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NAPLEX > HIV > Flashcards

HIV Flashcards

1
Q

Abacavir

A

Ziagen, ABC (NRTI)
use: HIV (preferred)
tablet, oral soln (BID)
AE: lactic acidosis, hepatomegaly, hypersensitivity, increased LFTs
screen for HLA-B*5701 gene (increased risk of rxn)
avoid alcohol (inc. AUC)
no renal dose adjustment

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2
Q

Didanosine

A 
ddl, Videx (NRTI)
use: HIV (avoid)
casule, soln (QD)
AE: lactic acidosis. hepatomegaly, pancreatitis, peripheral neuropathy, diarrhea, increased LFTs, insulin resistance/diabetes, HTN, vision/retinal changes
decrease dose in renal impairment
take on empty stomach (EC)
avoid with stavudine and tenofovir
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3
Q

Emtricitabine

A 
FTC, Emtriva (NRTI)
use: HIV (preferred)
capsule, oral soln (200mg QD)
AE: lactic acidosis, hepatomegaly, hyperpigmentation, increased CPK/LFTs
exacerbation of HepB with D/C
decrease dose in renal impairment
avoid with lamivudine (no benefit)
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4
Q

Lamivudine

A 
3TC, Epivir (NRTI)
use: HIV (preferred), HBV
tablet, oral soln (BID or QD)
AE: lactic acidosis, hepatomegaly, myalgias, increased LFTs
decrease dose in renal impairment
may exacerbate Hep B with D/C
Epivir-HBV for Hep B treatment
avoid combo with emtricitabine
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5
Q

Stavudine

A

d4T, Zerit (NRTI)
use: HIV (avoid)
capsule, oral soln (BID)
AE: lactic acidosis, hepatomegaly, increased LFTs, pancreatitis, insulin resistance/diabetes, peripheral neuropathy, lipoatrophy/lipodystrophy, hyperlipidemia
decrease dose in renal impairment
avoid with didanosine (pancreatitis) and zidovudine

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6
Q

Tenofovir

A 
TDF, Viread (NRTI)
use: HIV (preferred), HBV (1st line)
tablet, oral powder (QD)
AE: lactic acidosis, hepatomegaly, fanconi syndrome, renal insufficiency, osteomalacia, decreased bone density, increased LFTs
decrease dose in renal insufficnency
D/C may exacerbate Hep B
avoid with didanosine
supplement with Vit D + Ca
1st line therapy in HBV infection
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7
Q

Zidovudine

A 
ZDV/AZT, Retrovir (NRTI)
use: HIV (pregnancy)
cap, tab, oral soln (BID)
AE: lactic acidosis, hepatomegaly, hematologic toxicities, myopathy, nail hyperpigmentation, lipoatrophy, increased LFTs, insulin resistance/diabetes, hyperlipidemia, bone marrow supression, macrocytic anemia
decrease dose in renal failure (CrCl<15)
avoid with stavudine
IV given during labor
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8
Q

Efavirenz

A 
EFV, sustiva (NNRTI)
use: HIV (preferred)
cap, tab (QD)
AE: Rash (SJS/TEN), hepatotoxicity, CNS, psychiatric symptoms, hyperlipidemia
take on empty stomach HS
Pregnancy Category D (avoid in 1st trimester)
can sprinkle onto food
CYP inhibitor/inducer and 3A4 substrate
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9
Q

Etravirine

A

ETR, Intelence (NNRTI)
use: HIV (experienced)
tablet (BID)
AE: SJS/TEN, rash, hepatotoxicity, increased cholesterol, hyperglycemia, peripheral neuropathy
take after meals
CYP 3A4 inducer, CYP inhibitor and substrate
activity against K103N mutation

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10
Q

Nevirapine

A

NVP, Viramune (NNRTI)
use: HIV (pregnancy)
tablet, oral susp (QD, BID)
AE: SJS/TEN/rash, HEPATOTOXICITY, increased LFTs
14-day lead in period
CYP 3A4 inducer and substrate
avoid in women with CD4>250, men >400 (hepatotoxicity)

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11
Q

Rilpivirine

A 
RPV, Edurant (NNRTI)
use: HIV (alternative)
tablet (QD)
AE: SJS, TEN, rash, CNS (depression, mood changes, suicidal ideation)
take with LARGE MEAL
separate from antacids (CI with PPIs)
CI with CYP 3A4 inducers/inhibitors
no dose adjustments
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12
Q

