Lamivudine Didanosine

Pharmacology Abacavir is a synthetic carbocyclic synthetic nucleoside analog with inhibitory activity against HIV. Abacavir has synergistic activity in combination with amprenavir, nevirapine, and zidovudine and additive activity in combination with didanosine, lamivudine, stavudine, and zalcitabine in vitro. 

Peripheral neuropathy occurs in up to 50% of patients taking zalcitabine. Stomatitis, esophageal ulceration, hepatotoxicity, rash, and pancreatitis may occur. Zalcitabine should be used with caution in individuals with a history of pancreatitis, liver disease, or alcohol abuse. Dosage adjustment is necessary for individuals with renal impairment. Zalcitabine should not be used in combination with didanosine, lamivudine, or stavudine. 

Alternative regimen Nevirapine Atazanavir Fosamprenavir Fosamprenavir + ritonavir Fopinavir/ ritonavir Abacavir/ lamivudine Didanosine/ lamivudine... 

In 1997, it was estimated that 30 million adults were infected with the human immunodeficiency virus (HIV) worldwide, with increments of five people infected every minute. It is estimated that approximately 7% of the population of sub-Saharan Africa has been infected. The incubation of the disease is 7 to 8 years. Currently available drugs for acquired immunodeficiency syndrome (AIDS) and HIV are zidovudine, didanosine, lamivudine, and stavudine. The causative agent for AIDS is generally an HIV virus, which is transmitted by sexual contact, blood and blood products, the use of contaminated drug needles, and from mother to fetus. 

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS GANCICLOVIRAfALGANCIC LOVIR 1. T adverse effects with tenofovir, zidovudine and possibly didanosine, lamivudine and zalcitabine 2. Possibly 1 efficacy of ganciclovir 1. Uncertain possibly additive toxicity. Lamivudine may compete for active tubular secretion in the kidneys 2. Uncertain L bioavailability 1. Avoid if possible otherwise monitor FBC and renal function weekly. It has been suggested that the dose of zidovudine should be halved from 600 mg to 300 mg daily. Monitor for peripheral neuropathy, particularly with zalcitabine 2. Uncertain clinical significance if in doubt, consider alternative cytomegalovirus prophylaxis... 

Abacavir is a guanidine analogue that inhibits HIV reverse transcriptase. In vitro, its potency is similar to that of zidovudine, protease inhibitors, and dual nucleoside combinations. There is evidence that abacavir is effective in reducing viral load and increasing the CD4 count in HIV-infected patients. Viral resistance is not rapidly selected for, but cross-resistance has been shown to other analogues of cytosine and guanidine (didanosine, lamivudine, and zalcitabine). 

The nucleoside analogue reverse transcriptase inhibitors (NRTIs) include abacavir, didanosine, lamivudine, stavu-dine, tenofovir, zalcitabine, and zidovudine (all rINNs). The following abbreviations have been used and may still be encountered in published papers ... 

Adverse effects Didanosine Lamivudine Stavudine Zalcitabine Zidovudine... 

Pancreatitis has been observed in patients treated with didanosine, lamivudine, stavudine, and zalcitabine (29), but its incidence is also increased in drug-naive patients with advanced HIV infection (30). 

Nudeoside analogue reverse transcriptase inhibitors (NRTls) were the first drugs developed for treatment of HIV infection. They are structural analogues of nucleic adds. When phosphorylafed intraceUularly to their triphosphate forms, fhey are competitive inhibitors of viral reverse franscripfase. Drugs in this class indude abacavir, adefovir, didanosine, lamivudine, sta-vudine, tenofovir, zalcitabine, and zidovudine. 

Anti-HIV drugs Nucleoside reverse transcriptase inhibitors Zidovudine Didanosine, lamivudine, stavudine, zalcitabine... 

Aymard, G. Legrand, M. Trichereau, N. Diquet, B. Determination of twelve antiretroviral agents in human plasma sample using reversed-phase high-performance liquid chromatography, J.Chromatogr.B, 2000, 744, 227-240. [for amprenavir efavirenz indinavir nelflnavir ritonavir saquinavir abacavir didanosine lamivudine stavudine nevirapine zidovudine]... 

Moyer, T.P. Temesgen, Z. Enger, R. Estes, L. Charlson, J. OUver, L. Wight, A. Drug monitoring of antiretroviral therapy for HIV-1 infection method vaUdation and results of a pilot study, CUn.Chem., 1999, 45, 1465-1476. [SPE LOQ 100 ng/mL for lamivudine didanosine lamivudine stavudine zalcitabine zidovudine delavirdine nevirapine indinavir nelflnavir ritonavir saquinavir]... 

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