Hiv Medications

Front 1

AZT or zidovudine (RETROVIR)

Back 1

– NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
(NRTI)

– a potent HIV drug, used in many combinations
– CBC done frequently due to anemia
• May need drug therapy such as Procrit to counteract this side effect
– *need to know drug

Front 2

3TC or lamivudine (EPIVIR)

Back 2

• NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
– used with AZT
– slows resistance to AZT
– well tolerated
– also is active against hepatitis B
– COMBIVIR is the combination of AZT and 3TC in one pill

Front 3

DDI or didanosine (VIDEX, Videx EC)

Back 3

• NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
– monitor for diarrhea, neuropathy, pancreatitis
– amylase, lipase done frequently
– must be taken on an empty stomach

Front 4

D4T or stavudine (ZERIT, Zerit XR)

Back 4

• NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
– watch for neuropathy
– cannot be used with AZT due to bone marrow toxicity
– often used with DDI or 3TC

Front 5

Abacavir (ZIAGEN)

Back 5

• NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
– hypersensitivity syndrome
• 2-6 weeks after starting
• fever and rash, myalgia, or GI symptoms
• discontinue immediately
• do not EVER take again
• should not D/C and restart medication
• new test available prior to starting to identify people at risk
– new formulation with AZT, 3TC and abacavir in one capsule for BID dosing (TRIZIVIR)

Front 6

Emtricitabine (Emtriva)

Back 6

• NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
– skin pigmentation of palms and soles
– Used to treat Hepatitis B also

Front 7

Delavirdine (RESCRIPTOR)

Back 7

• NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS `
(NNRTI)
• Potent in combination with NRTI or PI
• Resistance to one is resistance to all
• All have rash as a potential side effect which may or may not be significant
– Instruct patients to report any incidence of rash to their HCP

Front 8

Nevirapine (VIRAMUNE)

Back 8

• NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS `
(NNRTI)
• Potent in combination with NRTI or PI
• Resistance to one is resistance to all
• All have rash as a potential side effect which may or may not be significant
– Instruct patients to report any incidence of rash to their HCP

Front 9

Efavirenz (SUSTIVA)

Back 9

• NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS `
(NNRTI)
• Potent in combination with NRTI or PI
• Resistance to one is resistance to all
• All have rash as a potential side effect which may or may not be significant
– Instruct patients to report any incidence of rash to their HCP

– 50% of patients will have disturbing dysphoria or nightmares which resolve with continued dosing. Dosed at night to reduce side effect.
– Teratogenic, avoid first trimester of pregnancy

Front 10

Etravirine (Intelence) new as of 1/08

Back 10

• NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS `
(NNRTI)
• Potent in combination with NRTI or PI
• Resistance to one is resistance to all
• All have rash as a potential side effect which may or may not be significant
– Instruct patients to report any incidence of rash to their HCP

Front 11

PROTEASE INHIBITORS(PI)

Back 11

• Expensive
• Resistance develops quickly from missing doses
• Lipodystrophy is disturbing to body image (abnormal redistribution of body fat)
• Hyperlipidemia, hyperglycemia, and osteoporosis are side effects with long term use
– Patients often on meds for diabetes, high cholesterol, osteoporosis prevention as a result of drug therapy for HIV
• Often used when VL is high or other drugs fail

Front 12

Ritonivir (NORVIR)

Back 12

• PROTEASE INHIBITORS
– many drug interactions
– often combined with other PI’s due to effect on drug levels

Front 13

Lopinavir (Kaletra)

Back 13

• PROTEASE INHIBITORS
– Small amount of ritonavir added to lopinavir to enhance drug levels

Front 14

Nelfinavir (VIRACEPT)

Back 14

• PROTEASE INHIBITORS
– diarrhea is major problem and can be treated

Front 15

PROTEASE INHIBITORS

Back 15

• Indinivir (CRIXIVAN)
– 1.5 liters of fluids per day to prevent renal calculi (4-5% will get)
• Amprenavir (AGERERASE)
• Atazanavir (Reyataz)
• Fosamprenavir (Lexiva)
• Tipranavir (Aptivus)
• Darunavir (Prezista)

Front 16

Tenofovir (Viread)

Back 16

Nucleotide RTI
– Other drug in this class was not approved due to renal toxicity, no significant renal toxicity reported to date, will monitor renal function
– Used for Hepatitis B also

Front 17

T-20, enfuvirtide (Fuzeon)

Back 17

Fusion Inhibitors
– New site for attacking the virus
– Must be given SQ BID
– Reconstitution of the powder
– SE: inflammation at the injection site
– Can cause serious allergic reaction, supervise first dose
– Viral resistance already being seen in some patients who are in clinical trials with this medication

Front 18

Maraviroc (Selzentry) Approved 8/07

Back 18

• Entry Inhibitors
– blocks a receptor that HIV uses to enter CD4 and T cells in the blood
– BID dosing, taken orally
– SE: postural hypotension, others
– Complications: MI, liver toxicity
– Drug interactions, including St John’s Wort

Front 19

Raltegravir (Isentress)

Back 19

• Integrase Inhibitors
– Approved 10/07
– Inhibits the integrase enzyme which allows for the insertion of HIV DNA into host cell DNA
– Cannot be given with rifampin (used for TB)
• Lowers drug levels