Nucleoside & Nucleotide Reverse Transcriptase Inhibitors

Nucleoside and nucleotide reverse transcriptase inhibitors are used in the treatment of HIV.  These medications work by terminating DNA synthesis after incorporation into DNA via the viral reverse transcriptase enzyme.  Adverse effects include hepatotoxicity and lactic acidosis. Resistance to these medications is common.  

Class Drugs

• Abacavir

• Didanosine

• Emtricitabine

• Lamivudine

• Stavudine

• Tenofovir

• Zidovudine

Class Mechanism of Action

DNA chain elongation inhibition

• Drug is phosphorylated by cell enzymes, then incorporated into viral DNA and terminates DNA synthesis (preference for viral reverse transcriptase)

Class Applications

HIV

See individual drugs for further applications

Class Adverse Effects

• Hepatotoxicity

• Lactic acidosis

• Resistance

Common

Drug Table

Drug Name	Application	Comments	Image
Abacavir		Adverse Reactions; Hypersensitivity	"ABBA Record" "Cave"
Didanosine		Adverse Reactions; Pancreatitis	"Did Ann Nose"
Emtricitabine	Hepatitis B	Adverse Reactions; Hyperpigmentation of palms and soles	"Empty Trash Bin"
Lamivudine	Hepatitis B		"Limousine"
Stavudine		Adverse Reactions; Peripheral Neuropathy	"Star" "Vudu" "Dine"
Tenofovir			"Ten" "Fiver"
Zidovudine	HIV Prophylaxis	Adverse Reactions; Bone marrow toxicity; Neutropenia; Anemia	"Zit" "Vudu" "Dine"