Page 2203 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 63

Immune Medications

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Priority Concepts
Immunity; Safety

I. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency
Syndrome (AIDS)
A. Medications include nucleoside-nucleotide reverse transcriptase
inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors
(NNRTIs), protease inhibitors (PIs), and fusion inhibitors (Box 63-
1).
B. NRTIs and NNRTIs work by inhibiting the activity of reverse
transcriptase.
C. PIs work by interfering with the activity of the enzyme protease.
D. Fusion inhibitors work by inhibiting the binding of HIV to cells.
E. Standard treatment consists of using 3 or 4 medications in

regimens known as highly active antiretroviral therapy (HAART); this
therapy is not curative but can delay or reverse loss of immune
function, preserve health, and prolong life.
F. Other medications include those that are used to treat
complications or opportunistic infections that develop (see Box 63-
1).

G. Nucleoside-nucleotide reverse transcriptase inhibitors

(NRTIs)
1. Abacavir: Can cause nausea; monitor for
hypersensitivity reaction, including fever, nausea,
vomiting, diarrhea, lethargy, malaise, sore throat,
shortness of breath, cough, and rash
2. Abacavir/lamivudine: In addition to the effects that
can occur from abacavir and lamivudine,
hypersensitivity reactions, lactic acidosis, and severe
hepatomegaly can occur.
3. Didanosine: Can cause nausea, diarrhea, peripheral
neuropathy, hepatotoxicity, and pancreatitis
4. Emtricitabine: Can cause headache, diarrhea, nausea,
rash, hyperpigmentation of the palms and soles, lactic

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