HIV

Question 1

What is the first line PI based regimen?

Answer 1

Darunavir/Ritonavir + Tenofovir/Emtricitabine (Truvada)

Question 2

What are the first line INSTI based regimens?

Answer 2

Raltegravir + Tenofovir/Emtricitabine (Truvada)

Elvitegravir/Cobicistat/TAF/Emtricitabine (Genvoya)

Dolutegravir + Tenofovir/Emtricitabine (Truvada)

Dolutegravir + Abacavir/Lamivudine (Triumeq)

Question 3

Which agents require a CrCL over 70 before starting?

Answer 3

Stribild (Elvitegravir / Cobicistat / Emtricitabine / Tenofovir)

Tenofovir

Cobicistat

Genvoya (Elvitegravir/Cobicistat/TAF/Emtricitabine)

Question 4

Which agent requires you to be Treatment experienced before starting?

Answer 4

Etravirine

Question 5

Which agent requires a low viral load? What is the cutoff?

Answer 5

Rilpivirine

(Also in complera)

Cutoff is viral load over 100,000 or CD4 below 200

Rilpiv = sounds like rip up = rip up the drug if you’re too far gone

Question 6

Which agent has a CD4 cutoff? What is the cutoff?

Answer 6

Nevirapine

NEVer use if CD4 is over 400 in males or over 250 in females (risk of hepatotoxicity)

Question 7

Which agents should be taken on an empty stomach?

Answer 7

Didanosine
Efavirenz
Indinavir

Aunt Diane is on a diet
When I don’t eat I have crazy dreams (Efavirenz)
Don’t eat indian food while taking Indinavir

Question 8

What agents can be taken with HBV?

Answer 8

Emtricitabine
Tenofovir
Lamivudine
Need Tenofovir + one of the other agents for adequate suppression

Atripla, Complera, Stribild, Genvoya would be good

Emily takes ten lambs to Haley’s Bakery (HB)
She tripped on Jenn’s computer and has to build a new one

Question 9

Which agent causes fat accumulation?

Answer 9

Indinavir (Crix belly)

This will cause an indent in your shirts bc it stretches out the stomach

Question 10

Which agent is contraindicated with PPI’s?

Answer 10

Rilpivirine

Question 11

Which agents are contraindicated with Fluticasone?

Answer 11

PI’s

1st line regimen Darunavir/Ritonavir + Truvada contraindicated

Question 12

Which agents are contraindicated with simvastatin and lovastatin?

Answer 12

PI’s
Stribild and Genvoya
STRIBILD (Elvitegravir, Cobicistat, Emtricitabine, Tenofovir)
GENVOYA (elvitegravir, cobicistat, emtricitabine, tenofovir AF)

(1st line regimen Darunavir/Ritonavir + Truvada contraindicated)

Question 13

Which agent is for treatment naive patients only?

Answer 13

Rilpivirine (R is for Rookie)

Remember this is also the one you can’t give if CD4 is too low!

(No complera either!!!)

Question 14

What is the preferred agent in pregnancy?

Answer 14

Kaletra:
Lopinavir
Ritonavir

LR Little replicas
Kaletra = Callie had a baby (Sophia) who is a Little Replica of her

Question 15

Which of the following antiretrovirals is the LEAST likely to cause lipoatrophy?

A: Zidovudine ᅚ
B: Emtricitabine ᅞ
C: Stavudine ᅞ
D: Didanosine

Answer 15

B: Emtricitabine ᅞ

Question 16

Which of the following medications should be taken WITHOUT food?

A: Efavirenzᅞ
B: Elvitegravirᅞ
C: Rilpivirineᅞ
D: Raltegravir

Answer 16

A: Efavirenzᅞ

Also Didanosine, Indinasine

Question 17

Which of the following antiretroviral medications is associated with nephrolithiasis?
Answer C was also accepted for this question.
ᅚ
A: Atazanavir ᅞ
B: Ritonavir ᅞ
C: Raltegravir ᅞ
D: Zidovudine

Answer 17

A: Atazanavir ᅞ

Question 18

HIV 10
Which of the following NRTIs should NOT be co-administered due to the potential risk for CD4 cell toxicity (decline)?

A:Tenofovir and didanosine
B:Tenofovir and abacavir
C:Tenofovir and stavudine
D:Tenofovir and lamivudine

Answer 18

A:Tenofovir and didanosine

Question 19

James is a 52-year old, HIV infected male on a regimen of darunavir, ritonavir, tenofovir, and emtricitabine. His physician would like to start a statin based on his most recent lipid panel and PMH. Based on the above, which of the following statins would you want to avoid giving James?

A: Rosuvastatin
B: Lovastatin
C: Atorvastatin
D: Pravastatin

Answer 19

B: Lovastatin

Question 20

Which of the following drugs is metabolized primarily through glucuronidation?

A: Delavirdine
B: Nevirapine
C: Dolutegravir
D: Nelfinavir

Answer 20

C: Dolutegravir

Doctor Ray is SWEET
Dolutegravir, Raltegravir

Question 21

HIV 13
Which of the following is a correct match of antiretroviral and corresponding side effect/adverse event?

A: stavudine - increase MCV (macrocytosis)
B: emtricitabine - skin hyperpigmentation
C: darunavir - increase total bilirubin (hyperbilirubinemia)
D: raltegravir - hepatic steatosis

Answer 21

B: emtricitabine - skin hyperpigmentation

Question 22

Which of the following medications is NOT part of the DHHS first-line (preferred) regimen for the treatment of HIV-infected adults and adolescents?

A: Efavirenz
B: Elvitegravir
C: Etravirine
D: Emtricitabine

Answer 22

C: Etravirine

EXTRA - need to have had EXTRA tx experience before we start this one