POSTEXPOSURE PROPHYLAXIS FOR HEALTH CARE PROVIDERS

If you sustain a needle stick injury, take the following actions immediately:

 Wash the area with soap and water.

 Alert your supervisor and initiate the injury-reporting system used in the setting.
 Identify the source patient, who may need to be tested for HIV, hepatitis B, and
hepatitis C. (State laws will determine if written informed consent must be obtained
from the source patient prior to his or her testing.)
 Report to the employee health services, the emergency department, or other
designated treatment facility.
 Give consent for baseline testing for HIV, hepatitis B, and hepatitis C.
 Get post-exposure prophylaxis for HIV in accordance with CDC guidelines. Start the
prophylaxis medications within 2 hours after exposure. Make sure that you are being
monitored for symptoms of toxicity. Practice safer sex until follow-up testing is
complete.
 Follow up with post-exposure testing at 6 weeks, 3 months, and 6 months and perhaps
1 year.
 Document the exposure in detail for your own records as well as for the employer.
 Take the psychosocial support offered or seek support outside of the employment
setting.

Classification of antiretroviral agents

Name of the drugs
Nucleoside Reverse
Transcriptase Inhibitors (NRTIs)
Abacavir (ABC) ziagen.
Truvada (FTC/TDF) zalcitabine
(ddC) Hivid
Non-Nucleoside reverse
Transcriptase inhibitors
Delavirdine (DLV) rescriptor
efavirenz (EFV) Sustiva
Protease inhibitors
Amprenavir (APV) Agenerase
Fusion Inhibitors
Enfuvirtide (T-20) Fuzeon
Food Interactions Adverse Effects
Take without regard to Hypersensitivity reaction, which can
meals. Alcohol increases be fatal; symptoms may include fever,
abacavir levels 41%. rash, nausea, vomiting malaise or
Abacavir has no effect on fatigue, loss of appetite, and
alcohol. respiratory symptoms such as sore
throat, cough, shortness of breath.
Take without regard to Rash (rare cases of Stevens-Johnson
meals. syndrome have been reported),
increased transaminase levels,
headaches
High fat-meal decreases GI intolerance, nausea, vomiting,
blood concentration diarrhea, rash, oral paresthesias,
21%; can be taken with hyperlipidemia, transaminase
or without food, but elevation, hyperglycemia, fat
high-fat meal should be maldistribution, possible increased
avoided. bleeding episodes in patients with
haemophilia.
Injected subcutaneously, Local injection site reactions-almost
so meals are not an issue. 100% of patients (pain, erythema,
induration, nodules and cysts, pruritus,
ecchymosis); increased rate of
bacterial pneumonia; hypersensitivity
reaction-symptoms may include rash,
fever, nausea, vomiting, chills, rigors,
 hypotension, or elevated serum
transaminases; may recur on challenge
Integrase strand transfer No food restrictions Diarrhea, nausea, headache, and fever
inhibitor identified have been reported.
Raltegravir (RAL) Isentress
Multiclass combination products
Atripla (EFV/FTC/TDF)