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1
Q

INSTIs end with what suffix?

A

“tegravir”

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2
Q

Dolutegravir

A

Tivicay

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3
Q

Raltegravir

A

Insentress

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4
Q

INSTIs class side effect

A

Headache, weight gain, nervous system/psychiatric effects (insomnia, depression), diarrhea

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5
Q

INSTIs work where in the HIV life cycle?

A

Integration

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6
Q

Abacavir

A

Ziagen

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7
Q

Lamivudine

A

Epivir

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8
Q

Tenofovir alafenamide

A

Vemlidy

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9
Q

Tenofovir DF

A

Viread

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10
Q

Zidovudine

A

Retrovir

(Retro means backwards, if you start from the end of the alphabet and go backwards, the first letter is Z)

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11
Q

NRTIs class effect

A

Lactic acidosis

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12
Q

Where do NRTIs work in the HIV life cycle?

A

Reverse transcription

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13
Q

NRRTIs have what in their name?

A

A “vir” somewhere in the middle of the generic name

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14
Q

Efavirenz

A

Sustiva

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15
Q

Etravirine

A

Intelence

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16
Q

Nevirapine

A

Viramune

(VIRAmune, neVIRApine)

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17
Q

Rilpivirine

A

Edurant

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18
Q

NNRTIs class effect

A

Rash (SJS/TEN)

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19
Q

Where do NNRTIs work in the HIV life cycle?

A

Reverse transcription

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20
Q

PIs end with what suffix?

A

“-navir”

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21
Q

PIs class effect

A

Metabolic abnormalities (HLD, hyperglycemia, lipohypertrophy), hepatic dysfunction, hypersensitivity reactions, diarrhea, nausea

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22
Q

Atazanavir

A

Reyataz

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23
Q

Darunavir

A

Prezista

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24
Q

Fosamprenavir

A

Lexiva

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25
Q

Lopinavir/ritonavir

A

Kaletra

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26
Q

Saquinavir

A

Invirase

(INVIRase, saquINaVIR)

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27
Q

Tipranavir

A

Aptivus

(TIP, aPTIvus)

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28
Q

Cobicistat

A

Tybost

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29
Q

Ritonavir

A

Norvir

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30
Q

Fostemsavir

A

Rukobia

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31
Q

Enfurvirtide

A

Fuzeon

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32
Q

Maraviroc

A

Selzentry

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33
Q

Ibalixumab-uiyk

A

Trogaro

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34
Q

Where do protease inhibitors work?

A

Budding and maturation

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35
Q

Biktarvy

A

bictegravir/emtricitabine/TAF

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36
Q

Triumeq

A

dolutegravir/abacavir/lamivudine

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37
Q

Dovato

A

dolutegravir/lamivudine

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38
Q

Juluca

A

dolutegravir/rilpivirine

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39
Q

Genvoya

A

elvitegravir/cobicistat/emtricitabine/TAF

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40
Q

Stribild

A

elvitegravir/cobicistat/emtricitabine/TDF

41
Q

Epzicom

A

abacavir/lamivudine

42
Q

Trizivir

A

abacavir/lamivudine/zidovudine

43
Q

Truvada

A

emtricitabine/TDF

44
Q

Combivir

A

lamivudine/zidovudine

45
Q

Cimduo

A

lamivudine/TDF

46
Q

Atripla

A

efavirenz/emtricitabine/TDF

47
Q

Odefsey

A

rilpivirine/emtricitabine/TAF

48
Q

Complera

A

rilpivirine/emtricitabine/TDF

49
Q

Evotaz

A

atazanavir/cobicistat

50
Q

Symtuza

A

darunavir/cobicistat/emtricitabine/TAF

51
Q

Prezcobix

A

darunavir/cobicistat

52
Q

Preferred regimens for treatment-naive patients

A

2 NRTIs, 1 INSTI

53
Q

Single-tablet regimens

A

Biktarvy, Triumeq, Dovato

54
Q

Two pills once daily regimens

A

Tivicay and Truvada
Tivicay and Descovy

55
Q

What do you need to test before before starting a patient on a regimen that contains abacavir?

A

HLA-B*5701 allele- if positive, you can’t use it!

56
Q

What medications can you not use if CrCl <30?

A

Biktarvy, Descovy, Dovato, Truvada, Triumeq

57
Q

NRTIs all have a warning for what?

