Fosamprenavir

INTRODUCTION

Indications

With other antiretrovirals in the management of HIV infection.

Action

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

Adverse Reactions/Side Effects

Reflects use with other antiretrovirals

CNS: headache, fatigue, mood disorders. GI: diarrhea, nausea, vomiting, abdominal pain, ↑ liver enzymes. Derm: rash. Endo: glucose intolerance. Hemat: neutropenia. Metab: fat redistribution, ↑ triglycerides. Misc: ALLERGIC REACTIONS, INCLUDING STEVENS-JOHNSON SYNDROME, ANGIOEDEMA, inflammatory response to opportunistic infection.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor rashes or other skin reactions such as hives, itching, raised patches of red or white skin (welts), burning, acne, exfoliation, and abnormal sweating. Notify physician immediately because certain skin responses may indicate serious allergic reactions such as Stevens-Johnson syndrome and angioedema.

• Monitor personality changes and mood disorders, including anxiety, depression, mood swings, severe restlessness, and increased thoughts of suicide. Notify physician if these changes become problematic.

• Watch for signs of neutropenia, including fever, sore throat, and signs of infection. Report these signs to the physician.

Interventions

• 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.

Patient/Client-Related Instruction

• Emphasize the importance of taking fosamprenavir 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 a consulting health care professional.

• Inform patient that fosamprenavir does not cure HIV or AIDS or prevent associated or opportunistic infections. Fosamprenavir 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 prevent spreading the AIDS virus to others.

• Advise patient that this drug may cause problems in fat and glucose metabolism (increased triglycerides and glucose intolerance, respectively). Remind patient that periodic blood tests may be needed to monitor plasma lipids.

• Inform patient that redistribution and accumulation of body fat may occur, causing central obesity, thin arms and legs, dorsocervical fat enlargement (buffalo hump), breast enlargement, and other symptoms that resemble Cushing's syndrome (moon face, striations on abdominal skin). Discuss possible effects on body image, and help patient explore ...