Abacavir

INTRODUCTION

Indications

Management of HIV infection (AIDS) in combination with other antiretrovirals (not with lamivudine and/or tenofovir).

Action

Converted inside cells to carbovir triphosphate, its active metabolite. Carbovir triphosphate inhibits the activity of HIV-1 reverse transcriptase, which in turn terminates viral DNA growth. Therapeutic Effects: Slows the progression of HIV infection and decreases the occurrence of its sequelae. Increases CD4 cell counts and decreases viral load.

Adverse Reactions/Side Effects

CNS: headache, insomnia. CV: MYOCARDIAL INFARCTION. GI: HEPATOTOXICITY, diarrhea, nausea, vomiting, anorexia. Derm: rashes. F and E: LACTIC ACIDOSIS. Misc: HYPERSENSITIVITY REACTIONS.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Be alert for signs of myocardial infarction. Seek immediate medical assistance if patient develops sudden chest pain, pain radiating into the arm or jaw, shortness of breath, dizziness, sweating, anxiety, and nausea.

• Monitor signs of hypersensitivity reactions, including pulmonary symptoms (tightness in the throat and chest, wheezing, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

• Be alert for signs of hepatotoxicity, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, fever, sore throat, malaise, weakness, facial edema, lethargy, and unusual bleeding or bruising. Report these signs to the physician immediately.

• Monitor signs of lactic acidosis, including confusion, lethargy, stupor, shallow rapid breathing, tachycardia, hypotension, nausea, and vomiting. Notify physician immediately if these signs occur.

Interventions

• Implement resistive exercises and other therapeutic exercises as tolerated to maintain muscle strength and function, and prevent muscle wasting associated with HIV infection and AIDS.

• Because of the risk of MI and lactic acidosis, use extreme caution during aerobic exercise and other forms of therapeutic exercise. Assess exercise tolerance frequently (blood pressure, heart rate, fatigue levels), and terminate exercise immediately if any untoward responses occur (See Appendix L).

Patient/Client-Related Instruction

• Instruct patient and family or caregiver to recognize and seek immediate medical assistance if symptoms of MI develop (see symptoms listed above under Examination and Evaluation.

• Emphasize the importance of taking abacavir as directed even if the patient is asymptomatic, and that this drug must always be used in combination with other antiretroviral drugs. Do not take more than prescribed amount and do not stop taking without consulting health care professional.

• Inform patient that abacavir does not cure HIV or AIDS, or prevent associated or opportunistic infections. Abacavir does not reduce the risk of transmission of HIV to others through sexual contact or blood contamination. Caution patient to use a condom, and avoid sharing needles or donating blood to prevent spreading the AIDS virus to others.

• Instruct ...