IMMUNOLOGIC DRUGS Flashcards
- Injection of infected
blood - Sexual contact
- Maternal-fetal
transmission
Three modes of transmission of HIV infection
AIMS TO :
1. REDUCE THE DETECTABLE VIRAL LOAD OF HIV RNA AS LOW AS POSSIBLE
- MAINTAIN THIS LEVEL OF SUPPRESSION FOR AS LONG AS POSSIBLE.
- PREVENT OPPORTUNISTIC INFECTIONS
Antiretroviral Therapy
GOALS OF _____?:
1. DECREASING VIRUS LEVEL TO AN UNDETECTABLE LEVELS
- PRESERVING AND INCREASING THE NUMBER OF CD4+ T CELLS
- PREVENTING RESISTANCE
- HAVING CLIENT IN GOOD CLINICAL CONDITION
- PREVENTING SECONDARY INFECTIONS AND CANCERS
Highly Active Antiretroviral Therapy (HAART)
- FORCE THE HIV VIRUS TO USE FAULTY VERSIONS OF BUILDING BLOCKS SO INFECTED CELLS CAN’T MAKE MORE HIV.
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
- ABACAVIR (ZIAGEN)
- DIDANOSINE (VIDEX)
- EMTRICITABINE (EMTRIVA)
- LAMIVUDINE (EPIVIR)
STAVUDINE (ZERIT)
TENOFOVIR ALAFENAMIDE (VEMLIDY)
TENOFOVIR DISOPROXIL FUMARATE (VIREAD)
ZIDOVUDINE OR ZDV (RETROVIR)
THESE ARE ALSO CALLED “NON-NUKES.” _____? BIND TO A SPECIFIC PROTEIN SO THE HIV VIRUS CAN’T MAKE COPIES OF ITSELF.
Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
.CABOTEGRAVIR/RILPIVIRIN
E (CABENUVA)
.DELAVIRDINE (RESCRIPOR)
.DORAVIRINE (PIFELTRO)
.EFAVIRENZ OR EFV
(SUSTIVA)
.ETRAVIRINE (INTELENCE)
.NEVIRAPINE (VIRAMUNE)
.RILPIVIRINE (EDURANT)
- THESE DRUGS BLOCK A PROTEIN THAT INFECTED CELLS NEED TO PUT TOGETHER NEW HIV VIRUS PARTICLES.
Protease Inhibitors (PIs)
- ATAZANAVIR(REYATAZ)
- DARUNAVIR(PREZISTA)
- FOSAMPRENAVIR(LEXIVA)
- INDINAVIR (CRIXIVAN)
- LOPINAVIR + RITONAVIR
(KALETRA) - NELFINAVIR (VIRACEPT)
- RITONAVIR (NORVIR)
- SAQUINAVIR(INVIRASE,
FORTOVASE) - TIPRANAVIR (APTIVUS)
- THESE STOP HIV FROM MAKING COPIES OF ITSELF BY BLOCKING A KEY PROTEIN THAT ALLOWS THE VIRUS TO PUT ITS DNA INTO THE HEALTHY CELL’S DNA. THEY’RE ALSO CALLED INTEGRASE STRAND TRANSFER INHIBITORS (INSTIS).
Integrase Inhibitors
- BICTEGRAVIR OR BIC (COMBINED WITH OTHER DRUGS AS BIKTARVY)
- CABOTEGRAVIR AND RILPIVIRINE (CABENUVA)
- CABOTEGRAVIR (VOCABRIA)
- DOLUTEGRAVIR OR DTG (TIVICAY)
- ELVITEGRAVIR OR EVG (VITEKTA)
- RALTEGRAVIR OR RAL (ISENTRESS)
- UNLIKE NRTIS, NNRTIS, PIS, AND INSTIS, WHICH WORK ON INFECTED CELLS, THESE DRUGS BLOCK HIV FROM GETTING INSIDE HEALTHY CELLS.
Fusion Inhibitors
- ENFUVIRTIDE, OR ENF OR T-20 (FUZEON)
- IT IS FOR ADULTS WHO HAVE TRIED MULTIPLE HIV MEDICATIONS AND WHOSE HIV HAS BEEN RESISTANT TO OTHER THERAPIES.
- IT TARGETS THE GLYCOPROTEIN 120 ON THE SURFACE OF THE VIRUS, STOPPING IT FROM BEING ABLE TO ATTACH ITSELF TO THE CD4 T-CELLS OF YOUR BODY’S IMMUNE SYSTEM.
gp120 Attachment Inhibitor
- FOSTEMSAVIR (RUKOBIA)
- Also stops HIV before it gets inside a healthy cell, but in a different way than fusion inhibitors.
- It blocks a specific kind of “hook” on the outside of certain cells so the virus can’t plug in.
CCR5 Antagonist
- Maraviroc, or MVC
(Selzentry)
- This is a new class of antiviral medication specifically for adults living with HIV who have tried multiple HIV medications and whose HIV has been resistant to other therapies.
- Blocks your body’s HIV infected cells from spreading the virus into those which are uninfected. “It is given by IV.”
Post-Attachment Inhibitor or Monoclonal Antibody
- Ibalizumab (Trogarzo)
- Ritonavir (RTV), taken in a low dose, increases blood levels of lopinavir (LPV) and the drug LPV/r (Kaletra).
- Cobicistat (Tybost) does the same thing in combination with atazanavir, darunavir, elvitegravir.
- Atazanavir + cobicistat (Evotaz)
- Darunavir + cobicistat, or DRV/c (Prezcobix)
- Elvitegravir + TDF + FTC + cobicistat, or EVG/c/TDF/FTC (Stribild)
- Elvitegravir + TAF + FTC + cobicistat, or EVG/c/TAF/FTC (Genvoya)
*Because these ______? can increase the levels of other drugs and cause potential harm, you should always tell your doctor about the medicines you are taking.
Pharmacologic Enhancers, or “Drug Boosters”
____? stands for “pre-exposure prophylaxis.” That means you take these medications before (“pre-“) HIV gets into your system (exposure) to help protect against infection (prophylaxis).
These medications work quite well, but they aren’t foolproof – you need to take them every day for best effect, and even then, they don’t work 100% of the time.
PrEP Medication
- Truvada and Descovy
____?, or “post-exposure prophylaxis”, is a short course of HIV medicines taken very soon after a possible exposure to HIV to prevent the virus from taking hold in your body.
- You must start it within 72 hours (3 days) after a possible exposure to HIV, or it won’t work. Every hour counts!
- PEP should be used only in emergency situations. It is not meant for regular use by people who may be exposed to HIV frequently.
- If you are prescribed PEP, you will need to take the HIV medicines every day for 28 days.
Post-Exposure Prophylaxis
- Constantly monitor patient’s adherence to their drug regimen.
- Encouraged to openly discuss any problems they experience with their drug regimen
- Adherence to regimen is major concern:
.Non adherence results
to
-Viral replication
-Increased VLs (Viral
load)
-Deterioration of the
immune system
-Development of
resistant viral strains
Nursing Responsibilities
