HIV pharmacy specialty residency program in Canada.

Prescribing and managing antiretroviral medications is be coming increasingly complex. Furthermore, patients may require agents for the prophylaxis or treatment of opportunistic infections, nutritional deficiencies, pain relief, sleep and mood disturbances, and gastrointestinal and lipid disorders. The median number of daily medications in people with HIV infection ranges from 2 to 5 but may be 24 or more. Such factors as efficacy, toxicity, drug interactions, medication compliance, and drug acquisition need to be considered when selecting a treatment regimen. In one study, 72 significant antiretroviral prescribing errors were noted for 59 hospitalized HIV-infected patients over a 28-month period. Almost half of the errors involved protease inhibitors. Seventy-eight percent of the errors were serious or severe, and 21% were clinically significant. The rate of prescribing errors increased from 2% in 1996 to 12% in the first four months of 1998, reflecting perhaps the increased complexity of the drug regimens. A recent Canadian study found that antiretroviral medications contributed to more than two thirds of adverse-drug-reaction-related