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Zidovudine

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VOL: 101, ISSUE: 48, PAGE NO: 33

Generic and proprietary names

 

Generic and proprietary names
- Zidovudine (AZT).

 

 

- Retrovir.

 

 

- Also with lamivudine in the combination drug Combivir.

 

 

Action
- Zidovudine inhibits the replication of the HIV virus.

 

 

Classification
- Antiviral drug.

 

 

- Nucleoside reverse transcriptase inhibitor.

 

 

Indications
- Used in combination with other antiretroviral drugs in patients with HIV infection, with or without Aids.

 

 

- Prevention of maternal-foetal HIV transmission.

 

 

Contraindications
- Abnormally low neutrophil count or haemoglobin levels.

 

 

- Neonates with raised transaminase or hyperbilirubinaemia needing more than just phototherapy.

 

 

- Breastfeeding.

 

 

Cautions
- Chronic hepatitis B or C.

 

 

- Hepatic impairment.

 

 

- Renal impairment.

 

 

- Pregnancy.

 

 

Side-effects
- Gastrointestinal disturbance.

 

 

- Pancreatitis.

 

 

- Liver damage.

 

 

- Lactic acidosis.

 

 

- Dyspnoea.

 

 

- Headache.

 

 

- Dizziness.

 

 

- Difficulty sleeping.

 

 

- Fatigue.

 

 

- Anorexia.

 

 

- Blood disorders.

 

 

- Myalgia.

 

 

- Arthralgia.

 

 

- Rash.

 

 

- Fever.

 

 

- Chest pain.

 

 

- Taste disturbance.

 

 

- Convulsions.

 

 

- Gynaecomastia.

 

 

- Urinary frequency.

 

 

- Sweating.

 

 

- Pigmentation of nails, skin and oral mucosa.

 

 

Interactions
- A wide range of drugs interact with zidovudine, either increasing its adverse effects or reducing its effectiveness.

 

 

Administration
- Capsule, oral solution or intravenous infusion.

 

 

Nursing considerations
- The abbreviation AZT has also been used for another medication.

 

 

- Optimum time to start treatment depends on the CD4 cell count, plasma viral load and clinical symptoms. The aim is to start treatment before the immune system is irreversibly damaged, but early treatment should be balanced against the development of toxicity.

 

 

- Regular blood tests to monitor for anaemia and assess viral load and CD4 count are required.

 

 

Patient teaching
- This medication needs to be taken regularly on a long-term basis to remain effective.

 

 

- Ensure patients understand that this drug is not a cure for Aids but will control symptoms.

 

 

- Advise patients to notify their prescriber if they have signs of infection, such as sore throat or swollen lymph glands.

 

 

- Education regarding safe sexual activity is essential as the medication does not prevent the virus being passed on to others.

 

 

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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