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zidovudine
Prototype
Drug Class: Nucleoside reverse transcriptase inhibitor
- AZTManagement of clients with HIV invection; prevention of maternal-fetal HIV transmission
- Mode of action: inhibits viral enzyme reverse transcriptase, an enzyme necessary for viral HIV replication
- S/E: Numbness/tingling, GI intolerance, fever, sore throat, heaache, pruritus, muscle pain, difficulty swollowing, arthralgia, insomnia, confusion, mental changes, bluish borwn bands on fingernails
- A/R: nausea vomiting, anemia, neutropenia, seizures
- Contra: life threatening allergies to zidovudine. Caution: bown marrow compromise, renal and hepatic dysfunction, decreased hepatic blood fow.
- Drug: ganciclovir, trimethoprim/sulfamethoxzole may increase risk of neutropenia; probenecid may increase concentration, risk of toxicity
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efavirenz
Prototype
Drug Class: nonnucleoside transcriptase inhibitor
- SustivaTreatment of HIV-1 infections in combination with at least two other anti-retroviral agents.
- Mode of action: binds to reverse transcriptase, blocking RNA dependent and DNA dependent DNA polymerase activity including HIV-1 replication.
- Side Effects: Rash, CNS effects (dizziness, insomnia, abnormal dreams, impaired concentaraqtion, amnesia, agitation, hallucinations, euphoria, anxiety) nausea, diarrhea
- Adverse Reactions: Agressive allergic reaction, convulsion, liver failure, neurpathy, suicide, abnormal vision
- Contra: allergies to efavirenz, concurent use of midazolam, triazolam, ergot alkaloids
- Drug: St. John's wort, May increase HDL, Avoid alcohol, high fat meals increase absorption.
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lopinavir
prototype only
- Kaletra
- treatment of HIV-1 infection in combination with other antiretroviral agents.
- Mode of Action: Inhibits HIV protease, rendering enzyme incapable of processing polyprotease precursors; production of non-infectious immature HIV particles results.
- S/E: nausea, vomiting, diarrhea, asthenia
- A/R: Hyperglycemia, diabetes mellitus
- Contra: life threatening allergies to lopinavir, concurrent use of ergot alkaloids, midazolam, triazolam, or pimozide.
- Caution: Hx of pancreatitis, liver impairment
- Drug: azole antifungals, lovastatin, rifampin, simvastatin, St. John's wort. Lab: may increase liver function tests, cholesterol, triglycerides
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varicella
prototype
Drug Class: vaccines
- VarivaxPrevention of chickenpox. Results in complete protection from chickenpox for the majority-if breakthrough chickenpox develops after vac. it is very mild. Vac. may also provide prophylaxis protection if administered 3-5days after exposure.
- S/E: pain and redness at injection site, fever chickenpox like rash.
- A/R: anaphylaxis, thrombocytopenia, encephalitis, Stevens-Johnson syndrome
- Contra:previous anaphylaxis to vaccine, pregnacy, immunocompromised vaccine recipient, presence of moderate to severe acute illness, active untreated tuberculosis
- Drug: Separate from MMR vaccine by 4 wk if not given on same day. Delay VV for at least 5 mo after blood transfusion immunie globulin (Ig). delay Ig for 2 mo after VV, high dose immunosuppressant meds, avoid calicylates for 6 wk after VV
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