• Neurological Disease – Dementia
Copyright © 2017 Wolters Kluwer • All Rights Reserved Signs and Symptoms of HIV/AIDS (cont.) Signs and Symptoms of HIV/AIDS (cont.) • Secondary Infections – Pneumocystis carinii, disseminated herpes simplex
Copyright © 2017 Wolters Kluwer • All Rights Reserved Drugs Used to Treat HIV/AIDS Drugs Used to Treat HIV/AIDS • Reverse Transcriptase Inhibitors • Protease Inhibitors • Nucleosides- NNRTI and NRTI • Fusion Inhibitors • CCR5 Coreceptor Antagonist • Integrase Inhibitors
Copyright © 2017 Wolters Kluwer • All Rights Reserved Non nucleoside /Nucleoside Reverse Transcriptase Inhibitors Non nucleoside /Nucleoside Reverse Transcriptase Inhibitors • Indications – Bind directly to HIV reverse transcriptase blocking both RNA and DNA dependent DNA polymerase activities /compete with the naturally occurring nucleosides • Pharmacokinetics – Rapidly absorbed from the GI tract, except (Didanosine) metabolized in the liver, excreted in the urine and feces • Contraindications – Pregnancy and lactation except zidovudine, Lamivudine and zalcitabine should not be given together • Adverse Reactions – Headache, nausea, vomiting, rash, chills, diarrhea, flu-like syndrome of fever, muscle aches and pains and bone marrow suppression with Zididovine
Copyright © 2017 Wolters Kluwer • All Rights Reserved Protease Inhibitors Protease Inhibitors • Indications – Block protease activity within the HIV virus • Pharmacokinetics – Rapidly absorbed in the GI tract, metabolized in the liver and excreted in urine and feces • Contraindications – Pregnancy and lactation and mild to moderate hepatic dysfunction • Adverse Reactions- GI effects, changes in liver function, elevated cholesterol and triglyceride levels may occur as well as Stevens-Johnson syndrome risk • Drug-to-Drug Interactions- Fosamprenavir, pimozide, rifampin, triazolam, or midazolam
Copyright © 2017 Wolters Kluwer • All Rights Reserved Fusion Inhibitors Fusion Inhibitors • Indications – Prevents the fusion of the virus with the human cellular membrane • Pharmacokinetics – Given sub-q; metabolized in the liver it is recycled in the tissues it is not excreted • Contraindications – Use cautiously with lung disease and pregnancy • Adverse Reactions – Headache, dizziness, myalgia, nausea, vomiting, and diarrhea • Drug-to-Drug Interactions – No reported drug interactions
Copyright © 2017 Wolters Kluwer • All Rights Reserved CCR5 Coreceptor Antagonist CCR5 Coreceptor Antagonist • Indications – Blocks the receptor site on the cell membrane to which the HIV virus needs to interact to enter the cell • Pharmacokinetics –Rapidly absorbed from the GI tract, metabolized in the liver, and excreted primarily through the feces • Contraindications –Hypersensitivity to any component of the drug, nursing mothers and liver disease • Adverse Reactions – Dizziness and changes in consciousness • Drug-to-Drug Interactions – Increased serum levels and toxicity when combined with cytochrome P450 CYP3A inhibitors(ketoconazole, lopinavir/ritonavir, ritonavir, saquinavir, atazanavir, delavirdine
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