Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dronabinol, delta-9-tetrahydrocannabinol in sesame oil, has been used for several years as an antiemetic for patients receiving cancer chemotherapy. In combination studies with prochlorperazine, enhancement of efficacy, as measured by duration of episodes of nausea and vomiting and by severity of nausea, has been found. The incidence of psychotropic effects from dronabinol appears to be decreased by concomitant administration of prochlorperazine. In open pilot studies, dronabinol caused weight gain in seven of ten patients with symptomatic HIV infection. In both HIV and cancer patients, dronabinol improved appetite at a dose which was well tolerated for chronic administration.
 ...
PMID:Recent clinical experience with dronabinol. 166 30

Therapeutic observations suggest that azidothymidine (AZT)-resistant HIV+/AIDS patients are frequently offered AZT/dideoxycytidine (DDC) or dideoxyinosine (DDI) therapy. The latter therapies have been associated with the development of acute pancreatitis. During the initial portion of this study, when patients reported limiting ethanol consumption, an increase in CD4+, a decrease in amylase, and a decrease in lipase was observed in patients on DDI monotherapy. Marinol/marijuana usage was associated with depressed CD4+ counts and elevated amylase levels within the DDI subgroup. The purpose of this study was to follow these patients over 1 year and compare clinical indicators of pancreatitis and HIV progression. After 1 year, the remaining 56 patients were reexamined in the follow-up portion for clinical indicators of HIV disease progression and pancreatoxic/hepatotoxic effects. Those in the AZT group, who remained on this therapy throughout the year, had significantly increased amylase values from 55.3 to 69.3 IU/liter (p < 0.05). In the AZT/DDC group, those who remained on combination therapy throughout the year, 4 of the 5 clinical indicators of disease progression changed. Amylase, ALT, and AST all increased significantly from 55.2 to 77.8 IU/liter (p < 0.01), from 38.0 to 92.3 IU/liter (p < 0.05), and from 55.2 to 97.0 IU/liter (p < 0.05), respectively. Lipase levels decreased significantly (106.0 to 74.6 IU/liter, p < 0.05). The most remarkable changes occurred in the AZT/DDC group (who reduced ethanol consumption), wherein clinical indicators of pancreatitis and liver dysfunction declined, including amylase (65.0 to 20.0 IU/liter, p < 0.05), ALT (350.0 to 100.0 IU/liter, p < 0.01), and AST (240.0 to 95.0 IU/liter, p < 0.01). No significant changes were noted in the DDI or AZT groups. Marinol/marijuana use was associated with declining health status in both the AZT and AZT/DDC groups. In contrast, all clinical indicators of pancreatitis improved in the DDI patients who utilized Marinol/marijuana, including amylase (-34%), lipase (-30.8%), ALT (-21.4%), and AST (-20.1%). This paired follow-up study suggests that HIV+/AIDS patients on antiretroviral therapies should restrict their ethanol consumption. In HIV+/AIDS patients with the lowest CD4+ counts (those on DDI monotherapy), utilization of Marinol/marijuana does not seem to have a deleterious impact.
 ...
PMID:The impact of ethanol and Marinol/marijuana usage on HIV+/AIDS patients undergoing azidothymidine, azidothymidine/dideoxycytidine, or dideoxyinosine therapy. 904 84

Marijuana and other drugs have been suggested to act as cofactors for HIV infection. Interestingly, delta 9-THC has been shown to upregulate NF kappa B, a transcription factor utilized by HIV. Therefore, it was of interest to investigate whether cannabinoids can modulate HIV infection and replication. Initially, we tested for evidence of receptor expression by examining for receptor mRNA in various cell lines used to study HIV infection and replication. Cellular RNA was isolated from SupT, and H9, H9MN, and MT-2 cells and RT-PCR was performed. Results showed that, although all of the cell lines tested were positive for CB2 mRNA, only the MT-2 cells also expressed CBI mRNA. Since the MT-2 cells expressed both CBI and CB2 receptor mRNA, we next wanted to determine whether different cannabinoid receptor agonists such as CP-55,940, delta 9-THC, WIN-55,212-2, and WIN-55,212-3 influenced infection of these cells by cell free HIV-1MN. Infectivity assays were performed where MT-2 cells were incubated with drug and cell free virus for 90 min, the free virus washed off, and the cells incubated further, and checked for virus growth by syncytia formation. It was found that the drugs significantly increased syncytia formation when MT-2 cells were cultured in the presence of both drug and cell free HIV-1MN. In conclusion, of the cell lines tested, only the MT-2 cells were positive for both CB1 and CB2 mRNA. In addition, since syncytia formation is an indication of virus infection and cytopathicity it was concluded that cannabimimetic drugs may enhance HIV-1 infection of susceptible cells.
 ...
PMID:Cannabinoid receptor agonists enhance syncytia formation in MT-2 cells infected with cell free HIV-1MN. 966 75

