Home Drug Guide Abacavir Sulfate

Drug Guide

Generic Name

Abacavir Sulfate

Brand Names Ziagen

Classification

Therapeutic: Antiretroviral agent

Pharmacological: Nucleoside reverse transcriptase inhibitor (NRTI)

FDA Approved Indications

  • Treatment of HIV-1 infection in combination with other antiretroviral agents

Mechanism of Action

Inhibits HIV-1 reverse transcriptase enzyme, causing chain termination during viral DNA synthesis, thereby blocking viral replication.

Dosage and Administration

Adult: 300 mg twice daily or 600 mg once daily in combination therapy.

Pediatric: Dose based on body weight or age, typically 8 mg/kg twice daily for children 3 months and older.

Geriatric: Adjust dose based on renal and hepatic function; no specific geriatric dosing, but caution advised.

Renal Impairment: Adjust dose in severe renal impairment; use with caution.

Hepatic Impairment: Use with caution in hepatic impairment; no specific dose adjustment recommended.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.

Excretion: Renal excretion; dose adjustment needed in renal impairment.

Half Life: Approximately 2 hours.

Contraindications

  • Hypersensitivity to abacavir or any component of the formulation.

Precautions

  • Risk of hypersensitivity reactions, especially in patients with HLA-B*57:01 allele, which predisposes to severe hypersensitivity. Prior to initiation, test for HLA-B*57:01 in appropriate populations.
  • Use with caution in patients with cardiovascular disease, as hypersensitivity reactions can include symptoms like fever, rash, gastrointestinal symptoms, and respiratory symptoms.

Adverse Reactions - Common

  • Nausea (Common)
  • Headache (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Hypersensitivity reactions, potentially severe or life-threatening (Rare but serious)
  • Lactic acidosis and hepatomegaly with steatosis (Rare)

Drug-Drug Interactions

  • May interact with other hepatotoxic drugs, or drugs affecting renal function.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for signs of hypersensitivity reactions, baseline liver function, renal function, and HLA-B*57:01 status before initiation.

Diagnoses:

  • Risk for hypersensitivity reaction
  • Risk for hepatic or renal impairment

Implementation: Administer as prescribed, monitor for adverse reactions, especially hypersensitivity, and educate the patient about early symptoms.

Evaluation: Monitor viral load, CD4 count, and adverse reaction symptoms to assess efficacy and safety.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any symptoms of hypersensitivity immediately, such as rash, fever, or difficulty breathing.
  • Do not stop medication without consulting healthcare provider.
  • Inform about the importance of HLA-B*57:01 testing before initiation.

Special Considerations

Black Box Warnings:

  • Severe hypersensitivity reactions can be life-threatening. Discontinue at first sign of hypersensitivity.
  • Genetic testing for HLA-B*57:01 is recommended prior to starting therapy.
  • Potential for lactic acidosis and hepatomegaly with steatosis.

Genetic Factors: Presence of HLA-B*57:01 allele increases risk of hypersensitivity.

Lab Test Interference: None specified.

Overdose Management

Signs/Symptoms: Nausea, vomiting, hypersensitivity symptoms, hypotension, and hypothermia.

Treatment: Supportive care, monitor vital signs, and provide symptomatic treatment. No specific antidote.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.