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Titolo:
PHARMACOTHERAPY OF HIV DEMENTIA
Autore:
MELTON ST; KIRKWOOD CK; GHAEMI SN;
Indirizzi:
VIRGINIA COMMONWEALTH UNIV,DEPT PHARM & PHARMACEUT,SCH PHARM,BOX 980533 RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,DEPT PHARM & PHARMACEUT,SCH PHARM RICHMONDVA 23298 GEORGE WASHINGTON UNIV WASHINGTON DC 00000 GEORGETOWN UNIV,SCH MED WASHINGTON DC 00000
Titolo Testata:
The Annals of pharmacotherapy
fascicolo: 4, volume: 31, anno: 1997,
pagine: 457 - 473
SICI:
1060-0280(1997)31:4<457:POHD>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; INFUSION ZIDOVUDINE THERAPY; AIDS-RELATED COMPLEX; CEREBROSPINAL-FLUID; CONTROLLED TRIAL; EXTRAPYRAMIDAL SYMPTOMS; DEPRESSED-PATIENTS; CLINICAL-FEATURES; LITHIUM-CARBONATE; TYPE-1 INFECTION;
Keywords:
HIV DEMENTIA; ZIDOVUDINE; ACQUIRED IMMUNODEFICIENCY SYNDROME; DIDANOSINE; STAVUDINE; LAMIVUDINE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
89
Recensione:
Indirizzi per estratti:
Citazione:
S.T. Melton et al., "PHARMACOTHERAPY OF HIV DEMENTIA", The Annals of pharmacotherapy, 31(4), 1997, pp. 457-473

Abstract

OBJECTIVE: To review the clinical presentation and management of cognitive impairment associated with central nervous system HIV type 1(HN-I) infection. DATA SOURCES: A MEDLINE search pertaining to HN-related dementia (HN-D) and pharmacologic management was performed. Additionalliterature was obtained from reference lists of the identified articles. STUDY SELECTION AND DATA EXTRACTION: All clinical trials and case reports evaluating pharmacologic efficacy in terms of clinical response, cerebrospinal fluid (CSF) changes, and neuropathology were considered for inclusion. Selection was not restricted by study design becausemost information consists of open uncontrolled trials and case reports. DATA SYNTHESIS: HN-D is characterized by a triad of disturbances incognition, motor performance, and behavior in adults. Children present with developmental delay, cognitive impairment, poor brain growth, and other neurologic symptoms, The exact pathophysiologic mechanisms ofHIV-D are not known. Numerous pharmacologic agents (e.g., nucleoside reverse transcriptase inhibitors, pentoxifylline, nitroglycerin, memantine, nimodipine, peptide T) are under investigation for management ofHIV-D. Zidovudine is the most thoroughly investigated medication, with patients developing HIV-D less frequently and showing improvement onneuropsychological, CSF, and neuropathologic evaluations. Sustained response to zidovudine lasts 6 months to 1 year and optimal response isachieved at higher, but less tolerated, dosages. HIV-D patients frequently have comorbid psychiatric disorders requiring psychopharmacologic agents and are sensitive to the adverse effects of these medications. CONCLUSIONS: HIV-D is a devastating complication of HIV-1 infection. Zidovudine is the therapy of choice for prevention and management of cognitive impairment in symptomatic HIV-infected patients and patientswith AIDS. Recommendations for other medications cannot be made secondary to lack of data, The management of HIV-D may include multiple agents as more data become available regarding combination therapy. Well-designed controlled trials are needed to evaluate the efficacy of established treatments and investigational medications in the management of HIV-D.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 00:22:19