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<< The HIV-Infected Adult Patient in the Emergency Department: The Changing Landscape of Disease (Pharmacology CME)

Medication Side Effects

Highly Active Antiretroviral Therapy

The first promising antiretroviral medication against HIV was the NRTI, zidovudine (AZT/ZDV), which was approved by the United States Food and Drug Administration (FDA) in 1987. In the years following, several more NRTIs were developed; however, the virus’s rapid rate of mutation created drug resistance, and mortality remained high. In 1996, the addition of protease inhibitors (PIs) revolutionized HIV treatment. Two landmark studies demonstrated a 60% to 80% decrease in AIDS, associated hospitalization, and mortality in patients treated with this drug combination, HAART.11-13 In addition, non-nucleoside reverse transcriptase inhibitors (NNRTI), integrase inhibitors, fusion inhibitors, entry inhibitors, and pharmacokinetic enhancers have been introduced as treatment, each directed at a different stage of viral reproduction. Medications are often administered in combination therapy through single pills. This section will discuss each of these drug classes and some of the more common adverse reactions and side effects associated with each.

Nucleoside Reverse Transcriptase Inhibitors And Nucleotide Reverse Transcriptase Inhibitors

The NRTIs and nucleotide reverse transcriptase inhibitors (NtRTIs) inhibit reverse transcription of HIV RNA into DNA, thereby preventing viral replication.

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