Skip to content

Emtricitabine and Tenofovir

  • by

1650154 and i’m from fifth year morning the topic of my presentation is essential drugs knowledge for pharmacists including rational and irrational drug use and the drug which are assigned to me is amtracita being with trinophobia the far discovery and development of combination of antiretroviral agents results in the long-term control of hiv replication android

Certain is often co-administered with tino forward and once daily fixed combinations available with or without efa virus as we know tinopovic and m tricycline is an antiviral therapy active against hiv and hepatitis b virus so we must know about hepatitis b and hiv first hepatitis b is an infection which affects the liver leading to damage to hepatocytes resulting

Cerebrospace cancer and finally death chronic hepatitis b infection is treated by antivirals now what is hiv the causative agent is retrovirus which enters by mucosal surface of blood into the body it binds to cd4 plus t cells and cause damage and it further spreads into the bloodstream and cause further complications here are the following stages of hiv the acute

Hiv stage is also known as initial stage in which the flu-like symptoms appear that occur days two weeks after hiv infection this test further progresses into chronic hiv stage which is also known as latent or asymptomatic stage it can last for several years single symptomatic stage appears in which the symptoms of hiv infection appears lastly the aids appear occurs

When cd4 cell count falls below 200 cells per millimeter cube which makes a person vulnerable to opportunistic infections now here is the classification of antiretroviral drugs for hiv there are five main classes nucleoside reversed obstetrics inhibitors and an rdis the third one is protease inhibitors and the anti-inhibitors and lastly the integrase inhibitors

Here are the false drugs as under prescribed uh there are some drugs which for the use for the prevention of vertical transmission that is from mother to child during pregnancy uh for the children the drugs has been prescribed for hiv positive and uh for post exposure prophylaxis means the person has been exposed to recently exposed to the hiv infection and within

48 to 72 hours he has been started with the drugs to prevent the infection or the progression of the disease for pre-exposure profile access means the person is at risk of hiv infection and he has been on the medications to prevent the infection now here are the combination drugs as well for the approved for the adult use as well as approved for the pediatric use

Among these languadin and lemon wooden hemi wooden is one of the most commonly prescribed uh um combination drug in common practices among this you know power plus i’m transitive is also very commonly used combination with or without effort virus it has been recommended that if the cd4 plus cell counts are below 200 per microliter dividing the drug of choice for

The initial treatment of symptomatic children or individuals infected with hiv and to prevent mother to child’s pair during birth several of the drugs may be combined into one single tablet to make it easier to take your medications known and antiretroviral therapy it further increases the patient compliance as is in the following drugs he may might uh skip any of

The medications so it increases the patient compliance compliance these are known as those combination of single tablet regimens according to who does when the cd call cd4 cell count is below or equal to 350 cells per millimeter cube the therapy should be started i’m transitive in antenna forward is one of the very good medications tinophobia is the first learned

Therapy for hiv infection along with antrocyte the efficacy increases who recommends two nrtis plus and an rt as the first line fixed dose combination while uh the second line art is their two nrtis and a boosted uh pi with right or number in case when the first run agent has been filled now coming towards our main topic that is amtrois theta being with tenophobia

Antioxidant keta bean is a chlorinated analog of planimodine while xenophobia is a nucleotide analog as available as retinophobia disoproxial product with enhanced bioavailability on the other hand tino foreign is a new product you know move over which treats hepatitis b infection at a lower dose than antenna fibrous tumor and is more safe at kidney levels because

It do not cause reduction in kidney function ambrositab and antinoco is considered as the first line and second line treatment for the individuals with hiv hepatitis b virus for infection now what is the mechanism reaction of the drugs anterior to viral drugs interfere with the with the ability of virus to multiply or produce the nrdis work by blocking the enzyme

Reverse transcriptase to form dna from rna now dna is not available to replicate so it blocks dividers to make copies of itself now what are the indications and uses of the therapy these are used for the treatment of hiv one infection and hiv one pre exposure prophylaxis in pre-exposure profile access it is for the in iron affected individuals having hiv one

Negative lab report who are tourists for hiv infection they are also used for the treatment of hepatitis b virus now what is the rational use of the therapy these are used for the treatment of hiv one infection as well as for hiv one pre-exposure profile axis amperacetamine alone cannot be used for hepatitis b virus only can be used in combination xenophobia is

The first line therapy for hiv infection which is also active against hepatitis b virus both the drug work by slowing the spread of hiv in the body although amtracita been antino favor will not cure hiv these medications decrease the chance of developing aids and hiv related illness such as serious infections or cancer what are what are the irrational uses of the

Therapy repeated exposure to antroxidable antenophobia the wrong selection of those also should be prescribed and recommended doses according to body weight age and creatinine treatment level taking it without prescription or without proper diagnosis of skipping the dose during a course may lead to resistance like if you stop taking tinophobia even for a short time

