Hypersensitivity Reactions, Lactic Acidosis and Severe Hepatomegaly; Exacerbations of Hepatitis B

Abacavir: Abacavir is a carbocyclic synthetic nucleoside analogue and an antiviral agent. Intracellularly, abacavir is converted by cellular enzymes to the active metabolite carbovir triphosphate, an analogue of deoxyguanosine-5'-triphosphate (dGTP). Carbovir triphosphate inhibits the activity of HIV-1 reverse transcriptase (RT) both by competing with the natural substrate dGTP and by its incorporation into viral DNA. Viral DNA growth is terminated because the incorporated nucleotide lacks a 3'-OH group, which is needed to form the 5′ to 3′ phosphodiester linkage essential for DNA chain elongation.
Reference: Drug Bank

Lamivudine: Lamivudine is a synthetic nucleoside analogue and is phosphorylated intracellularly to its active 5'-triphosphate metabolite, lamivudine triphosphate (L-TP). This nucleoside analogue is incorporated into viral DNA by HIV reverse transcriptase and HBV polymerase, resulting in DNA chain termination.
Reference: Drug Bank

Zidovudine: Zidovudine, a structural analog of thymidine, is a prodrug that must be phosphorylated to its active 5′-triphosphate metabolite, zidovudine triphosphate (ZDV-TP). It inhibits the activity of HIV-1 reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleotide analogue. It competes with the natural substrate dGTP and incorporates itself into viral DNA. It is also a weak inhibitor of cellular DNA polymerase α and γ.
Reference: Drug Bank

abacavir:

• Suspected of causing genetic defects.
• Suspected of causing cancer.
• Suspected of damaging fertility or the unborn child.
• Causes serious eye irritation.
• May cause an allergic skin reaction.

Reference: SDS - Cayman Chemical

lamivudine:

• Suspected of damaging fertility or the unborn child.

Reference: SDS - Cayman Chemical

zidovudine:

• Suspected of causing genetic defects.
• May cause cancer.
• Causes damage to organs through prolonged or repeated exposure.

Reference: SDS - Cayman Chemical

abacavir:
NIOSH 2016 & 2020: Malignant tumors observed in male and female mice and rats; Genotoxic in vivo micro-nucleus test.

zidovudine:
NIOSH 2016 & 2020: IARC Group 2B

DrugBank

NIH DailyMed

NIH PubChem

FDA Medication Guides

FDA Specific Drug Information

NIOSH Documents:

• 2016
  
• 2020 (draft)
  
• Procedures for Developing the NIOSH List of Hazardous Drugs in Healthcare Settings
  
• Managing Hazardous Drug Exposures: Information for Healthcare Settings