HIV

Question 1

NRTIs

Answer 1

Abacavir
Lamivudine
Emtricitabine (keep in original container)
Tenofovir
Zidovudine
Didanosine

Question 2

NNRTIs

Answer 2

Efavirenz (risk in 1st tri pregnancy) *no breastfeeding for HIV patients
Etravirine
Rilpivirine
Nevirapine (viramune)
(never monotherapy - causes resistance)
*most are CYP substrates

Question 3

NRTI black box

Answer 3

lactic acidosis

severe hepatomegaly

Question 4

Zidovudine severe reaction

Answer 4

blood toxicity - neutropenia, severe anemia

myopathy with long term use

Question 5

Didanosine severe reaction

Answer 5

Pancreatitis (could be fatal)

Question 6

Triumeq

Answer 6

Abacavir(NRTI) + Lamivudine(NRTI) + Dolutegravir(integrase)

*once daily, keep in original container

Question 7

Truvada

Answer 7

Emtricitabine(NRTI) + Tenofovir fumarate(NRTI)
1 daily with or without food
*watch renal toxicity

Question 8

Descovy

Answer 8

Emtricitabine(NRIT) + Tenofovir alafenamide(NRTI)
newer version of truvada - almost same SE
1 daily
*interacts w/ pglycoprotein. avoid anticonvulsants, rifampin, st johns

Question 9

Stribild

Answer 9

Emtricitabine(NRTI) + Tenofovir fumarate(NRTI) + Elvitegravir/cobicistat
1 daily with food

Question 10

Epzicom

Answer 10

Lamivudine + Abacavir (both NRTIs)

1 daily

Question 11

Triumeq

Answer 11

Lamivudine + Abacavir/Dolutegravir

1 daily

Question 12

Didanosine interaction

Answer 12

Avoid allopurinol

avoid with tenofovir or reduce dose

Question 13

NNRTI/Nevirapine Black Box

Answer 13

Hepatotoxicity
Skin reactions (SJS/TEN)

Question 14

Atripla

Answer 14

Tenofovir(NRTI) + Emtricitabine(NRTI) + Efavirenz(NNRTI)

1 QHS empty stomach

Question 15

Intelence

Answer 15

Etravirine (NNRTI)
SE: rash, liver increased enzymes
major CYP
200 mg BID with meals

Question 16

Which HIV meds can reduce contraceptive effectiveness?

Answer 16

Efavirenz
Nevirapine
Ritonavir

Question 17

Protease Inhibitors

Answer 17

-NAVIR meds
SE: lipodystrophy, buffalo hump/breast enlargement
-must give with booster
-Some have sulfa allergy and avoid PPIs
-most are CYP3A4 inhibitors(avoid anticoag)

Question 18

Reyataz

Answer 18

Atazanavir

take 2 hrs before or 1 hr after PPIs

Question 19

What are boosters?

Answer 19

Use with Protease Inhibitors
Ritonavir
Cobicistat

Question 20

Integrase Inhibitors (INSTI)

Answer 20

Isentress (Raltegravir)

Tivicay (Dolutegravir)

Question 21

Treatment naive Regimen pg.187

Answer 21

2 NRTIs + NNRTI(EER) or Protease(navir)/booster or INSTI

Question 22

Which HIV med is not PO?

Answer 22

Fuzeon(Enfuvirtide) - injection subQ Q12H for treatment-experienced

Question 23

Which HIV meds overlap with Hep B?

Answer 23

Emtricitabine, Lamivudine, Tenofovir

they can treat hepB, pts might have increased resistance

Question 24

Contraindicated with PPIs?

Answer 24

Rilpivirine

Question 25

HIV meds with food

Answer 25

Darunavir, Atazanavir, Rilpivirine

Question 26

HIV med without food

Answer 26

Efavirenz

Question 27

Which HIV med has sulfa?

Answer 27

Tipranavir

Question 28

Which HIV med requires high fat meal?

Answer 28

Elvitegravir

Question 29

The updated Tenofovir version reduces what SE?

Answer 29

Less Bone loss

Less Renal toxicity

Question 30

Which HIV med can increase INR (bleed risk with Warfarin)

Answer 30

NORVIR - CYP3A4 inhibitor

same with Gleevec, imatinib a TKI