Or you start skipping those so the virus may become resistant to medications and it may be harder to treat note are the diagnostic and aggravating features increasing age high viral load that is greater than 100 000 copies per animal previous year’s history the previous years history makes a person vulnerable to its uh further vulnerable to a further uh prone

To the hiv infection increasing alcohol and smoking increase the risk of disease progression as these are the aggregating signs the optimal time to initiate antiretroviral therapy in patients is when the cd4 cell counts is between 200 to 350 cells per millimeter cube the combination therapy is always recommended in patients who are asymptomatic the assessment of

The micro data like the rap report t cell count viral load measurements medical conditions which are coconut currently and medication addiction history like morphine or cocaine the results of the resistance testing should be considered before initiating therapy hiv is spread through the hiv partner sti by sharing contaminated needles blood transfusion and during

Pregnancy or during breastfeeding what is the brand name of an alternative the two water is the brand name of amtrachetamine team of over disapproximate having their prescribed doses both are the nrti drugs having a greater risk of kidney failure as well as the bone density loss discovery is another alternative and is safer because of the tin of alphanamide as we

Have discussed with the lesser dose that is 10 milligram or 25 milligrams and it is both are the nrtis and but having our advantage have less bone loss and lesser kidney issues as compared to pinocchio-disorders stimulate in truvada currently the preferred regimen according to who is a tripler having a two-wire plus e for violence in the dose of 600 milligrams if

A violence is an an rti and it is having only the long-term side effects but it’s more expensive and more costly than the two weather simdo is the combination drug of lemon wooden plus stinophobia and it is from the pharmaco economic point of view it is less costly than truvada these are the alternative recommended antiretroviral agents that combi where is the

Combination drug of the zydopoulos landing wooden axicom with the combination of the other cover plus lamingodine the and commonly prescribed antivirals are given like i said in among these that odin is safe in hiv positive pregnant women because of the less chance of infection to the baby these are the separately uh prescribed brand names of the drugs and common

Nrtis in practice include abec ever am tricitable in lamy wooden tenophobia is recommended and the adults and adolescent weighing at least 17 to 35 kg rate and this copy is prescribed in the adults and patriotic patients weighing at least 35 25 to 35 kg body weight and k8 clearance level greater or equal to 30 ml per minute so at least four weeks of therapy should

Be completed in both of the brands and both of the drugs the drugs can cross the placenta so should be avoided in pregnancy no antidote are available for antioxidant antenna footwear so in case of serious side effects the patient must report the physician insulation might save the switch the drugs with the safer replacement now those are adjustment in pediatrics

And renal impairment in pediatrics uh the according to body weight the dosing of two wider recommended so this chart should be referred for the dosing of the pediatrics those is adjustment individuals with renal impairment the treatment clearness level is greater than 50 ml per minute so together is given once daily while in the lesser than 50 that is 30 to 49

Ml per unit up to what has given 2 q 48 hours and below 30 ml per minute it is not recommended the side effects of the therapy headache diarrhea nausea rash or gi complaints that is nausea diarrhea vomiting platinus these are the common side effects no in the short-term therapy in long-term therapy the toxicity may appear like a reduction of lineal functions

Fan connect syndrome because of the therapy so it should be used in caution with patients with renal dysfunction lactic acidosis hepatomegaly with ketosis and osteomalacia can be a long term toxicity forward can cross the placenta so should be avoided in pregnancy these are the drugs having a mechanism of toxicity so the telopoper enters the proximal tubule

Cells through blasolateral organic anion transporter exists through the optical transporter multi drop resistance escalated protein so co-administered drugs like didenosine are substrate for oeit and tritono titan available are substrate for mrp2s can block these transporters which increases the plasma concentration obtainer for goodies of course the fumarate by

Increasing the plasma concentration of tinophobia so it can be hazardous to the patient in a further cause renal tubulopathy which causes excessive calcium phosphate loss and the causative effects of vitamin d which might be leading to osteomalacia that is bone softening in long term use bmd and respect should be monitored especially in those patients with history

Of osteoporosis what are the drug infections co-administration of two vita with uh acyclovir and sales and myoglycides for example gentamycin and regency clover velocity clover should be avoided as these are eliminated by the active tubular secretion which increases the concentration of antioxidability and antenophobia landing wooden and anthracitabini has has

Also the drug impression so should be avoided taken together cyclosporine leftover with having exposure to the tinopoulos who should be avoided taking together while dogs should be awarded in pregnancy now coming towards our case study that is the male person 36 years old is positive for hiv he is feeling well but he has reported 25 years of smoking history and

