HIV: Drug Treatment - Term Paper Example

? HIV: Drug Treatment Add Add Add Add HIV: Drug Treatment Introduction The outbreak of HIV was evidently the most crucial point in history where nurses contributed greatly to public health, especially in regions where the disease has been highly endemic. There has been a considerable shift in the responsibilities of a nurse, from clinical settings to leadership roles. The change can be attributed to the ongoing experiments and development of HIV drug and treatment. Although scientist could not develop a cent percent effective medicine for AIDS, it is identified that antiretroviral drugs are capable of reducing both the mortality and morbidity of HIV infection. The present data point out that intensified AIDS awareness and preventive measures have played a significant role in reducing the number of AIDS deaths and new infections. This paper will evaluate the HIV drug treatment used in the past and the new drug treatments, and how these improvements have altered the role of nurses in health care settings. Past HIV Drug Treatment The first antiviral drug zidovudine (ZDV; AZT) for the prevention of HIV replication was approved by US Food and Drug Administration in 1986. Scientists argued that this drug would prevent HIV replication by restraining the activity of the reverse transcriptase enzyme. During the early 1990s, a new class of anti-HIV drugs called the non-nucleoside analog reverse transcriptase inhibitors was invented. The development of a new class of antiviral drugs called protease inhibitors was the next step in the HIV drug invention. This class of drugs was entirely different from the reverse transcriptase inhibitors as its function was to prevent an already infected cell from producing more copies of HIV rather than to avert infection of a host cell. In mid 1980s, the nurses had a series of issues to resolve in the prevention and intervention of HIV primarily because of the unavailability of effective medicines and lack of HIV awareness. The dreadfulness and incurability of the disease had also mentally affected the infected individuals. Therefore, the nurses could not effectively deliver a quality care to individuals with HIV infection. During the period between 1986 and 1995, “monotherapy” was the most widely used standard antiretroviral therapy for HIV infected individuals and this treatment method was based on a single drug. In this period, it was scientifically proven that the AIDS symptoms were the result of a slow “war of attrition” between HIV and the host immune system but not the result of a sudden resurgence of a latent virus. According to the concept of multidrug resistance, if an organism has developed a resistance capacity to one drug, it can also be resistant to same class of all other drugs or to a number of various drugs. As per this perspective, the monotherapy became ineffective to AIDS because HIV could quickly develop resistance to such medications. In response to this situation, scientists expanded the number of distinct classes of antivirus medications and this practice led to a shift from monotherapy to combination therapy, in which drugs from two or more classes are applied simultaneously. The combination therapy produced dramatic effects in HIV treatment since the method was capable of suffocating mutated forms of HIV before they spread. The combinations of nucleoside analog drugs, the non-nucleoside analog drugs, and the protease inhibitors are referred to as highly active antiretroviral therapy or HAART. This therapy was widely used by physicians because convincing evidences had come out; they proved that specific combinations of one protease inhibitor and other drugs can have remarkable effects including reduction in the amount of viruses in the blood, enhancement in the number of CD4+ cells, improved health, and minimized chances of new mutations that might lead to the development of drug-resistant strains of HIV. By the beginning of 1997, the combination therapy was widely used as the standard care for HIV infected individuals who had begun to exhibit signs of immunosuppression. Fusion and entry inhibitors are other agents that keep HIV from entering human cells. The first drug in this group was Enfuvirtide and which is given in an injectable form like insulin. Maraviroc is another drug that adheres to a protein on the surface of the human cell and it is usually given by mouth. Both these drugs are used for HIV prevention in combination with other anti-HIV drugs. Kennedy (2010) argues that nurses’ effective caring practice can greatly mitigate the impacts of HIV including deaths to a great extent (p.7). Current Developments in HIV Drug Treatment Most recent drug developments in HIV treatment greatly assist nurses to effectively confront with this dreadful disease. Today, physicians refer to HIV/AIDS treatment guidelines before making any suggestions to infected individuals. According to Springer, Stevens, Webb (2010), the experiences from the last two decades show that combination antiretroviral therapy (ART) is the most effective method for improving the quality of life of HIV infected individuals and thereby dramatically slowing down the progression to AIDS and death (p.37). Presently, ART is the most recommended treatment for HIV. However, researchers argue that chronic use of drugs for the treatment of HIV/HIDS may lead to a series of long term complications including metabolic abnormalities that may result in hypertension, cardiovascular disease, and stroke. To illustrate, Aschenbrenner (Sep. 2011) indicates that when the HIV protease inhibitors saquinavir and ritonavir are taken together, it may cause dangerous electrocardiographic changes (p.23). Aschenbrenner (Oct. 2011) adds that the drug treatment for aids may sometimes cause more adverse impacts than benefits (pp.22-23). CCRK antagonists are another class of drugs which is going to be the next new antiretroviral class. These drugs were approved by FDA on 6th August 2007. Scientists claim that it is the first antiretroviral drug that aims the host cells rather than attacking the virus directly. It is also identified that R5 HIV would not be completely suppressed with CCR5 co-receptor antagonist therapy. A combination drug or fixed-dose combination (FDC) can be referred to the formation of a single dosage by the combination of two or more active ingredients. Although, fixed-dose drug products are used for a wide variety of purposes, they are mainly developed to target single diseases, particularly AIDS. For instance, antiretroviral FDCs. Aschenbrenner (Feb. 2011) reports that rilpivirine has been recently approved for the treatment of AIDS (p.27). Since a number of drugs for HIV treatment has been developed in modern days although they are not cent percent effective, nurses can provide quality care to HIV infected persons. In addition to medication, modern caregivers (nurses) provide counseling services to persons with HIV, and this practice has been proved as an effective part of treatment. A number of governmental and non-governmental institutions are currently working towards the objective of mitigating HIV related impacts and such practices strengthen nursing care management. In short, researchers have recently developed a systematic treatment practice for HIV, which has enhanced the role of nurses in HIV treatment. Conclusion Since the discovery of HIV/AIDS, nursing career has been a more relevant and challenging task especially with regard to various phases of drug development and treatment. A sequence of drug treatment methods have been invented over time even though none of them is effective enough to completely cure HIV/AIDS. However, nurses have a vital role in every initiative varying from drug development to patient care and rehabilitation. Among the various drug treatment practices, antiretroviral therapy is the most common method in use today. Currently, a wide variety of antiretroviral drugs are available in market and some of them are still under research. Regardless of the research outcomes, nursing career will be the most essential element of HIV combat. References Aschenbrenner, D. S. (2011).”The FDA limits the dosage of Simvastatin”. AJN, 111(3), 22-23. Retrieved 9/23/2011 from http://journals.lww.com/ajnonline/pages/default.aspx Aschenbrenner, D. S. (2011). Two drugs now approved to treat pancreatic cancers. AJN Editorial, 111(9), 23. Aschenbrenner, D. S. (2011). New warning for HIV drug saquinavir. AJN Editorial, 111(2), 27. Bradley-Springer, L., Stevens, L & Webb, A. (2010). Every nurse is an HIV nurse. AJN, 110(3), 32-39. Kennedy, M. S. (2010). No time for complacency in AIDS prevention: Gains will be short-lived if health care providers don’t continue efforts. AJN Editorial, 110(3), 7. Read More