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NRTIs Nucleoside Reverse Transcriptase Inhibitors (AE (Lactic Acidosis,…
NRTIs
Nucleoside Reverse Transcriptase Inhibitors
MoA
Nucleoside imposters
causes termination
of DNA chain growth
AE
Lactic Acidosis
Lipodystrophy
(atrophy & fat accumulation)
Dose
adjustments
RENALLY DOSE ADJUST
Only exception is Abacavir!&TAF
Hepatic dose adjustments
Zidovudine ( AZT)
ONLY ARV AVAILABLE AS IV!!!!!
SE
Macrocytic Anemia
(BMS)
labs
MCV (high)
Hg (low)
100% of pts
(so can use for adherence)
Mitocondrial toxicity
Didanosine(ddi)
SE
Eye changes!
BID drugs
Zidovudine
Abacavir can
(can be qd too)
Emtricitabine & Lamivudine are cousins
Stavudine
Worst
Lactic Acidosis
Tenofovir
(work identically)
(TDF)
AE
Acute & Chronic renal toxicity
(nephrotoxic
Decrease bone mineral density
Poor Concentration in lymph
Alfalfa (TAF)
concentrates well in lymph
so able to give 1/10 of dose
this leads to less renal toxicity
and less loss of Bone density
**Abacavir (ABC)
CAUTION
Must do genetic testing
if (+) don't use bc risk
of hypersensitivity run
AE
Hypersensitivity rxn
(fever, rash, resp arrest)
More you take worse it gets
Not as effective in high viral load
if baseline VL >100 reconsider