Antiretroviral drugs in UMMC Presenter: TE CHIN YEW Preceptor: KHOO SU LIN.

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Presentation transcript:

Antiretroviral drugs in UMMC Presenter: TE CHIN YEW Preceptor: KHOO SU LIN

Treatment goal reduce HIV-associated morbidity and prolong the duration and quality of survival, restore and preserve immunologic function, maximally and durably suppress plasma HIV viral load, and prevent HIV transmission.

Life cycle of HIV and targets for antiretroviral drugs.

1 NNRTI/ 1 PI 2 NRTI 1 st line

Nucleoside Reverse Transcriptase Inhibitor Lamivudine, Zidovudine, Stavudine, Tenofovir

Lamivudine (3TC) 150mg BD Brand name: 3TC OP

Zidovudine (AZT) 300mg BD Brand name: Zidovudine Side effects: Bone marrow suppression: macrocytic anemia/neutropenia; GI intolerance, headache, insomnia, asthenia OP

Stavudine (d4T) 30mg BD Brand name: Stavudine Capsules USP Side effects: Peripheral neuropathy, lipodystrophy, panreatitis, lactic acidosis with hepatic steatosis, hyperlipidemia OP

Tenofovir 300mg OD Brand name: Tenvir Side effects: asthenia, headache, diarrhea, nausea, vomiting, flatulance, renal insufficiency Kedai PharmUMMC

Nonnucleoside Reverse Transciptase Inhibitors Efavirenz, Nevirapine

Efavirenz (EFV) 600mg ON Brand name: Stocrin Side effects: rash, CNS symtoms (insomnia, irritability, lethargy, dizziness, vivid dreams), increase LFT OP

Nevirapine (NVP) 200mg BD Brand name: Nevirapine Tablets USP Side effects: rash including Steven-Johnson Syndrome, symptomatic hepatitis (including fatal hepatic necrosis) OP

Kaletra, Indinavir, Ritonavir, Darunavir, Atazanavir Protease Inhibitors

Indinavir 800mg TDS Brand name: Crixivan Side effects: Nephrolithiasis, GI intolerance, nausea, hyperlipidemia, headache, asthenia, blurred vision, dizziness, metallic taste, thrombocytopenia, alopecia, hyperglycemia, fat maldistribution OP

Ritonavir 600 mg BD Brand name: Norvir Side effects: GI intolerance, nausea, diarrhea, paresthesias, hyperlipidemia, hepatitis, asthenia, hyperglycemia, fat maldistribution Kedai PharmUMMC

Darunavir 600mg BD Brand name: Prezista Side effects: skin rash, diarrhea, nausea, headache, hyperlipidemia, hyperglycemia, fat maldistribution Kedai PharmUMMC (Study)

Atazanavir 400mg OD Brand name: Reyataz Side effects: prolonged PR interval, hyperglycemia, fat maldistribution Kedai PharmUMMC (Study)

Integrase Inhibitor Raltegravir

400 mg BD Brand name: Isentress Side effetcs:headache, fatigue, dizziness, pruritis Kedai PharmUMMC

Combination drugs

Zidovudine + Lamivudine 1 tab BD Brand name: Combivir OP

Tenofovir + emtricitabine (Truvada) 1 tab OD Brand name: Tenvir-EM Kedai PharmUMMC

Lopinavir + ritonavir 2 tabs BD Brand name: Kaletra Kedai PharmUMMC

Stavudine + Lamivudine + Nevirapine 1 tab BD Brand name: SLN OP

LASA

References: Marie A. Chisholm-Burns, et. al Pharmacotherapy principles & practice. Mc. Graw Hill. Department of Health and Human Services (DHHS)( Guidelines. ( PPUM Drug Formulary