Increasing use of ‘party drugs’ in people living with HIV on antiretrovirals

Bracchi, Margherita; Stuart, David; Castles, Richard; Khoo, Saye; Back, David; Boffito, Marta

doi:10.1097/qad.0000000000000786

Cited by 96 publications

(95 citation statements)

References 82 publications

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“…Proteaz inhibitörleri arasında CYP3A4 üzerine etkinliklerinin gücüne göre: ritonavir>indinavir>sakinavir şeklinde bir sıralama yapılabilir [28] . Nükleozit revers transkriptaz inhibitörleri (NRTİ), rilpivirin, raltegravir, dolutegravir ve maravirok etkileşim açısından düşük risk potansiyeline sahip olan ilaçlardır [29] . Sitokrom P450 dışında "çoklu ilaç direnç proteini", "p-glikoprotein", "çoklu ilaç direnci ile ilişkili protein" ve "meme kanseri direnç proteini" gibi efluks proteinleri ilaç etkileşimlerinden sorumlu olabilecek proteinlerdir.…”

Section: İlaç-i̇laç Etkileşimiunclassified

“…Bu yüzden kokain ve Pİ birlikte kullanıldığında (özellikle ritonavir) enzim inhibisyonuna bağlı olarak toksisite gözlenirken; nevirapin, efavirenz ve etravirin gibi enzim indüksiyonu yapan ajanlarla kullanıldığında yoksunluk belirtileri gelişebilir [25,29] . Norkokain hepatotoksik bir ajan olarak bilinir.…”

Section: Kokainunclassified

“…Metamfetamin CYP3A4 ve CYP2D6 ile metabolize olur ve CYP3A4'ü indükleyebilir ve ART ilaçlara yanıtta azalmaya neden olabilir [16] . Metamfetamin metabolizasyonu ritonavirin inhibitör etkisiyle önemli derecede azalır, bu etkileşim toksisite ve mortaliteye neden olabilir [25,29] .…”

Section: Metamfetamin (Kristal Meth)unclassified

“…Ritonavir CYP3A4 yanında CYP2D6, CYP2C9 ve CYP2C19'u da inhibe ederek, MDMA toksisitesinde artışa neden olur [25,58] . Amfetamin ve ARV ilaçların farmakodinamik etkileşiminin bir sonucu olarak organ toksisitelerinde artış görülebilir [29] .…”

Section: Metilen Dioksimetamfetaminunclassified

“…Metabolizasyonunda CYP2B6, 3A4 ve 2C9 izoenzimleri rol alır [29,31,32] . Ketamin ile özelikle ritonavir, nelfinavir, efavirenz arasında etkileşimler görülebilir.…”

Section: Ketaminunclassified

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Recreational Drugs and Antiretrovirals: Is It Worth the World or Trivial?

Kara¹,

İnkaya²,

Demirkan³

et al. 2018

mjima

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According to the World Health Organization, 1 out of 200 people in the world was living with Human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS) in 2015 and four new HIV infections occurred each minute. A relationship between HIV infection and recreational drug use was evident from the very beginning of the HIV epidemic. Recreational drug use is more common in patients living with HIV/AIDS compared to others. Needle-sharing activities, psychological and cognitive consequences of the abused substances facilitate new infections. It is assumed that 1.650.000 individuals were infected with HIV out of 12.190.000 intravenous drug users in 158 countries in 2013. Cytochrome isoenzymes (i.e. CYP3A4, CYP2D6) are responsible from metabolism of non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors and chemokine receptor 5 inhibitors as well as recreational drugs. Recreational and antiretroviral drugs (ARV) may share the same metabolic pathways resulting in drug interactions. Drug interactions may occur because of pharmacodynamic and pharmacokinetic properties of the drugs. Induction of CYP3A4 (due to cocaine, tobacco, chronic alcohol use, etc.) may lead to decreased antiretroviral treatment (ART) effectiveness and increased risk of metabolites-related toxicity, however, inhibition of CYP3A4 (due to marijuana, acute alcohol use, etc.) may lead to increased side effects and drug toxicity. The feeling of moving away from reality and reduction of social pressure associated with recreational drugs mean all the world to the user. However, drug interaction risk makes it challenging for the physicians, when it is time for the selection of ARV. Therefore, physicians' awareness on Abstract Özİnsan immün yetmezlik virüsü ["Human immunodeficiency virus" (HIV)]/Edinsel immün yetmezlik sendromu ["Acquired immune deficiency syndrome" (AIDS)] ile yaşayan insan sayısı, 2015 yılı Dünya Sağlık Örgütü verilerine göre, dünya üzerinde yaşayan tüm insanların yaklaşık 1/200'ini oluşturmaktadır ve her dakika yaklaşık dört kişi HIV ile enfekte olmaktadır. İnsan immün yetmezlik virüsü/Edinsel immün yetmezlik sendromu salgını ilk ortaya çıktığı zamandan itibaren keyif verici madde kullanıcıları ile salgın arasında bir ilişki olduğu fark edilmiştir. Keyif verici maddelerin kullanımı HIV/AIDS ile yaşayan bireylerde genel nüfusa oranla daha fazla görülmektedir. Bu ilişkide enjektörlerin paylaşılması, kullanılan maddelerin neden olduğu psikolojik ve bilişsel durumun etkisi gibi faktörler rol oynamakta ve bulaşı kolaylaştırmaktadır. Tahminlere göre 2013 yılında 158 ülkede 12 milyon 190 bin damar içi madde kullanıcısı bulunmaktadır ve bu kişilerin yaklaşık 1.650.000'i HIV ile enfektedir. Sitokrom izoenzimleri (örneğin; CYP3A4, CYP2D6) antiretroviral tedavide (ART) kullanılan ilaçlardan non-nükleozit revers transkriptaz inhibitörleri, proteaz inhibitörleri, integraz inhibitörleri ve kemokin reseptör tip 5 inhibitörlerinin ve aynı zamanda keyif verici maddelerin metabolizasyonundan...

