HIV/AIDS Flashcards
(16 cards)
What are the main causes of HIV in Manitoba’s Indigenous population?
IV drug use and heterosexual contact
Describe neuropathic pain for HIV/AIDS patients
- Plays a huge part in the disease, patients experience HIV neuropathy because
the virus attacks the nerves and because it is a side effect of HAART. - These pts often have (1) peripheral neuropathy, may experience (2) HIV
myelopathy when the virus attacks the spinal cord as well as allodynia (pain
caused by a stimulus that does not normally elicit pain)
What are the pharmacological interventions for neuropathic pain in HIV/AIDS patients?
- 1st line tx: Anticonvulsants (gabapentin/neuronin, carbamazepine), TCA
(amitriptyline, nortriptyline), SNRI (venlafaxine/Effexor) - 2nd line tx: Opioid and tramadol, 3rd line tx: Cannabinoids (Nabalone,
Nabiximol) - 4th line tx: corticosteroids (prednisone, dexamethasone – works because the
virus attacks the nerves) - Other adjuncts: baclofen, ketamine, methadone, capsaicin cream, lidocaine
What are the symptoms of HIV/AIDS?
dyspnea
diarrhea
nausea/vomiting
HIV-related fatigue
IV-related fatigue
Describe dyspnea in pts with HIV/AIDS
Caused by opportunistic infections (TB, fungal pneumonia, shingles, etc.),
pulmonary kaposi’s tumors (signals pt has AIDS or end stage HIV) and musclerelated myopathy (virus attacks muscles).
What is the pharm treatment for dyspnea in HIV/AIDS pts?
1st line: opioids like morphine/hydromorphone, incident: fentanyl,
Sufentanil
2nd line: benzodiazepines (to break the dyspnea-anxiety cycle)
What is the non-pharm treatment for dyspnea for HIV/AIDS pts?
position in a semi/high fowler, breathing techniques (pursed lip,
diaphragmatic), ↑ air flow with fan or opening window, dust-free & cool environment
Describe diarrhea in pts with HIV/AIDS
can be d/t idiopathic HIV enteropathy when the virus attacks the lining of
the gut & changes gastric mucosa, chronic bowel inflammation d/t virus attacking
stomach, kaposi’s tumor, most HIV/AIDs pts are lactose intolerant, meds, pathogens
What are the pharm interventions for diarrhea in pts with HIV/AIDS?
lomotil (↓gastric motility, helps w/ abd pain, halts peristaltic activity)
antibiotics (if d/t infection), octreotide (↓gastric secretions, ↓painful spasms)
corticosteroids (↓ chronic inflammation caused by virus)
What are the non-pharm interventions for diarrhea in pts with HIV/AIDS?
maintain hydration, replace electrolytes, LOW residue diet (↓fiber),
diet, ↑protein/fat, lactaid for lactose intolerance, small & frequent meals (no large
meals), easy access to bathroom/commode, good pericare, dignity for toileting
What are the pharm interventions for nausea/vomiting in pts with HIV/AIDS?
metoclopramide/domperidone, haloperidol/methotrimeprazine,
olanzapine, ondansetron/granisteron, dexamethasone (if d/t bowel obstruction),
laxatives (if d/t constipation)
What are the non-pharm interventions for nausea/vomiting in pts with HIV/AIDS?
avoid strong/triggering odours, sips of water, sit up after meals, food
at room temp, ginger/peppermint tea, acupressure (sea bands), guided imagery
Describe HIV-related fatigue
Caused by depression/anxiety, med effects, sleep disturbance,
anemia, electrolyte imbalances, drugs/alcohol, infection
-treat underlying cause (infection, anemia)
What are some non-pharm interventions for HIV-related fatigue?
PACE activities, energy conservation, warm showers, sleep hygiene
Describe IV-related fatigue
Caused by impaired erythropoiesis, ↑destruction of RBC (do not
last entire 120 day lifespan), malabsorption d/t idiopathic HIV enteropathy (lining of
gut is destroyed by virus), medications that decrease hemoglobin (HAART,
antifungal, abx, etc)
What are the pharm interventions for IV-related fatigue?
treat underlying cause (ex. anemia), recombinant erythropoietin (eprex) 3x a month to increase Hgb
