Dosing Nucleoside Reverse Transcriptase Inhibitors in Adults Receiving Continuous Veno-Venous Hemofiltration

McLaughlin, Milena M.; Ammar, Abeer T.; Gerzenshtein, Lana; Scarsi, Kimberly K.

doi:10.1007/s40261-015-0275-9

Cited by 3 publications

(1 citation statement)

References 27 publications

(26 reference statements)

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“…Increased clearance of NRTIs may lead to decreased drug concentrations, which impact ART efficacy and increase risk for drug resistance [ 21 , 83 ]. Proposed guidelines on dosing of NRTIs based on CVVH flow rate (L/hour) have been published, but later pharmacokinetic studies demonstrated inaccuracies in this approach, with only 41% of NRTIs providing a favorable pharmacokinetic profile [ 83 , 85 ]. Further studies are needed to demonstrate safety and efficacy of renally eliminated antiretroviral medications in the setting of increased renal clearance.…”

Section: Antiretroviral Interactions With Disease States In Pwh Who A...mentioning

confidence: 99%

Managing Modern Antiretroviral Therapy in the Intensive Care Unit: Overcoming Challenges for Critically Ill People With Human Immunodeficiency Virus

Chastain,

Tu,

Brizzi

et al. 2024

Open Forum Infectious Diseases

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People with HIV (PWH) have a 50% excess risk for intensive care unit (ICU) admission, often for non-HIV-related conditions. Despite this, clear guidance for managing antiretroviral therapy (ART) in this setting is lacking. Selecting appropriate ART in the ICU is complex due to drug interactions, absorption issues, and dosing adjustments. Continuing ART in the ICU can be challenging due to organ dysfunction, drug interactions, and formulary limitations. However, with careful consideration, continuation is often feasible through dose adjustments or alternative administration methods. Temporary discontinuation of ART may be beneficial depending on the clinical scenario. Clinicians should actively seek resources and support to mitigate adverse events and drug interactions in critically ill PWH. Navigating challenges in the ICU can optimize ART and improve care and outcomes for critically ill PWH. This review aims to identify strategies for addressing the challenges associated with the use of modern ART in the ICU.

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Section: Antiretroviral Interactions With Disease States In Pwh Who A...mentioning

confidence: 99%

Managing Modern Antiretroviral Therapy in the Intensive Care Unit: Overcoming Challenges for Critically Ill People With Human Immunodeficiency Virus

Chastain,

Tu,

Brizzi

et al. 2024

Open Forum Infectious Diseases

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Evaluation of nucleoside reverse transcriptase inhibitor dosing during continuous veno-venous hemofiltration

McLaughlin

Masic²,

Gerzenshtein

2016

Int J Clin Pharm

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Background Unpredictable drug concentrations may lead to suboptimal exposure to nucleoside reverse transcriptase inhibitors (NRTIs) due to inadequate doses administered during continuous veno-venous hemofiltration (CVVH), which in turn may lead to decreased antiretroviral efficacy and possibly further HIV disease progression. Objective To compare administered doses of NRTIs to calculated doses of NRTIs to evaluate if patients were expected to have a favorable pharmacokinetic exposure profile while receiving CVVH. Methods The NRTI dose was compared to a table of recommendations based on a mathematical formula that estimates the amount of drug expected to be removed during CVVH. Results Twelve patients were on 27 NRTIs. Eleven (41%) NRTI doses were expected to provide a favorable pharmacokinetic profile based on pharmacokinetic mathematical calculations. Conclusion The majority of NRTIs were potentially not optimally dosed based on proposed pharmacokinetic calculations.

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Antiretrovirals for People with HIV on Dialysis

Dandachi

Fabricius

Saad

et al. 2022

AIDS Patient Care and STDs

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Dosing Nucleoside Reverse Transcriptase Inhibitors in Adults Receiving Continuous Veno-Venous Hemofiltration

Cited by 3 publications

References 27 publications

Managing Modern Antiretroviral Therapy in the Intensive Care Unit: Overcoming Challenges for Critically Ill People With Human Immunodeficiency Virus

Managing Modern Antiretroviral Therapy in the Intensive Care Unit: Overcoming Challenges for Critically Ill People With Human Immunodeficiency Virus

Evaluation of nucleoside reverse transcriptase inhibitor dosing during continuous veno-venous hemofiltration

Antiretrovirals for People with HIV on Dialysis

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