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INTRODUCTION

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saquinavir (sa-kwin-a-vir)

Invirase

Classification

Therapeutic: antiretrovirals

Pharmacologic: protease inhibitors

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Indications
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HIV infection with ritonavir (may also add other antiretrovirals).

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Action
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Inhibits the action of HIV protease and prevents the cleavage of viral polyproteins. Therapeutic Effects: Slowing of the progression of HIV infection and its sequelae. Increased CD4 cell counts and decreased viral load.

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Adverse Reactions/Side Effects
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CNS: SEIZURES, confusion, headache, mental depression, psychic disorders, weakness. CV: thrombophlebitis. GI: abdominal discomfort, diarrhea, increased liver enzymes, jaundice, nausea. Derm: photosensitivity, severe cutaneous reactions. Endo: hyperglycemia. Hemat: acute myeloblastic leukemia, hemolytic anemia, thrombocytopenia. Neuro: ataxia. Misc: STEVENS-JOHNSON SYNDROME.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Be alert for new seizures or increased seizure activity, especially at the onset of drug treatment. Document the number, duration, and severity of seizures, and report these findings immediately to the physician.

  • Monitor rashes or other skin reactions (hives, acne, abnormal sweating, exfoliation). Notify physician immediately because certain skin reactions may indicate serious hypersensitivity reactions (Stevens-Johnson syndrome).

  • Assess any signs of thrombophlebitis, including localized pain, redness, or swelling in the affected area. Report these signs to the physician, and avoid exercising the affected extremity while awaiting further tests and evaluation.

  • Assess weakness or ataxia that might affect gait, balance, and other functional activities. Report balance problems and functional limitations to the physician, and caution the patient and family/caregivers to guard against falls and trauma.

  • Monitor signs of thrombocytopenia (bruising, nose bleeds and bleeding gums), hemolytic anemia (weakness, fatigue, dizziness, jaundice, abdominal pain), or unusual weakness and fatigue that might be due to other anemias and leukemias. Report these signs to the physician.

  • Monitor confusion, headache, mental depression, personality changes, and increased thoughts of suicide. Notify physician if these changes become problematic.

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Interventions
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  • Implement resistive exercises and other therapeutic exercises as needed to maintain muscle strength and function, and prevent muscle wasting associated with HIV infection and AIDS.

  • Design and implement aerobic exercise and endurance training programs to help prevent heart disease associated with drug-related hyperlipidemia and other problems with lipid and glucose metabolism.

  • Causes photosensitivity; use care if administering UV treatments.

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Patient/Client-Related Instruction
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  • Emphasize the importance of taking saquinavir as directed even if the patient is asymptomatic, and that this drug must always be used in combination with other antiretroviral drugs. Do not take more than prescribed amount, and do not stop taking without consulting health care professional.

  • Inform patient that saquinavir does not cure HIV or AIDS or prevent associated or opportunistic infections. Saquinavir does not reduce the risk of transmission of HIV to others through sexual contact or blood contamination. Caution patient to use a condom, and to avoid sharing needles or donating blood to ...

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