Atazanavir

A 
ATV, Reyataz (PI)
use: HIV (preferred + pregnancy)
capsule (QD)
AE: metabolic (hyperglycemia, hyperlipidemia), lipoatrophy, hepatitis, immune reconstitution syndrome, PR interval prolongation, hyperbilirubinemia, rash, nephrolithiasis, cholelithiasis, jaundice ("bananavir")
take with food and water
*separate from acid-supressive agents
CYP drug interactions (inhibition)
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13
Q

Darunavir

A 
DRV, Prezista (PI)
use: HIV (preferred)
tablet, oral suspension
AE: metabolic (hyperglycemia, hyperlipidemia), lipoatrophy, hepatitis, immune reconstitution syndrome, N/V/D, rash (SJS/TEN)
caution in sulfa allergy
take wit food (swallow whole)
CYP drug interactions (inhibition)
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14
Q

Fosamprenavir

A 
FPV, Lexiva (PI)
use: HIV (alternative)
tablet, oral susp (QD, BID)
AE: metabolic (hyperglycemia, hyperlipidemia), lipoatrophy, hepatitis, immune reconstitution syndrome, rash (SJS, TEN), nephrolithoasis
caution in sulfa allergy
susp= take without food
CYP drug interactions (inhibition)
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15
Q

Ritonavir

A 
RTV, Norvir (PI)
use: HIV (preferred)
cap, tab, oral soln
AE: metabolic (hyperglycemia, hyperlipidemia), lipoatrophy, hepatitis, immune reconstitution syndrome, N/V/D, paresthesias, asthenia, altered taste, PR prolongation
Take with food
MANY DRUG INTERACTIONS (CYP 3A4)
BOOSTER
capsules= refrigerate
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16
Q

Lopinavir

A

LPV, Kaletra (PI)
tab, oral soln (QD, BID)
AE: metabolic (hyperglycemia, hyperlipidemia), lipoatrophy, hepatitis, immune reconstitution syndrome, pancreatitis, asthenia, abdominal pain, PR/QT prolongation
oral soln= take with food and refrigerate
avoid QD dosing with CYP inducers
CYP drug interactions (inhibition)

17
Q

Enfuvirtide

A

T20, Fuzeon (Fusion inhibitor)
use: HIV (tx-experienced/salvage therapy)
AE: injection site rxn**, increased risk of bacterial pneumonia
no significant drug interactions

18
Q

Maraviroc

A 
MVC, Selzentry (CCR5 antagonist)
use: HIV (tx-experienced)
AE: hepatotoxicity, URTI, fever, rash (SJS), musculoskeletal symptoms, hepatotoxicity, dizziness, orthostasis
decrease dose in renal inpairment
only effective in CCR5-tropic disease
P-gp and 3A4 substrate
19
Q

Raltegravir

A 
RAL, Isentress (INSTIs)
use: HIV (preferred)
tablet (BID)
AE: CPK elevation, myopathy, rhabdomyolysis, rash (SJS)
UGT1A1 metabolism
20
Q

Dolutegravir

A 
DTG, Tivicay (INSTIs)
use: HIV (preferred)
tablet (QD)
AE: insomnia, CPK elevation, increased LFTs
avoid with dofetilide
21
Q

Elvitegravir

A 
EVG, Stribild combo (INSTIs)
use: HIV (preferred)
tablet (QD)
AE: renal impairment, decreased bone mineral density, proteinuria
separate from antacids
2C9 inducer (mild)
22
Q

Emtricitabine + Tenofovir

A

Truvada (NRTIs)
1 tablet QD
preferred combo

23
Q

Lamivudine + Zidovudine

A

Combivir (NRTIs)
1 tablet BID
preferred for pregnancy

24
Q

Abacavir + Lamivudine

A

Epzicom (NRTIs)
1 tablet QD
alternative combo

25
Q

Abacavir + Lamivudine + Zidovudine

A

Trizivir

1 tablet BID

26
Q

Emtricitabine + Tenofovir + Efavirens

A

Atripla (NRTI + NNRTI)
1 tablet QD on empty stomach
preferred regimen

27
Q

Emtricitabine + Tenofovir + Rilpivirine

A

Complera (NRTI + NNRTI)
1 tablet QD with food
alternative combo

28
Q

Emtricitabine + Tenofovir + Cobicistat + Elvitegravir

A 
Stribild (NRTI + INSTI)
quad-pill
preferred regimen
1 tablet QD with food
Cobicistat= booster (CYP and P-gp inhibitor)

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