Home Drug Guide Zidovudine

Drug Guide

Generic Name

Zidovudine

Brand Names Retrovir

Classification

Therapeutic: Antiretroviral agent, HIV/AIDS treatment

Pharmacological: Nucleoside reverse transcriptase inhibitor (NRTI)

FDA Approved Indications

  • HIV-1 infection in adults and children; Prevention of maternal transmission of HIV

Mechanism of Action

Zidovudine is a nucleoside analog reverse transcriptase inhibitor that incorporates into viral DNA during reverse transcription, leading to chain termination and inhibition of viral replication.

Dosage and Administration

Adult: 200 mg orally every 4 hours or 300 mg twice daily, with dose adjustments based on renal function.

Pediatric: Dosage based on body weight; typically 4 mg/kg every 4 hours, up to a maximum dose.

Geriatric: Use with caution; monitor for adverse effects and organ function.

Renal Impairment: Reduce dosage based on degree of impairment.

Hepatic Impairment: Use with caution; there are limited data, so monitor closely.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed into body tissues and fluids.

Metabolism: Primarily metabolized in the liver to inactive metabolites.

Excretion: Primarily excreted via the kidneys; dose adjustment needed in renal impairment.

Half Life: Approximately 1.1 hours.

Contraindications

  • Hypersensitivity to zidovudine or any component of the formulation.

Precautions

  • Use with caution in anemia, neutropenia, or hepatic impairment; monitoring blood counts recommended.

Adverse Reactions - Common

  • Headache (Common)
  • Nausea (Common)
  • Asthenia (Common)
  • Myelosuppression (anemia, neutropenia) (Serious)

Adverse Reactions - Serious

  • Lactic acidosis and hepatic steatosis (Serious, life-threatening)
  • Severe anemia or neutropenia requiring discontinuation (Serious)

Drug-Drug Interactions

  • Other myelosuppressive agents, hepatotoxic drugs, and drugs affecting bone marrow.

Drug-Food Interactions

  • No significant interactions noted.

Drug-Herb Interactions

  • Limited data; converse with caution when using herbal supplements with potential hematologic or hepatic effects.

Nursing Implications

Assessment: Monitor blood counts (CBC), liver function tests, and signs of anemia or neutropenia.

Diagnoses:

  • Risk for infection due to immunosuppression,
  • Risk for bleeding due to anemia.

Implementation: Administer as prescribed, monitor laboratory parameters, assess for symptoms of adverse effects.

Evaluation: Evaluate effectiveness (reduction in viral load) and adverse effects regularly.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report symptoms of anemia, unusual fatigue, or signs of infection.
  • Avoid alcohol and hepatotoxic drugs.
  • Use barrier methods to prevent HIV transmission.

Special Considerations

Black Box Warnings:

  • Severe severe, life-threatening lactic acidosis and hepatic failure have been reported.

Genetic Factors: Genetic mutations may affect metabolism, but no routine testing is currently standard.

Lab Test Interference: May cause reversible elevations in serum transaminases and serum bilirubin.

Overdose Management

Signs/Symptoms: Nausea, vomiting, anemia, lactic acidosis, and possibly coma.

Treatment: Supportive care, interruption of drug therapy, and monitoring of vital signs and laboratory parameters.

Storage and Handling

Storage: Store at 20°C to 25°C (68°F to 77°F); protect from light.

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.