Mejia, Danilo Group 51 4B1-C DRUG STUDY February 18, 2009

DRUG CLASS INDICATION ACTION CONTRA ADVERSE EFFECTS ROUTE/ NURSING

INDICATION DOSAGE IMPLICATION

Generic Name: Abdominal pain, nausea, =Monitor Vital signs

LAMIVUDINE Anti-retrovirus For Chronic Inhibits viral DNA Hypersensitivity, vomiting, diarrhoea, insomnia, PO 100mg once = Monitor serum amylase, lipase
Anti-viral hepatitis B synthesis by inhibiting Lactation cough, nasal symptoms, daily and Triglyceride during therapy.
Trade Name: infection and HIV enzyme reverse Impaired renal function arthralgia, muscle pain, Increase levels may indicate
Epivir Nucleoside transcriptase Pedia: patients with headache, fever, rash, alopecia, Adult: Pancreatitis.
Epivir HBV Reverse history of Pancreatitis malaise, increased creatinine 100 mg once daily. =Instruct to take medication
3TC transcriptase phosphokinase and alanine every 12 hours.
inhibitor aminotransferase, peripheral Child: >2 yr: 3 = Monitor for signs of Hepatitis
neuropathy. Rarely mg/kg once daily. such as jaundice, Fatigue,
rhabdomyolysis, pancreatitis, Max: 100 mg/day. anorexia and pruritus.
hepatitis. Neutropenia and =Explain that it will not cure the
anaemia (in combination with disease.
zidovudine), thrombocytopenia, =Monitor for liver function tests.
increases in LFTs. Paronychia. =Monitor for signs of peripheral
Angioedema, urticaria, and neuropathy
anaphylactoid reaction.
Potentially Fatal: Lactic acidosis
associated with severe
hepatomegaly and hepatic
steatosis.
=Avoid alcohol intake
Generic Name: Anti-viral For Chronic Entecavir is a Hypersensitivity, Lactic acidosis/hepatomegaly w/ PO 0.5 mg once = Monitor for signs of Hepatitis
ETECAVIR hepatitis B guanosine nucleoside Lactation steatosis. Exacerbation of daily such as jaundice, Fatigue,
Nucleoside infection. analogue with potent Impaired renal function hepatitis after discontinuation of anorexia and pruritus.
Trade Name: analogue and selective activity treatment. Patients w/ renal Should be taken on =Monitor for liver function tests.
Baraclude Treatment of against HBV impairment, liver transplant an empty stomach
chronic hepatitis B polymerase. recipients. Pregnancy & (Take on an empty
virus infection in Interferes viral DNA lactation. stomach at least 2
adults w/ evidence synthesis thereby hr after a meal & 2
of active liver decreasing hepatic hr before the next
inflammation. damage caused by meal.).
hepatitis B infection.
 DRUG CLASS INDICATION ACTION CONTRAINDICA ADVERSE EFFECTS ROUTE/DOS NURSING
TION AGE IMPLICATION

Generic Name:
MILK THISLE For Liver cirrhosis, Has antioxidants & Hypersensitivity, Laxative effects, Nausea, PO = Monitor for signs of Liver
Antidote Chronic Hepatitis, hepatoprotectant Pregnancy or Lactation Anorexia 240mg Bid failure such as jaundice, gen
Trade Name: Liver cleansing and actions.Prevents toxic Tea= 3-4 x daily 30 edema and mental status
Silybin liver detoxification penetration & stimulate mins before meals changes.
Silymarin hepatocyte =Monitor for liver function tests.
regeneration. =Avoid alcohol intake

