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