Pharmacology notes

Apr 15th, 2015
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Pharmacology notes

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ANTIRETROVIRAL AGENTS Substantial advances have been made in antiretroviral therapy since theintroduction of the first agent, zidovudine, in 1987, and many antiretroviralagents are now available. In addition, greater knowledge of viral dynamics through the use of viral loadand resistance testing has made clear that combination therapy withmaximally efficacious and potent agents reduce viral replication to the lowestpossible level and decrease the likelihood of emergence of resistance. Thus,administration of highly active antiretroviral therapy (HAART), typicallycomprising a combination of 34 antiretroviral agents, has become thestandard of care. Such regimens may be composed of nucleoside reverse transcriptaseinhibitors, nonnucleoside reverse transcriptase inhibitors, protease inhibitors,and a fusion inhibitor.Viral susceptibility to specific agents varies among patients and may changewith time, owing to development of resistance.Therefore, such combinations must be chosen with care and tailored to theindividual.In addition to potency and susceptibility, important factors in the selection ofagents for any given patient are tolerability, convenience, and optimization ofadherence.Four classes of antiretroviral agents are available for use:1) Nucleoside/nucleotide reverse transcriptase inhibitors (nrtis)2) Nonnucleoside reverse transcriptase inhibitors (nnrtis),3) Protease inhibitors (pis)4) Fusion inhibitors.Importan

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