Widespread use of smoked marijuana in the San Francisco Bay Area as a treatment for HIV-related anorexia and weight loss, as well as nausea related to prescribed therapy, prompted the design of a clinical trial to evaluate the safety and effectiveness of this controlled substance. The Community Consortium--the Bay Area's community-based HIV clinical trials organization--designed a first pilot evaluation of smoked marijuana compared to oral tetrahydrocannabinol (THC, synthesized as dronabinol or Marinol) in 1993. A legal source of marijuana could not be identified. Two subsequent applications to the National Institutes of Health were submitted in 1996 and 1997. During the intervening period, increasing numbers of people with HIV infection were obtaining marijuana for "medicinal use" from local Cannabis Buyer's Clubs. In November 1996, California voters endorsed the medical use of marijuana by approving Proposition 215. The federal government's attempt to oppose the voters' mandate led to public outrage. Organized medicine demanded more studies into marijuana's potential use as medicine. The consortium's 1997 proposal to evaluate the potential interaction between THC and widely-prescribed protease inhibitors was positively received. Funding and study-required marijuana cigarettes have been obtained from the National Institute of Drug Abuse, and the first subjects are being enrolled in the trial. When politically sensitive research proposals include sound science, they can prevail if investigators are willing to persist.
 ...
PMID:Medical marijuana: tribulations and trials. 969 78

Dronabinol is an oral form of delta-9-tetrahydrocannabinol indicated for treatment of anorexia associated with weight loss in individuals with AIDS, and nausea and vomiting associated with cancer chemotherapy. The authors reviewed the literature and conducted surveys and interviews among addiction medicine specialists, oncologists, researchers in cancer and HIV treatment, and law enforcement personnel to determine the abuse liability of dronabinol. There is no evidence of abuse or diversion of dronabinol. Available prescription tracking data indicates that use remains within the therapeutic dosage range over time. Healthcare professionals have detected no indication of "scrip-chasing" or "doctor-shopping" among the patients for whom they have prescribed dronabinol. Cannabis-dependent populations, such as those treated in our Clinic and seen by the addiction medicine specialists we interviewed, have demonstrated no interest in abuse of dronabinol. There is no street market for dronabinol, and no evidence of any diversion of dronabinol for sale as a street drug. Furthermore, dronabinol does not provide effects that are considered desirable in a drug of abuse. The onset of action is slow and gradual, it is at most only weakly reinforcing, and the overwhelming majority of reports of users indicate that its effects are dysphoric and unappealing. This profile of effects gives dronabinol a very low abuse potential.
 ...
PMID:Abuse potential of dronabinol (Marinol). 969 81

Anorexia and cachexia are diagnosed in more than two-thirds of all cancer patients with advanced disease, and are independent risk factors for morbidity and mortality. Anorexia, nausea and vomiting often are described as more significant inhibiting factors for quality of life of cancer patients than even intense pain. In 1986, delta-9-tetrahydrocannabinol (THC), the main effective constituent of cannabis, was licensed as an anti-emetic drug in cancer patients receiving chemotherapy. In addition, in clinical studies THC has shown significant stimulation of appetite and increase of body weight in HIV-positive and cancer patients. The appetite-stimulating effect of cannabis itself has also been well documented in many anecdotal cases. There are strong indications that cannabis is better tolerated than THC alone, because cannabis contains several additional cannabinoids, like cannabidiol (CBD), which antagonize the psychotropic actions of THC, but do not inhibit the appetite-stimulating effect. Therefore, we intend to compare the therapeutic effects of whole-plant extracts of cannabis to those of THC (dronabinol) alone in controlled studies.
 ...
PMID:Cancer cachexia and cannabinoids. 1057 85