A

Lactic acidosis and hepatomegaly with steatosis

58
Q

NRTIs class side effects

A

nausea, diarrhea, HAs, increased LFTs

59
Q

NRTIs with HBV and HIV confection BBWs

A

emtricitabine, lamivudine, tenofovir

60
Q

Emtricitabine unique side effect

A

Hyperpigmentation of the palms of the hands or soles of the feet

61
Q

Side effects with tenofovir-containing formulations

A

renal impairment, decreased bone density

62
Q

TDF vs. TAF

A

TDF has more side effects than TAF, but if switching from TDF to TAF, monitor lipids because TAF can cause lipid abnormalities more than TDF

63
Q

Zidovudine unique side effects

A

Hematologic toxicity, neutropenia, anemia, myopathy

64
Q

Didansoine and staduvine unique side effects

A

Pancreatitis, peripheral neuropathy

65
Q

Unique feature about bictegravir and dolutegravir

A

They all increase SCr without actually affecting the GFR

66
Q

Unique features about raltegravir and dolutegravir

A

Increased CPK, myopathy, rhabomyolysis, hypersensitivity reactions

67
Q

Unique features about dolutegravir alone

A

Preferred drug in pregnancy
Heptotoxicity possible

68
Q

IM cabotegravir side effect

A

Injection site reaction

69
Q

INSTI drug interactions with polyvalent cations

A

Separate from polyvalent cations

Take 2 hours before or 6 hours after aluminum, calcium, magnesium, and iron-containing products

70
Q

INSTI exceptions to the polyvalent cations

A

Dolutegravir and bictegrabir can be taken with PO Ca or Fe if taken with food

Raltegravir: avoid all polyvalent cations if possible

71
Q

Efavirenz side effects

A

Psychiatric symptoms
CNS effects (but resolve in 2-4 weeks)
increases total cholesterol and TGs

72
Q

NNRTI drug interactions: all of them are substates of what?

A

All of them are CYP3A4 substrates

73
Q

Rilpivirine and doravirine: don’t use with what?

A

Strong 3A4 inducers (PS PORCS)

74
Q

Efavirenz and etravirine are moderate CYP3A4 ____?

75
Q

Rilpivirine needs what for absorption?

A

Acidic gut

76
Q

Rilpivirine and PPIs

A

Don’t even try to use them together

77
Q

Rilpivirine and H2RAs

A

Separate them! Take H2RAs 12 hours before or 4 hours after rilpivirine

78
Q

Rilpivirine and antacids

A

Take antacids 2 hours before or 4 hours after

79
Q

All PIs are recommended to take with a ____ and ____?

A

Recommended to take with a booster and food

80
Q

PIs you shouldn’t take with food (or is optional)

A

Fosamprenavir PO solution
Lopinavir/ritonavir can take with or without food

81
Q

Atazanavir side effects

A

Hyperbilirubinemia (jaundice); reversible and doesn’t mean you have to D/C treatment

82
Q

Atazanavir requires what for absorption?

A

Acidic gut

83
Q

Atazanavir and antacids

A

take antacids 2 hours before or 1 hour after

84
Q

H2RAs and atazanavir

A

avoid, or take atazanavir 2 hours before or 10 hours after

85
Q

PPIs and atazanavir

A

avoid with unboosted atazanavir; take boosted atazanavir 12 hours after the PPI

86
Q

MDD of a PPI with atazanavir

A

20mg of omeprazole or equivalent

87
Q

PIs that are CI’ed with a sulfa allergy

A

Darunavir, fosamprenavir, tipranavir

88
Q

Kaletra and metronidazole

A

Disulfiram reaction

89
Q

Tipranavir side effect

90
Q

Drugs you shouldn’t use with PIs

A

Alfuzosin
Colchicine
Dronedarone
Lovastatin and simvastatin (but you CAN use rosuvastatin or atorvastatin)
CYP3A4 inducers (PS PORCS)
DOACs and antiplatelets (warfarin preferred)
DAAs for HCV
Some hormonal contraceptives
Steroids

91
Q

Safety issue with maraviroc

A

hepatotoxicity (BBW)
SJS/TEN
CV events
Orthostatic hypotension

92
Q

Baseline testing for maraviroc

A

Must have tropism assay

93
Q

Fostemsavir safety issues (3 things)

A

Don’t use with strong CYP3A4 inducers
must maintain effective HBV treatment in patients connected with HBV
Can increase SCr

94
Q

Rilpivirine counseling point

A

TAKE WITH FOOD AND WATER!

95
Q

Efavirenz counseling point

A

TAKE AT HS ON AN EMPTY STOMACH

96
Q

Take cobicistat with ___?

97
Q

PrEP treatment options

A

Truvada or Descovy
Don’t dispense more than a 90-day supply at a time

Can also take IM cabotegravir injection- monthly for first 2 doses, then every 2 months after

98
Q

PEP treatment options

A

Truvada with Tivicay or Insentress
Start after HIV exposure, within 72 hours and take for 28 days

99
Q

HIV treatment in pregnancy

A

Most patients who were already taking a regimen can continue on it
If need to start: dolutegravir or boosted darunavir, PLUS dual NRTI backbone (emtricitabine/tenofovir)

NAPLEX (18 decks)

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