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Section: İlaç-i̇laç Etkileşimiunclassified

Section: Kokainunclassified

Section: Metamfetamin (Kristal Meth)unclassified

Section: Metilen Dioksimetamfetaminunclassified

“…Metabolizasyonunda CYP2B6, 3A4 ve 2C9 izoenzimleri rol alır [29,31,32] . Ketamin ile özelikle ritonavir, nelfinavir, efavirenz arasında etkileşimler görülebilir.…”

Section: Ketaminunclassified

See 3 more Smart Citations

Recreational Drugs and Antiretrovirals: Is It Worth the World or Trivial?

Kara¹,

İnkaya²,

Demirkan³

et al. 2018

mjima

View full text Add to dashboard Cite

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Addictions and Substance Misuse

2021

The Maudsley Prescribing Guidelines in Psychiatry

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A pilot RCT of an online mindfulness‐based cognitive intervention for chemsex

Banbury,

Lusher,

Chandler

et al. 2023

Couns and Psychother Res

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ObjectivesChemsex is a term used to describe sex acts using psychoactive substances to enhance the sexual experience/arousal and predominates among men who have sex with men (MSM). Chemsex drugs predominantly include γ‐hydroxybutyric acid (GHB) and analogues, methamphetamine, mephedrone and erectile dysfunction agents (e.g., Sildenafil). Mindfulness‐based cognitive therapy (MBCT) combines cognitive therapy and mindfulness and has been shown to help support both sexual functioning and methamphetamine use. However, limited clinical trials have evaluated the use of cognitive mindfulness for chemsex in MSM. The present study assessed the effectiveness of an online mindfulness‐based cognitive intervention (MBCI) among 29 MSM aged 18–30 years engaged in chemsex.Design and SettingA mixed methods approach consisted of a randomised waitlist‐controlled trial and a content analysis reviewing participants' feedback on MBCI. The design of the intervention was based on a behavioural taxonomy mapped to selected behaviour change techniques (BCTs) to support the reliability of MBCI in its delivery.Main Outcome MeasuresParticipants completed assessments measuring levels of chemsex, mindfulness, sexual self‐efficacy and well‐being, taken at Weeks 0, 8 and 12 (follow‐up).ResultsParticipants reported lower levels of chemsex and higher levels of cognitive mindfulness, sexual self‐efficacy and well‐being postintervention and at the 12‐week follow‐up. The content analysis feedback responses yielded favourable outcomes, suggesting that participants developed a sense of self‐compassion, confidence and positive identity.ConclusionsThe MBCI effectively reduced chemsex; however, this study warrants replication with a larger, more diverse group of participants.

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Increasing use of ‘party drugs’ in people living with HIV on antiretrovirals

Cited by 96 publications

References 82 publications

Recreational Drugs and Antiretrovirals: Is It Worth the World or Trivial?

Recreational Drugs and Antiretrovirals: Is It Worth the World or Trivial?

Addictions and Substance Misuse

A pilot RCT of an online mindfulness‐based cognitive intervention for chemsex

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