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Joanne J Orrick

Publications and source records attributed to Joanne J Orrick.

4 recordsLinked to original sources
PubMed2004

Atazanavir.

OBJECTIVE: To review the pharmacology, virology, pharmacokinetics, resistance profile, clinical efficacy, safety, and drug interactions of atazanavir. DATA SOURCES: A PubMed and NLMGateway search (1966-June 2004) utilizing the key words atazanavir and BMS-232632 was performed. Abstracts from scientific meetings, including the Conference on Retroviruses and Opportunistic Infections, International AIDS Society Conference on HIV Pathogenesis and Treatment, Interscience Conference on Antimicrobial Agents and Chemotherapy, and the Infectious Diseases Society of America, were also reviewed. STUDY SELECTION AND DATA EXTRACTION: All publications and meeting abstracts were reviewed, and information relevant to the formulary decision-making process was selected. DATA SYNTHESIS: Atazanavir is a once-daily protease inhibitor (PI) that received approval by the Food and Drug Administration in June 2003. In clinical trials in antiretroviral (ARV)-naïve patients, atazanavir had efficacy similar to that of efavirenz or nelfinavir. In ARV-experienced patients, atazanavir was inferior to lopinavir/ritonavir unless atazanavir was coadministered with low-dose ritonavir. Following failure of an atazanavir-containing regimen in ARV-naïve patients, a unique 150L mutation was seen. Atazanavir resistance is likely when resistance to >/=3 PIs is present. Atazanavir can cause increases in unconjugated bilirubin levels, which rarely leads to jaundice or scleral icterus. In contrast to comparators, atazanavir did not negatively impact the lipid profile. Similar to other PIs, atazanavir is metabolized by and inhibits CYP3A at clinically relevant concentrations; therefore, many potential drug interactions exist. CONCLUSIONS: Atazanavir is a once-daily PI that, unlike other PIs, does not negatively impact the lipid profile. Atazanavir may be particularly desirable in patients with hyperlipidemia or other coronary artery disease risk factors.

Atazanavir Sulfate↗
PubMed2004

Resource use and cost of care for patients hospitalised with community acquired pneumonia: impact of adherence to infectious diseases society of america guidelines.

OBJECTIVE: The objective of this study was to compare the inpatient resource use and cost of care for patients hospitalised with community-acquired pneumonia (CAP) who were treated with preferred antibacterial therapy according to the 1998 Infectious Diseases Society of America (IDSA) guidelines with those who were not treated with preferred therapy. METHODS: A multicentre, observational study was conducted in Florida between 1999 and 2000. Hospitalised adult patients (aged > or = 18 years) started on antibacterial therapy for suspected or confirmed CAP were enrolled in the study. Data collected included patient demographic characteristics, pneumonia risk class, resource use (pharmacy, laboratory, radiology, respiratory services, hospital room and board) and economic data. Risk classification according to Fine et al.'s criteria was determined for each patient. Patient's antibacterial therapy was classified as being preferred or non-preferred according to the 1998 IDSA guidelines. Resource utilisation and cost of care were compared between these two groups. RESULTS: Ninety-nine patients were enrolled in the study. The average age was 60.6 years +/- 20.5 years. The percentage of patients in each risk class (according to Fine et al.) were 11.1% in class I, 39.4% in class II, 29.3% in class III, 16.2% in class IV and 4% in class V. The mean cost of hospitalisation per admission (excluding physician cost) was US 3,490 dollars +/- US 3,058 dollars (median US 2,430 dollars) with hospital room/board accounting for the largest percentage (83.7%), followed by laboratory (8.1%), antibacterial (4.6%), radiology (2.6%) and respiratory (0.9%) cost centres [year 2000 values]. The majority of patients (75.8%) received preferred antibacterials according to the IDSA guidelines. The group treated with preferred antibacterials had a shorter mean length of hospital stay (4.5 vs 6.8 days, p = 0.002), a lower total cost of hospitalisation (mean US 3,009 dollars +/- US 2,682 dollars vs US 4,992 dollars +/- US 3,686 dollars; median US 2,047 dollars vs US 3,805 dollars, p = 0.021) and lower antibacterial costs (mean US 117 dollars +/- US 79 dollars vs US 301 dollars +/- US 409 dollars; median US 97 dollars vs US 171 dollars, p = 0.038) compared with patients who did not receive preferred therapy. CONCLUSION: Implementation of protocols according to IDSA guidelines may result in cost savings to institutions wishing to reduce the economic burden associated with treating hospitalised patients for CAP.

Adult↗
PubMed2003

Recognizing and preventing drug interactions in older adults with HIV.

Currently, adults older than 50 account for approximately 15% of the total number of acquired immune deficiency syndrome (AIDS) cases. As baby boomers age, the number of older adults infected with the human immunodeficiency virus (HIV) is expected to rise. This expected increase is due, in part, to an increase in the number of individuals newly diagnosed with HIV, and, in part, to improved efficacy of the highly active antiretroviral therapy (HAART) medications used to treat HIV/AIDS. Older individuals who are infected with HIV also are expected to seek treatment for common conditions associated with aging. Thus, a considerable risk for drug interactions between the medications used specifically for HIV treatment and those used for other conditions exists. This article is intended as a guide for gerontological nurses facing these complexities. It includes reviews of the goals of HAART therapy and of the mechanisms of drug interactions, as well as detailed discussions related to the effects of HAART and their potential interactions with medications used to treat conditions commonly found in aging populations.

Age Factors↗