Knowing my Medicines
1. The Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
My two ARV’s namely, Tenofovir and Lamivudine fall under this group.
Mechanism of Action. When HIV infects a CD4 cell in a person's body, it copies its own genetic code into the cell's DNA. In this way, the cell is then "programmed" to create new copies of HIV. HIV's genetic material is in the form of RNA. In order for it to infect CD4 cells, it must first convert its RNA into DNA. HIV's reverse transcriptase enzyme is needed to perform this process.
NRTIs, sometimes called "nucleoside analogues" or "nukes," contain faulty versions of the building blocks (nucleotides) used by reverse transcriptase to convert RNA to DNA. When reverse transcriptase uses these faulty building blocks, the new DNA cannot be built correctly. In turn, HIV's genetic material cannot be incorporated into the healthy genetic material of the cell and prevents the cell from producing new virus.
While nucleotide analogues (Viread is the only nucleotide analogue approved at this time) are technically different than nucleoside analogues, they act very much the same way. In order for nucleoside analogues to work, they must undergo chemical changes (phosphorylation) to become active in the body. Nucleotide analogues bypass this step, given that they are already chemically activated.
2. The Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Im taking Efavirenz and it falls under this group.
Mechanism of Action. When HIV infects a CD4 cell in a person's body, it copies its own genetic code into the cell's DNA. In this way, the cell is then "programmed" to create new copies of HIV. HIV's genetic material is in the form of RNA. In order for it to infect CD4 cells, it must first convert its RNA into DNA. HIV's reverse transcriptase enzyme is needed to perform this process.
NNRTIs, also known as "non-nucleosides" or "non-nukes" for short, attach themselves to reverse transcriptase and prevent the enzyme from converting RNA to DNA. In turn, HIV's genetic material cannot be incorporated into the healthy genetic material of the cell, and prevents the cell from producing new virus.
3. Cotrimaxazole
This drug is a PCP prophylaxis. If the CD4 count falls below 350 it will be recommended start taking HIV treatment. It is very important to start HIV treatment before the CD4 cell count falls to 250 to 200, the point at which one becomes vulnerable to PCP. If not start HIV treatment at this point, or if the CD4 count is at this level or lower when your HIV is diagnosed, one will be recommended to start taking treatment to stop you getting PCP.
If one is starting or changing HIV treatment and have a low CD4 cell count it will be recommended to continue taking PCP prophylaxis until the CD4 cell count has risen to above 200 to 250 for at least three months. It is then safe to stop PCP prophylaxis, even if one have had PCP in the past. However, if the CD4 cell count falls to below 250 to 200 one should start prophylaxis again.
Mechanism of Action. Cotrimoxazole is the standard first choice treatment for PCP. Cotrimoxazole is made up of two drugs: trimethoprim (TMP) and sulphamethoxazole (SMX). The abbreviation TMP-SMX is sometimes used.
Treatment with cotrimoxazole is provided in hospital by injection or continuous drip for the first few days, and then by tablets, normally at home. The total duration of treatment is normally three weeks.
Cotrimoxazole also works against bacteria that can cause other infections in HIV-positive people with very low CD4 counts.
In severe cases of PCP it might be necessary to take a steroid. Although steroids can suppress the immune system, they also dampen down inflammation in the lungs caused by PCP.
One may be given oxygen during PCP treatment, normally through a face mask or by assisted ventilation. It's important to rest until one is fully recovered from PCP. Expect to be tired for about two months.
4. Azithromycin
This is an opportunistic infection (OI) prophylaxis. Prophylaxis against opportunistic infection is treatment given to HIV-infected individuals to prevent either a first episode of an OI (primary prophylaxis) or the recurrence of infection (secondary prophylaxis). Prophylaxis is recommended to prevent three important OIs: Pneumocystis jiroveci pneumonia (PCP),Mycobacterium avium complex (MAC), and toxoplasmosis. Prophylaxis also is recommended to prevent tuberculosis (TB) in patients with latent Mycobacterium tuberculosis infection.
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