Antiviral

• Abacavir
• Didanosine
• Emtricitabine
• Lamivudine
• Stavudine
• Zidovudine

• Delavirdine
• Efavirenz
• Nevirapine

• Atazanavir
• Indinavir
• Lopinavir
• Ritonavir
• Saquinavir

• Enfuvirtide
• Maraviroc

Raltegravir

• competitive inhibition of HIV-1 reverse transcriptase
• Incorporation into viral DNA chain -> premature chain termination.

HIV 1/2

Mitochondrial toxicity

NRTI

• Guanosine analog
• Oral
• Resistance needs 2-3 mutations

A/E: hypersensitivity reactions

• NRTI
• Deoxyadenosine synthetic analog
• Oral (empty stomach)

A/E: Pancreatitis, neuropathy, cardiomyopathy, retinal changes***

CONTRA: with indinavir, delavirdane, atazanavir, dapsone, itraconazole, & fluoroquinolone

• NRTI
• Fluorinated analog of Lamivudine
• ORAL
• Spectrum: HIV & HBV

Contra: Kids, pregnancy, renal failure, hepatic failure, with metronidazole disulfira or lamivudine

• NRTI
• Cytosine analog
• ORAL
• Spectrum: HIV-1, HBV

MOA: inhibits HIV reverse transcriptase and HBV DNA polymerase

CONTRA: with zalcitabine

• NRTI
• Thymidine analog
• ORAL

A/E: neuropathy, panreatitis, arthralgias.

• CONTRA: Advanced immunosuppression.
• With neuropathy-inducing drugs

• NRTI
• Deoxythymidine analog

• CLINICAL:
• Prevent HIV vertical transmission
• Occupational HIV

MOA: Bind HIV-1 reverse transcriptase in an allosteric fashion.

A/E: Steven Johnsons syndrome

• CONTRA:
• Not with: Anti-arrhythmics
• antihistamines
• sedative hypnotics
• Neuroleptics
• Ergot alkaloid derivatives
• HMG COA reductase inhibitors
• Anticonvulsants
• Oral contraceptives

• NNRTI
• ORAL

CONTRA: pregnancy

ORAL (empty stomach)

• CONTRA:
• High fat meals
• Pregnancy

• NNRTI
• ORAL

Clincal: HIV vertical transmission

MOA: prevent posttranslational cleavage of Gag-Pol polyprotein -> immature viral particles

• A/E: Cushing like fat redistribution
• inc LDL and trigylceride levels

• PI
• ORAL

• Contra:
• with acid-reducing agents
• with indinavir, irinotecan, tenofovir, and efavirenz

• PI
• Oral (empty stomach)

• A/E: indirect hyperbilirubinemia and nephrolithiasis
• Thrombocytopenia

• PI
• Oral with ritonavir (inhibits CYP3A metabolism of lopinavir)

• PI
• Oral

A/E: paresthesias, elevated aminotransferase levels

• Contra: impaired hepatic function
• with digoxin and theophylline

• PI
• Oral(with ritonavir, 2 hours after fatty meal)

Entry inhibitor

Spectrum: HIV 1

MOA: bind gp 41 (mutation)

A/E: hypersensitivity, inc risk of bacterial pneumonia

Entry inhibitor

Oral

Spectrum: R5 HIV-1

• MOA: bind CCR5
• Mutation: in V3 loop of gp 120

Last drive drug

• Integrase inhibitor
• ORAL

Spectrum: HIV1/2

MOA: binds integrase (mutation)

Clinical: treatment experienced patients as last resort

Contra: with rifampin and antacids