Generic Name: =Monitor for signs of

INTERFERON Cytotoxic For chronic Interferon are protein Previous Neuropyschiatric disorders, IM , SQ neuropsychiatric disorders
ALFA Chemotheraphy, hepatitis B capable of modifying hypersensitivity to insomnia, blurred vision, colitis, =Monitor for signs of infections
infection, the immune response interferon or Human Pancreatitis, Nausea, Vomiting, 3 mill units 3x =Assess for cardiovascular
Trade Name: Interferon, Hepatitis C and have anti- Serum Albumin Diarrhea weekly for 24 disorders
Interferon alpha 2b infection, proliferative action months for =Monitor Bone marrow
A2 Interferon Anti-viral Hairy cell leukemia against tumor cells and Hypersensitivity. Flu-like symptoms; alopecia; hepatitis C depression
Intron A have antiviral activity. Hepatic hypersensitivity reactions; =Administer anti-emetics for
It decreases progression decompensation, nausea; anorexia; 5 mill units / day Nausea and vomiting
of hepatic damage. autoimmune hepatitis or myelosuppression; lethargy; for Hepatitis B =Monitor Intake and output,
a history of ocular side effects; depression; infection weight and appetite
autoimmune disease, CV problems; nephrotoxicity; =Monitor, CBC and diff count
immunosuppressed hypertriglyceridaemia; thyroid =Monitor Liver function test
transplant recipients abnormalities; hyperglycaemia;
psoriasiform rash; confusion;
coma; seizures.
Potentially Fatal: Hepatotoxicity,
pulmonary infiltrates,
pneumonitis and pneumonia,
autoimmune diseases.
 DRUG CLASS INDICATION ACTION CONTRAINDICA ADVERSE EFFECTS ROUTE/DOS NURSING
TION AGE IMPLICATION

Generic Name: Anti-viral For Chronic Telbivudine is a Hypersensitivity. Fatigue, malaise, headache, PO 600 mg once Patients with risk factors for
TELBIVUDINE hepatitis B synthetic thymidine abdominal pain. Dizziness, daily. liver disease (especially in
nucleoside nucleoside analogue. It insomnia, fever, rash, increased female gender, obesity,
Brand name: analogue undergoes intracellular lipase, nausea and vomiting, pregnancy or prolonged
Sebivo film-coated phosphorylation to diarrhea, dyspepsia, cough, flu- exposure). Discontinue treatment
tab form its active like symptoms. in patients who develop
metabolite, telbivudine Potentially Fatal: Lactic acidosis clinical/laboratory findings
triphosphate. and severe Hepatomegaly suggestive of lactic acidosis or
Telbivudine hepatotoxicity. Interrupt therapy
triphosphate inhibits if myopathy is suspected;
hepatitis B viral DNA discontinue if myopathy is
polymerase; enzyme diagnosed. Monitor LFTs several
inhibition blocks months after discontinuation of
reverse transcriptase treatment due to risk of severe
thus reducing viral acute exacerbation of hepatitis B.
DNA replication. It is
used in the treatment of
chronic hepatitis B
infection.

Generic Name: Anti-viral For Chronic Adefovir dipivoxil is an Lactation. Nausea, dyspepsia, abdominal PO May be taken with or without
ADEFOVIR Hepatitis B acyclic nucleoside pain, flatulence, diarrhoea, Adult: >18 yr: 10 food.
DIPIVOXIL infection reverse transciptase asthenia, headache. Pruritus, mg once daily. Pregnancy; elderly; child; renal
inhibitor. The diester skin rashes, and respiratory or hepatic impairment. HIV
Brand name: function is hydrolyzed effects e.g. cough, pharyngitis antibody testing to be performed
Hepsera tab and subsequently and sinusitis. before initiation due to possible
phosphorylated to the Potentially Fatal: Lactic resistance development in
active adefovir acidosis, severe hepatomegaly untreated HIV infection.
diphosphate. The active with steatosis, hepatotoxicity, Increased risk of hepatotoxicity
metabolite inhibits nephrotoxicity. in females, obese patients and
HBV DNA polymerase with prolonged treatment.
(reverse transcriptase) Monitor renal function every 3
and hence inhibits viral mth; hepatitis B biochemical,
replication. It can be viral and serological markers
used in patients with every 6 mth and LFTs.
lamivudine-resistant Discontinue therapy if liver
hepatitis B. function worsens.