Secondary Adrenal Insuffciency Due to the Co-Administration of Ritonavir and Inhaled Fluticasone Propionate Case report
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 3
Abstract
Ritonavir is a powerful inhibitor of the cytochrome P450 3A4 (CYP3A4) isoenzyme. It is used as a pharmaceutical enhancer in the management of HIV-positive patients. However, when co-administered with other drugs that are metabolised via the CYP3A4 pathway, ritonavir can potentially cause serious drug-drug interactions. Inhaled fluticasone propionate, which is used to treat asthma and chronic obstructive airway disease, is particularly prone to such interactions due to its physiological attributes. We report a HIV-positive 48-year-old male patient who presented to Al Nahdha Hospital, Muscat, Oman, in 2012 with weight loss, generalised weakness and fatigue and diagnosed with secondary adrenal insufciency as a result of concomitant ritonavir and inhaled fluticasone.
Authors and Affiliations
Ali Al-Maqbali| Department of Communicable Disease Surveillance & Control, Directorate General of Health Services, Ministry of Health, Al Batinah North Governorate, Oman, Bina Kamble| Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman, Salim Al-Qassabi| Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman, Ali Elgalib| Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman
Keywords
Related Articles
- EP ID EP14800
- DOI 10.18295/squmj.2017.17.03.014
- Views 334
- Downloads 17
Cerebrospinal Fluid Involvement in a Case of Visceral Leishmaniasis Associated with Hemophagocytic Lymphohistiocytosis
Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate with erythrophagocytosis and it includes familial hemophagocytic lymphohistiocytosis and secondary hemophgocytosis. Spinal flu...
Small Incidental Renal Masses in Adults Review of the literature
Incidental renal tumours are becoming an important clinical problem that many physicians will need to deal with. A good knowledge of the nature of these tumours and how to manage them is therefore needed. Te aim of thi...
Re: Perinatal Mortality Rate as a Quality Indicator of Healthcare in Al-Dakhiliyah Region, Oman
Improvement in Adherence to Surgical Antimicrobial Prophylaxis Guidelines after Implementation of a Multidisciplinary Quality Improvement Project
Objectives: Tis study aimed to show the impact of a multidisciplinary quality improvement project on adherence to antimicrobial prophylaxis guidelines in oncological surgery. Methods: Tis pre- and post-intervention pr...
The Dundee Ready Education Environment Measure A prospective comparative study of undergraduate medical students’ and interns’ perceptions in Oman
Objectives: Tis study aimed to assess perceptions of the educational environment in Oman among medical undergraduate students and interns using the Dundee Ready Education Environment Measure (DREEM) tool. Methods: Tis...