Anti virals

Question 1

NTRI’s initial Rx

Answer 1

Tenofovir/emticitabine

Then add one of the other boxes (see color diagram)

Question 2

Considerations for tx choice

Answer 2

Pt compliance
Pregnancy
ADEs
DIs
CD4 count
Comorbidities

Question 3

Tenofovir Disoproxill Fumarate

Adverse events

Answer 3

Renal insufficient so check creatine

Question 4

Tenofovir Disoproxill Fumarate

Used as

Answer 4

Pre or post exposure prophylaxis

Question 5

Emitricitabine

Adverse event

Answer 5

Hyperpigmentation of palms, skin discoloration (can mimic 2ndary syphilis)

Question 6

Zidovudine

Adverse drug effect

Answer 6

Bone marrow suppression

Question 7

Lamivudine

Special consideration

Answer 7

Caution with Epivir HBV

Low dose to tx HBV and high dose for HIV

Question 8

Combo products

Answer 8

Emticitabine + tenofovir (truvada)
Emticitabine + tenofovir + efavirenz (atripla)
Emticitabine + tenofovir + elvitegravir + cobicistat (stribild)
Abacavir + Lamivudine (triumeq)

They’re all 1 tablet PO daily

Question 9

Emticitabine + tenofovir + efavirenz (atripla)

Answer 9

Revolutionary in HIV

First 1 dose/day drug

Question 10

NNRTIs non nucleoside reverse transcriptase inhibitors

Answer 10

Efaviranz
Rilpiviline
Nevirapine

Question 11

Efavirenz

Instructions

Answer 11

Dose: 600mg PO HS

Take on an empty stomach

Question 12

Efavirenz

ADE

Answer 12

CNS effects: dizzy, drowsy, vivid dreams- take at bedtime, rash, elevated LFTs, teratogenic, false positive cannabinoid test

Not a good choice for pregnancy

Question 13

Rilpiviline

Answer 13

Not for use in high viral loads (inferior to efavarinz w/viral load >100,000

Avoid use with proton pump inhibitor (needs stomach acid)

Question 14

Nevirapine

ADE

Answer 14

Hepatitis, including fetal hepatic necrosis (higher freq w/ high CD4 count)

Question 15

PI’s

Protease inhibitors

Answer 15

Ritonavir
Atazanavir
Darunavir
Kaletra (lopinavir/ritonavir)

Question 16

PI’s considerations

Answer 16

Use the same pharmacy bc many drug interactions

Question 17

PI’s

Metabolic syndrome

Answer 17

Insulin resistance, inc. triglyceride/chol. levels, lipodystrophy redistribution
Hepatotoxic
GI intolerance
Osteopenia and osteoporosis

Question 18

Ritonavir

Fxn

Answer 18

Used as pharmacokinetic booster w/other PIs

100-400 mg/day in 1-2 doses

Question 19

Atazanavir

Answer 19

Separate from PPI by 12 hrs bc it needs an acidic stomach
ONLY omeperazole 20 mg QID
If you need a PPI switch form this antiviral

Question 20

Atazanavir

ADE

Answer 20

Indirect hyperbillirubinemia

Lack of effect on lipids- this is good! (Only one with no lipid effect)

Question 21

Darunavir

ADE/ allergy

Answer 21

Contains SULFA

Rash 7% overall occurrence

Question 22

Lopinavir/ritonavir (kaletra)

Answer 22

Drug of choice in pregnancy

Question 23

Integrate inhibitor class
ADE

Answer 23

Raltegravir
Stribild
Doutegravir
Increase creatine kinase 
- monitor statins and levels

Question 24

Raltegravir

Dose

Answer 24

BID

Question 25

Stribild

Dose

Answer 25

PO 1x day

Question 26

Dolutegravir

Dose

Answer 26

PO BID

Question 27

Drugs in class NRTI ( nucleoside reverse transcriptase inhibitors)

Answer 27

Tenofovir Disoproxil
Fumarate
Emitricitsbine
Zidovudine
Lamivudine

Question 28

HSV and VZV

Tx

Answer 28

Acyclovir 
Valacyclovir
Famciclovir
Penciclovir
Docosanol
Trifluride

Question 29

HSV and VZV

Topicals:

Answer 29

Penciclovir
Docosanol
Triflurdine (eye drops)

Question 30

Acyclovir

Drug forms

Answer 30

Topical: oral labial herpes ONLY
IV for disseminated zoster
Oral for all others

Question 31

Acyclovir

Coverage

Answer 31

Broad spectrum

HSV 1 HSV 2 and VSV