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

2. 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.

3. Life cycle of HIV and targets for antiretroviral drugs.

4. 1 NNRTI/ 1 PI 2 NRTI 1 st line

5. Nucleoside Reverse Transcriptase Inhibitor Lamivudine, Zidovudine, Stavudine, Tenofovir

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

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

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

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

10. Nonnucleoside Reverse Transciptase Inhibitors Efavirenz, Nevirapine

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

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

13. Kaletra, Indinavir, Ritonavir, Darunavir, Atazanavir Protease Inhibitors

14. 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

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

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

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

18. Integrase Inhibitor Raltegravir

19. 400 mg BD Brand name: Isentress Side effetcs:headache, fatigue, dizziness, pruritis Kedai PharmUMMC

20. Combination drugs

21. Zidovudine + Lamivudine 1 tab BD Brand name: Combivir OP

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

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

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

25. LASA

26. References: Marie A. Chisholm-Burns, et. al. 2007. Pharmacotherapy principles & practice. Mc. Graw Hill. Department of Health and Human Services (DHHS)( Guidelines. (http://aidsinfo.nih.gov)http://aidsinfo.nih.gov PPUM Drug Formulary