Pharmacologic: protease inhibitors, metabolic inhibitors
HIV infection (with other antiretrovirals).
Lopinavir: Inhibits HIV viral protease. Ritonavir: Although ritonavir has antiretroviral activity of its own (inhibits the action of HIV protease and prevents the cleavage of viral polyproteins), it is combined with lopinavir to inhibit the metabolism of lopinavir, thus increasing its plasma levels. Therapeutic Effects: Increased CD4 cell counts and decreased viral load with subsequent slowed progression of HIV infection and its sequelae.
Adverse Reactions/Side Effects
CNS: headache, insomnia, weakness. GI: diarrhea (↑ in children), abdominal pain, nausea, pancreatitis, taste aversion (in children), vomiting (↑ in children). Derm: rash.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Emphasize the importance of taking lopinavir as directed even if the patient is asymptomatic and that this drug must always be used in combination with other antiretroviral drugs. Do not take more than prescribed amount, and do not stop taking without consulting health care professional.
Inform patient that lopinavir does not cure HIV or AIDS or prevent associated or opportunistic infections. Lopinavir does not reduce the risk of transmission of HIV to others through sexual contact or blood contamination. Caution patient to use a condom, and to avoid sharing needles or donating blood to prevent spreading the AIDS virus to others.
Advise patient about the likelihood of GI reactions (nausea, diarrhea, vomiting, taste changes). Instruct patient to report severe or prolonged GI problems or signs of pancreatitis such as upper abdominal pain (especially after eating), indigestion, weight loss, and oily stools.
Instruct patient to report other troublesome side effects such as prolonged or severe headache, skin rash, or sleep loss.
Absorption: Well absorbed following oral administration; food enhances absorption.
Distribution: Ritonavir—poor CNS penetration.
Protein Binding: Lopinavir—98–99% bound to plasma proteins.
Metabolism and Excretion: Lopinavir—completely metabolized in the liver by cytochrome P450P3A (CYP450P3A); ritonavir is a potent inhibitor of this enzyme. Ritonavir—highly metabolized by the liver (by CYP450P3A and CYP2D6 enzymes); one metabolite has antiretroviral activity; 3.5% excreted unchanged in urine.
Half-life: Lopinavir—5–6 hr; Ritonavir—3–5 hr.
Log In to View More
If your institution is currently a subscriber
of the F.A. Davis PT Collection please sign in below.
If your institution is not a subscriber
please click here
to learn more.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.