Term
| MOA of Zidovudine (Retrovir, AZT): |
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Definition
| inhibits reverse transcriptase |
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Term
| Adverse effects of Zidovudine (Retrovir, AZT): |
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Definition
i.Anemia and neutropenia—Principal toxic effects; increased risks with high dose therapy, advanced HIV infection, deficiencies in vitamin B12 and folic acid and with concurrent use of drugs that are myelosuppressive, nephrotoxic, or toxic to circulating blood cells; determine hematologic status before treatment and every 4 weeks
ii.Lactic acidosis—With severe hepatomegaly and hepatic steatosis
iii.Other adverse effects—GI effects; #1 is CNS effects (headache) and myopathy |
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Term
| What are the nursing implications of Zidovudine (Retrovir, AZT): |
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Definition
i.Preadministration Assessment: Baseline viral load and CD4 T-cell count. Baseline hemoglobin and granulocyte count. (WBC & Hgb) for anemia
ii.Administration: Available in capsules and syrup for oral therapy and solution for IV; avoid rapid infusion |
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Term
| What is important to monitor when giving Zidovudine (Retrovir, AZT)? |
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Definition
| Viral load and CD4 T-cell count. CBC, hemoglobin, hematocrit. |
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Term
| MOA of Efavirenz (Sustiva): |
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Definition
| Binds directly to HIV reverse transcriptase and disrupts active center of enzyme; only for HIV-1 |
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Term
| Efavirenz (Sustiva) has some adverse effects, what are they? |
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Definition
| Most common reaction is CNS (insomnia, dizziness, hallucinations, depression), also rash, liver damage Is teratogenic. |
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Term
| Drug interactions with Efavirenz (Sustiva) include? |
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Definition
| meds that are metabolized by P450. St John’s Wort- reduces level of Efavirenz, alprazolam- levels can become increased (SSRI, Valium, benzodiazapenes levels increase causing sedation, respiratory depression, low BP) |
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Term
| What HIV medication should be taken on an empty stomach? |
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Definition
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Term
| MOA of Lopinavir/Ritonavir (Kaletra): |
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Definition
Protease inhibitor (does the splicing)
Protease catalyzes final step in HIV maturation (cleaves the bonds in the polyproteins, which would allow for HIV to mature); inhibitors prevent the cleaving process so virus remains immature and noninfectious; in this combination, ritonavir inhibits P450 and decreases the metabolism of lopinavir |
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Term
| Adverse effects of Lopinavir/Ritonavir (Kaletra): |
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Definition
| GI, headache, weakness/tiredness, hyperglycemia, diabetes, fat misdistribution, hyperlipidemia, bone loss, elevation of transaminases, increased bleeding in hemophiliacs, liver problems (much like 2nd generation antipsychotic) |
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Term
| Nursing implications, Preadmin assessment and monitoring for Lopinavir/Ritonavir (Kaletra) include: |
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Definition
i. Preadministration Assessment: Viral load, CD4 T-cell count, LFTs, lipid panel, blood glucose
ii. Administration: Oral
iii. Monitoring: Viral load, CD4 T-cell count, LFTs, lipid panel, blood glucose
iv. Need to follow diet! |
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Term
| MOA of Enfuvirtide (Fuzeon): |
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Definition
| Prevents the HIV envelope from fusing with the cell membrane of CD4 cells, and thereby blocks viral entry and replication |
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Term
| Adverse effects of Enfuvirtide (Fuzeon): |
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Definition
i.Injection-site reactions- given Sub-Q b.i.d. (rotate sites)
ii.Pneumonia (caution in smokers and lung disease)
iii.Hypersensitivity reactions |
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Term
| Nursing Implications of Enfuvirtide (Fuzeon): |
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Definition
i. Preadministration Assessment: Viral load, CD4 T-cell count
ii. Administration: Dispensed in single-use vials of powdered drug, which must be reconstituted with sterile water for injection; administered Sub-Q twice daily; powdered drug stored at room temperature
iii. Monitoring: Viral load, CD4 T-cell count |
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Term
| Why does drug resistance occur in HIV infection? |
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Definition
| Not taking medication as directed and being infected by resistant strain. |
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