RESUMO
Voriconazole is the preferred antifungal agent for Aspergillus infections. Therapeutic drug monitoring is recommended to achieve target concentrations and prevent toxicity. However, variable pharmacokinetics, cytochrome P450 polymorphisms, and extensive drug-drug interactions can contribute to subtherapeutic concentrations. We report a voriconazole "boosting" effect of omeprazole to achieve target concentrations for the treatment of Aspergillus in a patient who had persistently subtherapeutic trough concentrations.
Assuntos
Antifúngicos/farmacocinética , Aspergilose/tratamento farmacológico , Omeprazol/uso terapêutico , Pirimidinas/farmacocinética , Triazóis/farmacocinética , Antifúngicos/sangue , Antifúngicos/farmacologia , Aspergilose/microbiologia , Aspergilose/patologia , Aspergillus fumigatus/efeitos dos fármacos , Aspergillus fumigatus/fisiologia , Encéfalo/efeitos dos fármacos , Encéfalo/microbiologia , Encéfalo/patologia , Vias de Administração de Medicamentos , Esquema de Medicação , Monitoramento de Medicamentos , Sinergismo Farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Omeprazol/farmacologia , Pirimidinas/sangue , Pirimidinas/farmacologia , Triazóis/sangue , Triazóis/farmacologia , Voriconazol , Adulto JovemRESUMO
The objective of this report is to describe an urban county hospital human immunodeficiency virus (HIV) infection prevention protocol offering prophylactic combination antiretroviral medications to female victims of sexual assault. A retrospective chart review was conducted from June, 2007 through June, 2008 of 151 women who were prescribed antiretroviral prophylaxis by protocol. All women receiving HIV prophylaxis initially screened HIV seronegative. Of the 58 women who reported taking any HIV prophylaxis, 36 (62%) were HIV screened at 12 and/or 24 weeks and none had HIV seroconverted. Although the initiation of an HIV post exposure prophylaxis protocol for sexual assault in a county hospital population is feasible, patient follow-up for counseling and HIV serostatus evaluation is an identified barrier.
