ISPN Review 6 Fixed Combination Drugs for Treatment of HIV Infection
6种治疗HIV感染的固定剂量复方药
Patients who are taking combination drug therapy for HIV infection may have to take a very large number of pills each day.
使用复方药物疗法治疗HIV感染的患者可能每天要服用大量的药丸。
Keeping track of these pills and swallowing such a large number each day can be an overwhelming task. In an effort to improve patient compliance and make it easier for some of these patients, some anti-HIV agents are now available in combination products.
Combivir is a combination of 150 mg lamivudine and 300 mg zidovudine. The patient takes one tablet twice a day. Because this is a fixed combination drug, it is not the drug of choice for patients who require a dose reduction owing to renal impairment or adverse effects that limit dose tolerance.
Trizivir combines 300 mg abacavir, 150 mg lamivudine, and 300 mg zidovudine. The patient takes one tablet twice a day. Because this is a fixed combination drug, it is not the drug of choice for patients who require a dose reduction owing to renal impairment or adverse effects that limit dose tolerance.
Patients taking Trizivir should be warned at the time the prescription is filled about the potentially serious hypersensitivity reactions associated with abacavir and should be given a written list of warning signs to watch for.
In 2004, two new combination products were approved to help make compliance with an HIV drug regimen easier. Epzicom (600 mg abacavir with 300 mg lamivudine) is taken as one tablet once a day. Truvada (200 mg emtricitabine with 300 mg tenofovir) is also a once-a-day tablet. Patient should be stabilized on each antiviral individually before being switched to the combination form.
The year 2006 saw another combination product, Atripla— 600 mg efavirenz, 200 mg emtricitabine, and 300 mg tenofovir, Atripla is recommended for patients 18 years old and older who have already been stabilized on each antiviral individually.
combivir – n. 双汰芝
lamivudine – n. 拉米夫定
trizivir – n. 三协唯
abacavir – n. 阿巴卡韦
epzicom – n. 【奥】阿巴拉米片(阿巴卡韦Abacavir和拉米夫定Lamivudine和复方制剂)
truvada – n. 【奥】特鲁瓦达（恩曲他滨emtricitabine和替诺法韦tenofovir的复方制剂）
emtricitabine – n. 恩曲他滨
tenofovir – n. 替诺福韦
atripla – n.【奥】阿曲普拉（依法韦伦efavirenz、恩曲他滨emtricitabine和替诺福韦tenofovir的复方制剂）
efavirenz – n. 依法韦伦
Test 1. A 25-year-old male patient has been diagnosed with HIV. The patient does not want to take more than one antiretroviral drug. What reasons can the nurse tell the patient about for taking more than one drug?
A. Together they will cure HIV.
B. It will prevent interaction with other drugs
C. They will decrease CD4+ T cell counts.
D. Viral replication will be inhibited.
2. Antiretroviral drugs are used to
A. Decrease viral RNA levels.
B. Cure acute HIV infection.
C. Treat opportunistic diseases.
D. Decrease pain and symptoms in terminal disease.
本期ISPN Review答案： 1. D. Viral replication will be inhibited.
The major advantage of using several classes of antiretroviral drugs is that viral replication can be inhibited in several ways, making it more difficult for the virus to recover and decreasing the likelihood of drug resistance that is a major problem with monotherapy. Combination therapy also delays disease progression and decreases HIV symptoms and opportunistic diseases. HIV cannot be cured. CD4+ T cell counts increase with therapy. There are dangerous interactions with many antiretroviral drugs and other commonly used drugs.
2. A. Decrease viral RNA levels.
The goals of drug therapy in HIV infection are to (1) decrease the viral load, (2) maintain or raise CD4+ T cell counts, and (3) delay onset of HIV infection-related symptoms and opportunistic diseases.
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