00 HIV Flashcards
What is the preferred combination therapy for Treatment Naive patients?
1 NNRTI or PI or INSTI (+ 2 NRTIs)
For the initial treatment of Treatment Naive patients using: 1 NNRTI or PI or INSTI (+ 2 NRTIs), what is the preferred “1 NNRTI”?
Efavirenz
For the initial treatment of Treatment Naive patients using: 1 NNRTI or PI or INSTI (+ 2 NRTIs), what is the preferred “PI”?
Atazanavir/Ritonavir combo
For the initial treatment of Treatment Naive patients using: 1 NNRTI or PI or INSTI (+ 2 NRTIs), what is the preferred “INSTI”?
Raltegravir
For the initial treatment of Treatment Naive patients using: 1 NNRTI or PI or INSTI (+ 2 NRTIs), what are the “2 NRTIs”?
Tenofavir + Emtricitabine
What does NRTI stand for?
Nucleoside/tide Reverse Transcriptase Inhibitors
What is the generic name of Ziagen?
Abacavir (NRTI)
What is the generic name of Epzicom?
Abacavir + Lamivudine
What is the BBW for all NRTIs?
Lactic acidosis and severe hepatomegaly with steatosis, sometimes fatal, especially with stavudine, didanosine and zidovudine
What must you screen for before starting Ziagen (Abacavir)?
Must screen for the HLA-B*5701 allele prior to starting abacavir therapy - if positive, increased risk for hypersensitivity reaction so do not use. Record as abacavir allergy in patient record
What is the generic name of Emtriva?
Emtricitabine (NRTI)
What is the generic name of Truvada?
Emtricitabine (NRTI) + Tenofovir (NtRTI)
What is the generic name of Atripla?
Emtricitabine (NRTI) + Tenofovir (NtRTI) + Efavirenz (NNRTI)
What is the generic name of Epivir?
Lamivudine (NRTI)
What is the generic name of Epzicom?
Lamivudine (NRTI) + Abacavir (NRTI)
What does 3TC stand for?
Lamivudine
What does FTC stand for?
Emtricitabine
What does ABC stand for?
Abacavir
What BBW is there for Lamivudine, Emtricitabine, and Tenofovir?
May exacerbate Hepatitis B once drug is discontinued or HBV resistance may develop
What is the generic name of Viread?
Tenofovir (NRTI)
What does TDF stand for?
Tenofovir
What is the only NRTI that CANNOT be taken w/ food?
Videx (Didanosine)
What is a class effect with NNRTIs?
Hepatotoxicity! Rash (SJS/TEN)
What is the generic name of Sustiva?
Efavirenz
What does EFV stand for?
Efavirenz
What are some side effects to look out for with Efavirenz?
CNS (impaired concentration, drowsiness, vivid dreams - usually resolve w/in 2-4 weeks) and psychiatric symptoms (depression, paranoia, suicide)
What are the common side effects seen for all Protease Inhibitors (PIs)?
Hyperglycemia/insulin resistance/diabetes, lipoatrophy, fat maldistribution, hyperlipidemia, hepatitis and hepatic decompensation, immune reconstitution syndrome
What is the generic name of Reyataz?
Atazanavir (PI)
What does ATV stand for?
Atazanavir (PI)
How is Atazanavir usually dosed?
300mg + 100mg Ritonavir daily
What are the ADRs associated with Atazanavir?
PR interval prolongation, indirect hyperbilirubinemia (leading to jaundice or scleral icterus - referred to as “bananavir”), rash, nephrolithiasis
What is the generic name of Prezista?
Darunavir (PI)
What does DRV stand for?
Darunavir
When should you use caution with Prezista (Darunavir)?
Use caution in patients with a sulfa allergy
What is the generic name of Norvir?
Ritonavir (PI)
What does RTV stand for?
Ritonavir
What are the ADRs assocaited with Ritonavir?
N/V/D, paresthesias, asthenia, altered taste, PR prolongation
What is the generic name of Kaletra?
Lopinavir (PI) + Ritonavir (PI)
What does LPV/r stand for?
Lopinavir + Ritonavir
What does INSTI stand for?
Integrase Strand Transfer Inhibitors
What is the generic name of Isentress?
Raltegravir (INSTI)
What does RAL stand for?
Raltegravir
What is Pre-Exposure Prophylaxis (PrEP)?
Emtricitabine/Tenofovir (Truvada) 1 tab PO daily to reduce risk of becoming infected, recommended for partners of people with HIV
What is the preferred regimen for Occupational Postexposure Prophylaxis?
Three drug regimen including Raltegravir + Tenofovir/Emtricitabine (Truvada) for a 4 week course. Taken within 72 hours of exposure
What is the treatment of choice for Cryptosporidosis?
ART + Hydration/Electrolytes + Anti-motility agents (Loperamide)
What is the treatment of choice for Tuberculosis?
Isoniazid (INH) + Rifampin (RIF)
What is the treatment of choice for Mycobacterium Avium Complex (MAC)?
Clarithromycin (Biaxin) + Ethambutol (EMB). Or Azithromycin (Zithromycin) + EMB
What is the treatment of choice for Aspergillus?
Voriconazole (Vfend)
What is the treatment of choice for Esophageal Candidiasis?
Fluconazole (Diflucan), Itraconazole (Sporonox)
What is the treatment of choice for HSV?
Acyclovir (Zovirax) - dosed based on IBW
What is the treatment of choice for Varicella (Chicken Pox) and Herpes Zoster (Shingles)?
Valacyclovir (Valtrex) or Famciclovir (Famvir)
What is the treatment of choice for Cytomegalovirus (CMV)?
Valganciclovir (Valcyte) or Ganciclovir (Cytovene)
What is the treatment of choice for Prophylaxis for PCP?
TMP/SMX
When is PCP prophylaxis indicated?
CD4 < 200, D/C once CD4 > 200 for at least 3 months
What is the treatment of choice for Toxo Prophylaxis?
TMP/SMX
What is good about dose adjustments for Abacavir?
NO renal adjustment needed
Which agent has a BBW for causing Neutropenia?
Retrovir (Zidovudine) - AZT
Which organ system does Fanconi-like syndrome harm and which HIV medication is associated with?
Kidney; tenofovir