teasing. If not, he's in big trouble!

 

[ZpackSux]

No problem. I think Zpak was just teasing. If not, he's in big trouble!

I'm all about "teasing.."

 

[ZpackSux]

I am really sorry about that I had to prepare for my seminar presentation on the effect of dissociation and phoria measurement. I had to help my course mate handle this post, no access and wasn't willing to get into the registration thing. My Bad, and I hope you can forgive me please I am soory for my bad manner.

I was just kidding..

 

[ituryu]

I was just kidding..

I am Glad about that I thought I would be excommunicated joke!, but I was Hoping if anyone really got more stuffs on the exact causative agent for me, with a possible pathophysiology , I would most appreciate it. And I hope I will be able to check and reply on time this time around 😀