Hd of five years of alcohol he’s not a regular drinker here’s a physical examination showing no abram science and currently has no abnormalities but blessings emptier cells 700 cells per milliliter cube hb 14 gram per deciliter created on canvas level 100 ml per minute lft normal cd4 cell counts and 278 cells per millimeter cube or a load one ten thousand copies

Per ml other category did not found to be efficient and reported hypersensitivity while tino4 was found to be beneficial lab reports improved now which combination therapy should be prescribed which anterior to viral regimen will you recommend later now we have to prepare the soap node subjective objectives assessment and plan so starting with the subjective chief

Complain is hiv hiv has been test based positive age is the 36 years gender male elevating factor smoking history and alcohol abuse he is not a regular drinker now but he is taking alcohol in intervals that should be avoided also history of medication no such history is found uh not uh prescribed in their case study but they he has shown the hypersensitivity to abec

Ever so it’s not used in therapy current medication is stenophobia that is antiviral objective as the virus and normal physical examination is non-vulnerabilities found lab reports must be monitored that is wbc 7800 milliseconds per millimeter cube that is normal hemoglobin 14 gram per deciliter cube uh the hb4 man is normally between 14 to 17 gram per deciliter

That is also the normal range and the creatinine level clearance is 100 ml per minute that is also normal cd4 cell count 278 cells per millimeter cube that is the optimal time to start antiretroviral therapy lft is normal viral load 110 000 copies per ml that is the aggregate aggravated uh weighted limit after treatment with tenofovir his lab reports improved

Now what is the assessment hiv is tested positive and high viral load is clearly indicated the disease alcohol abuse and addiction was the aggravating factors it usually speeds up the progression of hiv now what is the plan check creating any report again so because they start the therapy the kidney function should be checked again medication is prescribed by the

Two by the one tablet qd po with or without meals therapy should be continued for four weeks later would be the switch to the choice of regimen that is the am tricitar bean um plus tino4 milligram that is two wired up plus e four final six once daily follow-up is after second week with the lab reports including cbc’s kitten and clearance uh level lft and viral

Load test report patients should monitor his condition for in case of any emergency where he should visit a physician and report at once the patient should be educated that he should stop taking alcohol completely and her patients should quit smoking avoid taking and seize aminoglycosides as it will create drug drug interactions with m transitability and tenofovir

Patients should be prescribed that he should take diet rich and calcium and vitamin d to overcome the side effects of the two weather drug abuse and alcohol use can also directly damage the liver increasing the risk for chronic liver disease like if the person smoke and have hiv a person is more likely to get hiv-related infections like cancer or serious infection

So smoking should be avoided what is the goal of the therapy reducing the hiv viral load and to increase the cd4 plus cell count is the main goal of the therapy suppression of the viral replication usually leads to increased 34 plus cell counts and which strengthens and boosts the immune system both the nrti drugs inhibit the reverse transcriptase inhibitor in time

Required for the replication of hiv now we are comparing the uh medications common in practice and and the recommended therapy though we have recommended this am triceratino forward together with amp transitiveness more uh efficacy uh shown similar effects with to the lemon is effective at lowering the water load and proving the liver disease and with showing the

Signalistic effect in combination with tinophobia or e4 virus or with boosted pis and alone and if the drug is uh given in monotherapy that is the latinophobia is given in the monotherapy so it will create after that time it will create a resistance so should be given in combination to improve the efficacy abba driver has been reported a hypersensitivity reaction

So it avoided into therapy lemon wooden alone may become resistant it’s always used with the dividing in practice uh and that odin is given always given in patient with cd4 plus t cell count lesser than 200 cells per millimeter cube and hematological toxicity is reported in asymptomatic patient so should be avoided in the asymptomatic question it’s always referred

To the symptomatic patients adverse effect as we have discussed already had nausea diarrhea and those adjustment areas in case of written clearance is if altered drug interaction is with the nsaid aminoglycoside so should be avoided taking instead what are the summary of the whole topic the skipping those uh could lead to resistance and further complications in

Case of serious side effects the patient should report the physician and physician could to change the regimen and may go for second land agent as we have discussed the and two nrtis and plus a boosted uh pi can be taken as the second line agent if the first time agent filled after starting a therapy one should keep in mind the benefits and risk of adverse effects

For it patient servant marker data that is the cd4 plus cell count lesser than 350 cells per millimeter cube and wire load greater than 100 000 copies per ml is the aggregating sign that to start the anterior to viral therapy therapy should suppress viral replication as soon as possible and should be monitored by lab reports in one or two weeks interval to get

The patient present report now these are the references which i’ve used for the proper understanding of my drugs hope you like my presentation thank you

Transcribed from video
Emtricitabine and Tenofovir By Pharmacy by Dr. Shahana wahid