Post-exposure prophylaxis making me so sick!

Nurses General Nursing

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Specializes in labor and delivery.

Hi All,

This past Tuesday at work I got stuck with an angiocath needle (gauge 24), after starting an IV on my HIV + patient. My error, completely. After going immediately to the ER and seeing the ER doctor, I was placed on my hospital's PEP regimine of epivir, retrovir, and viread. My body completely rejected the meds and I was literally incapacitated...stuck in my bed at home with severe GI distress and migrane headaches. Thinking the symptoms might resolve in time, I stuck it out with the meds until Thursday night, when I literally started seeing spots. I called my primary care physician who spoke with one of the ID doctors at my hospital, who then started me on Truvada once a day, and Kaletra twice a day. I started this new regimine Thursday night. So far, I am migrane free, which is great, but I am still extremely weak, my body aches, I sleep for like 10 hours a night and still wake up exhausted. I have had diarrhea each day, been nauseous, and have little appetite as I have this metallic taste in my mouth, and am absolutely dreading the next 3 weeks I have to continue on these medications.

The doctors have told me that over time these side effects resolve, but to what degree? I have already called out this weekend (both saturday and sunday) and thankfully am not scheduled again until this coming wednesday, but I'm terrified to try to work (my twelve and a half hour + shift), because of how the meds make me feel after I take them. I am scared that my employers are going to think I am trying to "milk this" for all its worth, when in all honesty I'd work 4 12 hour shifts a week in a row for the next month if I didn't have to feel this way.

Anyone ever have to take these or other anti-retrovirals before after a needlestick injury? I need some support, desperately. :crying2:

Thanks all.:confused::uhoh3:

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Specializes in ER, ICU.

Sorry about your situation. I don't have any experience with those drugs but don't worry about what your employer thinks. Just keep following up with your doctor. God forbid you actually get sick later, you will need to show that you followed all recommended treatments. This sucks but stay in touch with your doctor and hang in there. Good luck!

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Specializes in labor and delivery.

thank you for your support. i appreciate it. i know that i need to continue the prophylaxis, i just honestly don't know how people actually learn to live on these drugs. talk about gaining a new sense of compassion for those living with HIV and actually living on these drugs on a day to day basis.

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Specializes in adult ICU.

I don't have anything to add, but I feel for you. I have heard these drugs are rough, but I don't know from experience like you do. Take care of yourself.

:hug:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

:redbeathe

thank you for your support. i appreciate it. i know that i need to continue the prophylaxis, i just honestly don't know how people actually learn to live on these drugs. talk about gaining a new sense of compassion for those living with HIV and actually living on these drugs on a day to day basis.

The actual incidence of infection post exposure is small, about 0.3%. That being said I am so sorry you have to go through this :hug:but thank goodness it is short lived. Patients take powerful aniemetic drugs like thalodimide and the use of medical marijuana has proven effective. Now before running out to get your script for your marajuana (I'm teasing ):lol2:.........you won't be on them long enough(:crying2:) :).......the symtoms will lessen but before you'll get used to them you'll be done with them. A mild antiemetic might help.........I took them at night so I could sleep through the worse part (most of the time):barf02: Unfortunately this is a reality of our profession. If you don't feel well..........call out! This is still workmans comp and you are covered and will be paid.

If you hae questions click below...it's a good info sheet for exposure.........

http://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html

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Specializes in Adult primary care, college health.

I completely sympathize - I didn't make it to 4 weeks on PEP when I was asked to start it after a needlestick about 4 yrs ago. I think I made it to somewhere around 2-3 wks...but the s/e were just too much to take, and I, too, kept looking at the stats cited by Esme12 in terms of incidence of seroconversion amongst exposed HCWs. (It helped my decision that my patient was on ARVs and had a very low viral load at the time of the stick.) I can't really remember whether the s/e got better - or if so, how much - over time, but I know I reached a point where I was just done.

That being said, I really wished at the time, and for awhile afterwards, that I'd stuck it out, since each of the following HIV f/u tests were pretty unnerving, and obviously I can't imagine what I would have done if I'd later seroconverted, knowing I hadn't completed the regimen.

Good luck...I hope this gets easier for you soon.

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Keep going no matter how incapacitated you become. This is not an issue of losing a paycheck. As MaldoniaNP pointed out, you cannot go back in time and retake prophylaxis.

These drugs were not available years ago and many suffered because of this. It's awful and my heart bleeds for you but please complete the course no matter how crappy you feel. It's a decision that literally could dictate your life-path.

Hugs.

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Specializes in labor and delivery.

Hey All,

Thank you again for the outpouring of support and information. I really, truly appreciate it. I'm trying to the best of my ability to "tough it out" but all of your words of encouragement really got me through today! Thank you so so much for your kindness.

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Sending lots of :hug:. Keep thinking positive thoughts, and hopefully things will be better soon.

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I have never taken these medications but do work with them on a daily basis. I am a little surprised no one gave you more information about coping with these side effects as they are common with the regimen you are on. I can't give you medical advice (though I very much wish I could!).

Maybe see if the ID docs have a nurse educator you could talk to? Symptom management is the key for everything you have described. There are pharmacological and non-pharm things you can do. If it is interfering with your function, be sure your providers know about it so they can take action to help.

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I'm going on my first week of PEP regime and I feel your pain. I'm taking Zofran before taking the medication and that's really helping with nausea, but the weakness is terrible. I'm also taking the medication at night so I won't feel the side effects so much. I can't imagine another 3 weeks of this but I'm definitely sticking it out. Hang in there and don't give up. :)

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Specializes in geriatrics,med/surg,vents.

I'm HIV+ and have been taking Kaletra for years now.It's notorious for causing diarrhea.Most important,avoid all caffeine,coffee,tea,soda even chocolate.Try some immodium if it's OK with your Dr.I just add it to my med regimen,every other day I take one and it works.Avoid eating too much at any one time,once you get your appetite back.And try to eat some whole grain cereal ,bran or oatmeal every day.I know the meds are bad but I thank God for them every day.Yes your body does adjust to them after time (usually a month) but you'll be off by then.Good luck

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