[med]HIV infection
Oral thrush
Bactrim
Fluconazole(200) 1 * 1 po pc 7day
Esophageal candidiasis
Fluconazole(200)1-2tab po OD 14-21day
PCP
Bactrim 3-4 tab po TID pc 21day
then 2 tab po OD long life
Prednisolone (60mg/day)7-10day เมื่อPaO2 <70 or A-a gradiene>35 or respiratory failure
TB
2IRZE/4-7 IR
Cryptococcosis
AmphotericinB 0.7-1 MKD 14day
then Fluconazole 400mg/day 10wk
then 200mg/day long life
Toxo
Bactrim 3 tab po TID
+- pyrimethamine (25)8tab po stat
then 4tab po OD 6 wk
then bactrim 2 tab po OD
MAC
Azithromycin 1,200 mg q wk
or
Clarithromycin 500 mg BID
Herpes simplex
Acyclovir (200) 1 tab po 5day
or 5 mg/kg iv q 8 hr 7-14day(severe)
PPE
0.1%TA cream apply lesion BID
Herpes zoster
Acyclovir (800) 1tab po OD 5day
or 10 mg/kg iv q 8 hr 10-14day
การเริ่มยาARV
นิยมใช้NNRTI regimen
NRTI 2 ตัว + NNRTI 1 ตัว
ได้แก่
: GPO Vir s 30 ( d4T + 3TC + NVP )
1 tab po q 12 hr
: GPO Vir Z 250 ( AZT + 3TC + NVP )
1 tab po q 12 hr
EFV base regimen ได้แก่
: d4T + 3TC + EFV
: AZT + 3TC + EFV
Boosted PI regimen กรณีใช้ NNRTI ไม่ได้
: IDV/r
: LPV/r
การ lead in
เพราะ NVP มักเกิดSJS, hepatitis, hepatic failure
โดยให้ NVP -> OD ไป 2 wk -> BID
เช่น GPO Vir S เช้า ร่วมกับ แยกเม็ดของ d4T และ 3TC เย็น
หรือ GPO Vir Z เช้า ร่วมกับ Zilavir(AZT+3TC) เย็น
โดย f/u CBC, AST, ALT, MP rash, SJS
Side effect ARV drug
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