Weight loss in the HIV patient appears to result from the interplay of poor nutritional intake, altered metabolism, and malabsorption. Rapid weight loss, defined as greater than 4 kg in four months or less, is associated with non-gastrointestinal secondary infection; and slower weight loss is typically associated with diarrheal disorders, malabsorption and villous atrophy. Non-infectious causes of HIV-associated diarrhea may include hyperosmolar tubal feedings, antibiotics, magnesium-containing antacids and supplements, Vitamin C, or sorbitol-containing liquid medications. Antidiarrheal agents fall into three categories: antimotility agents, agents acting directly in the intestinal lumen, and hormonal agents such as octreotide. In one study, 41 percent of the subjects experienced a reduction in diarrhea when treated with octreotide. Nutritional deficits may be associated with painful symptoms of opportunistic infections, side effects of medications, lifestyle issues or psychological issues related to drug treatment. Such deficits can be treated with nutritional supplements, megestrol acetate (Megace), dronabinol (Marinol) and testosterone therapy. One study compared Advera, a recently-released peptide-based nutritional supplement, with a standard formulation, Ensure. It was found to result in better maintenance of body weight with significantly fewer hospitalizations. Recombinant human erythropoietin has been shown to reduce the number of transfusions required in patients receiving zidovudine with low endogenous erythropoietin levels (<500 IU/L). Where it fails to increase the serum hematocrit, iron deficiency is often present. Supplemental iron, given orally as a tablet or liquid, or intravenously as iron dextran, can help resolve this problem.
 ...
PMID:Pharmacologic agents used for nutritional disorders of HIV/AIDS. 1136 99

MediCal will now provide reimbursement for the recombinant human growth hormone (Serostim) from Serono Laboratories through an Food and Drug Administration (FDA)-sanctioned Treatment Investigational New Drug program. The drug has shown promise in the treatment of AIDS-related wasting. California has appropriated $10 million for Serostim for MediCal clients. Patients qualify to receive the drug if they have failed either Megace or Marinol. Patient reimbursement advocacy activities and the distribution of Serostim are now handled by Stadtlanders Pharmacy, a mail-order business that has high visibility among people living with HIV infection and AIDS.
 ...
PMID:Wider access to human growth hormone. 1136 98

Controversy exists about the use of a new oral testosterone treatment, oxandralone (Oxandrin), manufactured by Bio-Technology General of Iselin, NJ. The drug was approved through the Food and Drug Administration's investigational new drugs (IND) procedure for promoting weight gain in HIV-positive individuals. Oxandralone, approved in the 1960s for disorders affecting growth in children, has been shown to have more anabolic activity and fewer masculinizing effects than other testosterone drugs, according to the company literature. However, experts in wasting syndrome are not prescribing the drug for their patients until larger efficacy studies are conducted. Some experts are prescribing the drug for patients identified with low levels of testosterone--research shows that about 20 percent of HIV-positive men have low testosterone levels. Kaposi's sarcoma (KS) may be an adverse effect of the testosterone supplement. Several case reports show that high doses of testosterone can suppress the biological mechanisms that help control KS lesions. Currently, the most effective treatment for wasting is human growth hormone therapy. However, the cost of the treatment, $1,000 per week, is too high for many. Two other drugs approved for the treatment of wasting are Marinol and Megace. In addition, progressive resistance exercise is effective in HIV-positive patients, even with advanced HIV disease and AIDS.
 ...
PMID:Experts leery of new oral testosterone treatment. 1136 43

Many individuals with AIDS will experience HIV wasting syndrome at some time in their disease progression. However, a number of new treatments, including anabolic steroids and a regular regimen of weight lifting, are providing benefits to those who experience this condition. Because wasting is difficult to stop once it has started, preventing or delaying the condition is imperative. Preventive measures include eating well, avoiding infections, and exercising. Treatments and interventions for wasting include nutritional supplements, appetite stimulants, anabolic steroids such as testosterone replacement, human growth hormone therapy, and weight lifting. However, the most effective human growth hormone therapy is probably expensive. Anabolic steroids can be valuable for the 20 percent of HIV-positive males who have below-normal levels of testosterone. Two appetite stimulants approved for use in AIDS patients with weight loss are megestrol acetate (Megace) and dronabinol (Marinol). Weight lifting is a natural way to gain lean body mass and muscle and has been shown to be effective in people who have advanced to a diagnosis of AIDS. Seven tips for fighting weight loss are included.
 ...
PMID:Testosterone replacement, weight lifting help wasting. 1136 46


1 2 3 Next >>