NRTIs Flashcards
When is HIV treatment initiated
CD4 < 500
When should HIV treatment be initiated immediately
Pregnant
Neuropathy
HBV
AIDS defining illness
What is the structure of NRTIs
Native ribonucleosides w/o 3’ OH
How do NRTIs act
Phosphorylated by cellular enzymes
RT incorporates into DNA
Chain termination
Most common site of mutation conferring resistance
Codon 184
What happens when pts become resistant to lamivudine
Become susceptible to Zidovudine and Tenofovir
Which NRTI increases didanosine levels
Tenofovir
What happens if NRTI inhibits Mito DNAP-gamma
Peripheral neuropathy
Myopathy
Lipoatrophy
Lactic acidosis
Which NRTIs inhibit a lot of Mito DNAP-gamma
Didanosine
Stavudine
Which NRTI is great at causing Myelosupression
Zidovudine
What are the other general NRTI AE
Pancreatitis
Cardiomyopathy
Liver tox
What are the Thymidine analogs
Stavudine
Zidovudine
What are the Adenosine analogs
Didanosine
Tenofovir
What are the Cytosine analogs
Lamivudine
Emtricitabine
What is the Guanosine analog
Abacavir
Can cause hyperlipidemia and NM weakness
Stavudine
Decrease dose in Renal insufficiency
Stavudine
Acid labile so take fasting or with antacid
Didanosine
Can cross BBB
Didanosine
Zidovudine
Pancreatitis in alcoholics or pt with hypertriglyceridemia
Didanosine
Can have CNS effects, diarrhea and liver failure
Didanosine
Preferred NRTI
Tenofovir
Emtricitabine
Current HIV regimen
Tenofovir
Emtricitabine +/- Efavirenz
Take with food to increase f
Tenofovir
Tenofovir AE
N/V/D
Flatulence
Tenofovir drug interactions
Increase Didanosine
Decrease Atazanavir
Adjust dose in people with cirrhosis
Zidovudine
How is Zidovudine toxicity potentiated
Probenecid Acetaminophen Lorazepam Indomethacin Cimetidine
Has NO effect on Mito DNA synth or BM
Lamivudine
Lamivudine AE
HA
Dry mouth
Emtricitabine AE
Hyperpigmentation of palms and soles
Abacavir AE
HS (never challenge)
GI distress
HA, dizziness
