HIV Flashcards
At what CD4+ T cell count level makes someone more susceptible to opportunistic infections
200
normal CD4+ count
800-1200
What is the recommended treatment for HIV
INSTI with 2 NRTIs
what test needs done prior to using abacavir
HLA-B*5701
-if positive do not use abacavir
Caution for tenofovir disoproxil fumarate
renal insufficiency
CI for triumeq
do not start if CrCL < 50
CI for Biktarvy
do not start if CrCl < 30
What does INSTI stand for
integrase strand transfer inhibitors
NRTIs MOA
competitively bind to the enzyme reverse transcriptase, blocking HIV viral RNA-dependent DNA polymerase. This results in DNA chain termination and stops further viral DNA synthesis
Warning for all NRTIs (2)
and which 3 are affected most
lactic acidosis and hepatomegaly with steatosis
zidovudine, stavudine, didanosine
Tenofovir toxicities (3)
nephrotoxicity
osteoporosis
Fanconi syndrome
List NRTIs (5)
abacavir lamivudine emtricitabine tenofovir Zidovudin
NNRtIs MOA
non-competitive binding to reverse transcriptase and blocking the RNA-dependent and DNA-dependent DNA polymerase activities including HIV replication
List NNRTIs (2)
Efavirenz
Rilpivirine
Protease inhibitors MOA
inhibiting HIV protease and rendering the enzyme incapable of cleaving the Gag-Pol polyprotein, resulting in non-functional viral proteins and preventing teh assembly and maturation of HIV virions
generic names of PIs end in
-navir
List PIs (2)
Darunavir
Atazanavir
What is a PI commonly taken with?
PK booster
ritonavir or cobicistat to increase the levels of the PI
Main drug interactions for PIs
All Pis are CYP3A4 substrates and most are strong inhibitors of CYP3A4
pharmacokinetic boosters
ritonavir
cobicistat
Integrase strand transer inhibitors MOA
block teh integrase enzyme needed for viral DNA to integrate with the host cell DNA/human genome
generic name for INSTIs end with?
-tegravir
list INSTIs (4)
Elvitegravir
Bictegravir
dolutegravir
Raltegravir
Common SE for INSTIs
increased CPK
