II. Mechanism
- Nucleoside Reverse Transcriptase Inhibitor
- Thymidine analogue
- Interferes with viral reverse transcriptase
- Interferes with elongation of the viral DNA chain
III. Pharmacokinetics
- Well absorbed from the Gastrointestinal Tract
- Glucuronidase added in the liver
- Excreted by the Kidney
- Crosses the blood-brain barrier and the placenta
IV. Efficacy
V. Dosing
- Zidovudine 200 mg PO tid ($279/month) OR
- Zidovudine 300 mg PO bid
VI. Adverse effects: General
VII. Adverse Effects: Major toxicities
- Effects
- Anemia (Macrocytosis) (7% late, 1.8% early)
- Leukopenia (Neutropenia) (37% late, 4% early)
- Hepatitis
- Management of toxicity
- Interrupt treatment
- Results in reversal of Anemia and Neutropenia
- Specific Therapy
- Anemia: Give Erythropoietin
- Neutropenia: Give growth factors
- Persistent Anemia or Neutropenia
- Change therapy
- Interrupt treatment
VIII. Monitoring
- Advanced disease: Complete Blood Count each month
- Early disease: Complete Blood Count every 2-3 months
IX. Resistance
- Develops 6 months into therapy