CCO Management Series
Optimizing the NRTI Backbone in HIV-Infected Patients Receiving Antiretroviral Therapy
Safety and Tolerability of Nucleoside and Nucleotide Reverse Transcriptase Inhibitors
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Module 1 of 3
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 Topics covered include:
- Introduction
- NRTI Side Effects and Potential Toxicities
- NRTI Side Effects and Potential Toxicities (Continued)
- NRTI Side Effects and Potential Toxicities (Continued)
- Individual Side-Effect Profiles of NRTI Agents
Learning Objectives
Upon completion of this activity, participants should be able to:
Identify severe and treatment-limiting side effects and toxicities associated with the use of specific NRTIs. Describe the potential clinical syndromes associated with the NRTI class and the risk factors for those syndromes. Discuss the results of studies demonstrating differences in the side-effect profiles of various NRTIs.
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Aiming for Simplicity and Convenience in NRTI Therapy
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Module 2 of 3
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Topics covered include:
- Introduction
- Importance of Patient Adherence
- Patient/Provider-Related Issues in Adherence
- Medication-Related Factors and Adherence
- Implications for Choosing an NRTI Backbone
Learning Objectives
Upon completion of this activity, participants should be able to:
Discuss the impact of pill burden and dosing frequency on patient adherence to antiretroviral therapy. Identify factors that affect patient acceptance of and adherence to antiretroviral therapy. Describe how the patient's need for treatment simplicity and convenience affects the selection of NRTI-containing regimens.
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Switching NRTIs to Improve Safety, Tolerability, or Convenience
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Module 3 of 3
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Topics covered include:
- Introduction
- Switching to Improve Adherence and Convenience of Administration
- Proactive Switching to Limit the Risk of a Future Adverse Event
- Reactive Switching to Manage an Established Adverse Event
- Switching for Pharmacologic Reasons
Learning Objectives
Upon completion of this activity, participants should be able to:
Discuss the different reasons for switching within the NRTI antiretroviral class. Identify NRTI-containing regimens that are associated with lower risk of morphologic and lipid level changes in treatment-experienced patients. Explain the difference between proactive and reactive NRTI switching.
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Interactive Case Challenges
Avoidance and Management of NRTI Toxicities
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 Consider appropriate regimens for an patient with advanced HIV disease who has rejected therapy to date, and assess the correct response to clinical and laboratory adverse events. Learning Objectives
Upon completion of this activity, participants should be able to:
Review the appropriate management of NRTI-associated side effects Identify antiretroviral regimens that are least likely to be associated with toxicities Discuss the response to renal abnormalities in patients receiving tenofovir
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Optimizing Antiretroviral Therapy in a Young, Newly Diagnosed, HIV-Infected Woman
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Decide whether to treat and which agents to use, and manage treatment-emergent adverse events. Get instant feedback on your choices and compare them with our faculty's advice. Learning Objectives
Upon completion of this activity, participants should be able to:
Discuss ways to improve adherence to antiretroviral therapy both before and during treatment Outline treatment options for patients at risk of being nonadherent List risk factors for nonadherence and discuss its relevance to the timing of antiretroviral therapy
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Regarding Antiretroviral Therapy for an HIV-Infected Woman Who Plans to Become Pregnant
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Balance considerations of potency, convenience, tolerability, and safety in selecting antiretroviral regimens for a woman who is actively trying to become pregnant. See how your decisions compare with those of other site users. Learning Objectives
Upon completion of this activity, participants should be able to:
List options for compact once-daily antiretroviral regimens Describe adverse effects associated with specific antiretroviral regimens Discuss considerations that affect the choice of antiretroviral therapy in women of child-bearing potential
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CCO Slidesets
Aiming for Simplicity and Convenience in NRTI Therapy
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Format: Microsoft PowerPoint (.ppt) | File size: 320 KB
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Safety and Tolerability of Nucleoside and Nucleotide Reverse Transcriptase Inhibitors
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Format: Microsoft PowerPoint (.ppt) | File size: 359 KB
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Switching NRTIs to Improve Safety, Tolerability, or Convenience
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Format: Microsoft PowerPoint (.ppt) | File size: 336 KB
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Tools
Selecting an NRTI Backbone: An Interactive Tool
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This interactive tool is intended to help the user assess the characteristics of different NRTI backbones, according to criteria that have been selected for their potential relevance in specific clinical settings.
Format: Adobe Flash | File size: 35 KB
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Animations
NRTI-Induced Mitochondrial Toxicity
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Review the proposed mechanism of mitochondrial toxicity, and the association with individual NRTI agents.
This animation and others are available for use offline from the Download Library.
To download to your own computer and use for personal or teaching purposes, click here
Format: Adobe Flash | File size: 885 KB
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Disclaimer: The materials published on the Clinical Care Options Web site reflect the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the CME provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the United States Food and Drug Administration. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.
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Jointly sponsored by University of Alabama School of Medicine and Clinical Care Options, LLC.
Pharmacist and nursing credit provided through the cosponsorship of Medical Education Collaborative and Clinical Care Options, LLC.
Contact Info
Educational grant provided by:
Educational grants support only the CME-certified components of this program.
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