Question

NNRTI's

Pharmacology Content Outline Directions: The information below is considered essential content in a nursing pharmacology course. You should know the following information for all classifications and actual medications studied in the pharmacology course. Use this outline as a guide to organize your notes and information when you study Classification Medication Indication Action Side Effects Adverse Effects/Untoward Effects Contraindication Nursing Consideration Patient Teaching

Answer 1

Ans) NNRTI:

Classification:

NNRTIs are therefore classified as non-competitive inhibitors of reverse transcriptase.

Indication:

Treatment of human immunodeficiency virus (HIV).

Action: they bind to a hydrophobic pocket distant from the catalytic site of the reverse transcriptase enzyme inducing steric hindrance and render the enzyme inactive thus inhibiting transcription.

Indications:
Components of a combination antiretroviral regimen.

Common Side Effects:
Drug hypersensitivity can occur in patients receiving NNRTIs, as well as in those receiving amprenavir (a protease inhibitor)
Skin rashes (potentially life threatening), including Stevens-Johnson syndrome have occurred
Liver toxicity (more common with nevirapine)

Contraindications:

- Hypersensitivity
• Patients taking midazolam, triazolam, ergots or voriconazole
• Use of alcohol or psychoactive drugs increase risk of CNS effects
• Use cautiously in clients with hepatic impairment or Hepatitis B or C.

Adverse effects:

• Steven's Johnson syndrome,
• lipodystrophy,
• hepatotoxicity
• Seizures and severe depression, paranoid or manic reactions.

Nursing Consideration:

• Administer on an empty stomach
• Administer at bedtime to decrease CNS effects
• Monitor liver function tests before and during therapy. Tell patient to notify provider of s/s of toxicity such as fatigue, jaundice, nausea or vomiting.
• Teach clients to notify provider for depression or manic episodes, rash that becomes denuded.
• Educated patients about physical changes that could develop secondary to lipodystrophy.
• Women of childbearing age should use contraception other than hormonal contraceptives.