DRUG NAME DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING

CLASSIFICATION ACTION CONSIDERATION

Abacavir/ Integrase Strand Abacavir; Þ For the treatment Þ Human Þ Insomnia Hepatic Impairment
Transfer Inhibitor dolutegravir; of human immunodeficiency virus Þ Pruritus
Dolutegravir/ Because abacavir may require a
(INSTI) and lamivudine is active immunodeficiency (HIV) infection Þ Headache dose adjustment in the presence
Lamivudine Nucleoside and against infections virus (HIV) resistance Þ Diarrhea of hepatic impairment, the fixed-
Nucleotide Reverse caused by human infection in Þ Autoimmune disease, Þ Vomiting dose combination of abacavir;
Transcriptase immunodeficiency combination with Graves' disease, Þ Nausea dolutegravir; lamivudine is not
Brand Name and Inhibitor (NRTI) virus type 1 (HIV-1). other antiretroviral Guillain-Barre Þ Flatulence recommended for patients with
Other Names: Combinations Both abacavir and agents. syndrome, immune Þ Abdominal pain impaired hepatic function.
lamivudine are Þ Adults who are reconstitution syndrome
Triumeq Þ Fatigue
nucleoside analogs treatment-naive or Þ Serious rash Þ Maculopapular rash
that work by treatment- Þ Hepatic disease,
inhibiting HIV Þ Rash Renal Impairment
experienced but hepatitis B and HIV
Routes and reverse transcriptase, Þ Dizziness
integrase strand coinfection, hepatitis C CrCl 50 mL/min or more: No
Dosages: while dolutegravir transfer inhibitor Þ Weight gain dosage adjustment is needed.
and HIV coinfection
works by inhibiting (INSTI)-naive Þ Arthralgia
Adults Þ Geriatric, renal failure CrCl 30 to 49 mL/min: No
the catalytic activity Þ Myalgia
Þ Depression, suicidal dosage adjustment is needed, but
• 1 tablet/day PO of HIV integrase. Þ Anxiety
ideation monitor for lamivudine-related
(abacavir 600
mg/day PO; hematologic toxicities. If new or
dolutegravir 50 worsening neutropenia or
mg/day PO; anemia develops, discontinue
lamivudine 300 use of the fixed-dose
mg/day PO); combination product and
dolutegravir administer the individual
100 mg/day PO components to allow for a
when lamivudine dose adjustment.
coadministered CrCl less than 30 mL/min: Use
with certain not recommended.
drugs.
 DRUG NAME DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
CLASSIFICATION ACTION CONSIDERATION
Efavirenz 400 Mg- Non-Nucleoside Efavirenz is classified Þ For the treatment Þ Hypophosphatemia, Þ Insomnia Hepatic Impairment
Lamivudine 300 Reverse as a non-nucleoside of human renal disease, renal Þ Pruritus
Caution is advised when
Mg-Tenofovir Transcriptase reverse transcriptase immunodeficiency failure, renal impairment Þ Headache administering to patients with
Disoproxil Mg Inhibitor (NNRTI) inhibitor (NNRT), virus (HIV) Þ Hepatic disease Þ Diarrhea mild hepatic impairment (Child-
Tablet and Nucleoside and emtricitabine is infection. Þ Human Þ Vomiting Pugh A). Avoid use in patients
Lamivudine Nucleotide Reverse classified as a immunodeficiency virus Þ Nausea with moderate to severe hepatic
Transcriptase nucleoside reverse (HIV) infection Þ Flatulence impairment (Child-Pugh B or
Inhibitors (NRTI) transcriptase inhibitor resistance Þ Abdominal pain C).
Brand Name and Combinations (NRTI), and tenofovir Þ Alcoholism, bipolar Þ Fatigue
Other Names: is classified as a disorder, depression, Þ Maculopapular rash
nucleotide reverse driving or operating
Atripla transcriptase inhibitor Þ Rash Renal Impairment
machinery, mania,
(although sometimes Þ Dizziness
neurotoxicity, psychosis, CrCl >= 50 mL/min: No dosage
classified with the Þ Weight gain adjustment is needed.
schizophrenia, substance
Routes & Dosages: NRTIs). Combination Þ Arthralgia
abuse, suicidal ideation
therapy targets Þ Myalgia CrCl < 50 mL/min: Not
Oral dosage Þ Exfoliative dermatitis, recommended.
different points in the serious rash Þ Anxiety
Adults life cycle of HIV,
Þ 40 kg or more: reducing viral
capacity to mutate to Intermittent hemodialysis
efavirenz 600
mg/day PO; drug-resistant strains. Hemodialysis can remove both
emtricitabine emtricitabine and tenofovir from
200 mg/day PO; the blood, but is not expected to
tenofovir 300 significantly remove efavirenz.
mg/day PO. It would be prudent to refrain
less than 40 kg: from administering efavirenz;
Use not emtricitabine; tenofovir to
recommended. patients requiring hemodialysis.

Reference:
Prescribers Digital Reference. (2011). Pdr. https://www.pdr.net/