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Ch 93
Drugs for HIV infection
15
Pharmacology
Undergraduate 3
07/30/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
MOA of Zidovudine (Retrovir, AZT):
Definition
inhibits reverse transcriptase
Term
Adverse effects of Zidovudine (Retrovir, AZT):
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
Term
What are the nursing implications of Zidovudine (Retrovir, AZT):
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
Term
What is important to monitor when giving Zidovudine (Retrovir, AZT)?
Definition
Viral load and CD4 T-cell count. CBC, hemoglobin, hematocrit.
Term
MOA of Efavirenz (Sustiva):
Definition
Binds directly to HIV reverse transcriptase and disrupts active center of enzyme; only for HIV-1
Term
Efavirenz (Sustiva) has some adverse effects, what are they?
Definition
Most common reaction is CNS (insomnia, dizziness, hallucinations, depression), also rash, liver damage Is teratogenic.
Term
Drug interactions with Efavirenz (Sustiva) include?
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)
Term
What HIV medication should be taken on an empty stomach?
Definition
Efavirenz (Sustiva)
Term
MOA of Lopinavir/Ritonavir (Kaletra):
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
Term
Adverse effects of Lopinavir/Ritonavir (Kaletra):
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)
Term
Nursing implications, Preadmin assessment and monitoring for Lopinavir/Ritonavir (Kaletra) include:
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!
Term
MOA of Enfuvirtide (Fuzeon):
Definition
Prevents the HIV envelope from fusing with the cell membrane of CD4 cells, and thereby blocks viral entry and replication
Term
Adverse effects of Enfuvirtide (Fuzeon):
Definition
i.Injection-site reactions- given Sub-Q b.i.d. (rotate sites)
ii.Pneumonia (caution in smokers and lung disease)
iii.Hypersensitivity reactions
Term
Nursing Implications of Enfuvirtide (Fuzeon):
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
Term
Why does drug resistance occur in HIV infection?
Definition
Not taking medication as directed and being infected by resistant strain.
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