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HIV Flashcards

1
Q

At what CD4+ T cell count level makes someone more susceptible to opportunistic infections

A

< 200

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2
Q

Normal CD4+ count

A

800-1200

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3
Q

What is the recommended treatment for HIV

A

INSTI with 2 NRTIs

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4
Q

what test needs done prior to using Abacavir

A

HLA-B*5701

- If positive do not use Abacavir (Ziagen)

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5
Q

Caution for Tenofovir Disoproxil Fumarate

A
  • Renal insufficiency

- Deceased bone density

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6
Q

CI for Triumeq

A

do not start if CrCL < 50

do not use if HLA-B*5701 positive

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7
Q

CI for Biktarvy

A

do not start if CrCl < 30

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8
Q

What does INSTI stand for

A

Integrase strand transfer inhibitors

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9
Q

NRTIs MOA

A

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

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10
Q

Warning for all NRTIs (2)

and which 3 are affected most

A

Lactic acidosis
Hepatomegaly with steatosis

Zidovudine
Stavudine
Didanosine

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11
Q

Tenofovir toxicities (3)

A

Nephrotoxicity
Osteoporosis
Fanconi syndrome

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12
Q

List NRTIs (5)

A
  • Abacavir (Ziagen)
  • Lamivudine (Epivir)
  • Emtricitabine
  • Tenofovir DF (Viread)
  • Tenofovir AF
  • Zidovudin (Retrovir)
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13
Q

NNRTIs MOA

A

Non-competitive binding to reverse transcriptase and blocking the RNA-dependent and DNA-dependent DNA polymerase activities including HIV replication

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14
Q

List NNRTIs

A
  • Efavirenz (Sustiva)

- Rilpivirine

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15
Q

Protease inhibitors MOA

A

Inhibiting HIV protease and rendering the enzyme incapable of cleaving the Gag-Pol polyprotein, resulting in non-functional viral proteins and preventing the assembly and maturation of HIV virions

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16
Q

generic names of PIs end in

A

-navir

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17
Q

List PIs (2)

A
  • Atazanavir (Reyataz)

- Darunavir (Prezista)

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18
Q

What is a PI commonly taken with?

A

PK booster

ritonavir or cobicistat to increase the levels of the PI

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19
Q

Main drug interactions for PIs

A

All Pis are CYP3A4 substrates and most are strong inhibitors of CYP3A4

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20
Q

Pharmacokinetic boosters agents

A
  • Ritonavir (Norvir)

- Cobicistat

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21
Q

Integrase strand transer inhibitors MOA

A

Block the integrase enzyme needed for viral DNA to integrate with the host cell DNA/human genome

22
Q

Generic name for INSTIs end with?

A

-tegravir

23
Q

List INSTIs (4)

A

Bictegravir

Dolutegravir (Tivicay)

Elvitegravir

Raltegravir (Isentress)

24
Q

Common ADE for INSTIs

A

Increased CPK

25
Q

CCR5 antagonist MOA

A

Inhibit binding to the CCR5 co-receptor on the CD4+ cells and prevents HIV from entering the cell

26
Q

List CCR5 antagonist

A

Maraviroc

Note: Patient must undergo a Tropism Test prior to start of this med

27
Q

Fusion inhibitors MOA

A

Block the fusion of the HIV virus with the CD4+ cells by blocking the conformational change in gp41 required for membrane fusion and entry into CD4+ cells

28
Q

List fusion inhibitors

A

Enfuvirtide

29
Q

Common complication of ART (4)

A
  • Lipodystrophy: changes in fat distribution
  • Immune reconstitution inflammatory syndrome (IRIS); worsening of preexisting OI or malignancy when ART is initiated
  • Lactic acidosis
  • Severe hepatomegaly with steatosis
30
Q

Indication for Megestrol in HIV

A

Anorexia or Cachexia (wasting of the body and weakness) associated with AIDS

It increases appetite

31
Q

Indication for Dronabinol in HIV

A

AIDS-related anorexia

32
Q

Pre-exposure prophylaxis

A

Emtricitabine/Tenofovir

33
Q

Ziagen

generic and class

A

Abacavir

NRTI

34
Q

Epivir

generic and class

A

Lamivudine

NRTI

35
Q

Viread generic

A

Tenofovir Disoproxil Fumarate

36
Q

Retrovir

generic and class

A

Zidovudine

NRTI

37
Q

Sustiva

generic and class

A

Efavirenz

NNRTI

38
Q

Prezista

generic and class

A

Darunavir

PI

39
Q

Reyataz

generic and class

A

Atazanavir

PI

40
Q

Tivicay

generic and class

A

Dolutegravir

INSTI

41
Q

Isentress

generic and class

A

Raltegravir

INSTI

42
Q

Which agents need to be taken with food?

A
  • Protease Inhibitors
  • Genvoya
  • Symtuza
  • Stribild
  • Rilpivirine in combo meds such as Complera, Juluca, Odefsey
  • Cobicistat
43
Q

Which agents DoNot need to be taken with food?

A
  • Atripla
  • Efavirenza (Sustiva) and combo meds such as Symfi
  • Didanosine
  • Indibavir (unboosted)
44
Q

What is the non-occupational post-expoure prophylaxis treatment regimen?

A 
Truvada 
\+
Raltegravir (Isentress)
\+ 
Dolutegravire (Tivicay)

Within 72 hours for 28 days supply

45
Q

What treatments are available for PrEP therapy?

A
  • Truvada
  • Descovy

Patient must be seen and tested every 3 months

46
Q

What is the occupational post-expoure prophylaxis treatment regimen?

A 
Truvada 
\+
Raltegravir (Isentress)
\+ 
Dolutegravire (Tivicay)

Within 72 hours for 28 weeks

47
Q

CI for Genvoya

A

do not start if CrCl < 30

48
Q

CI for Stribild

A

do not start if CrCl < 70

49
Q

Which combo meds have PI and Booster in them?

What are some clinical pearls to recognize?

A
  • Stribild
  • Genvoya
  • Symtuza

PI are CYP3A4 inhibitors
PI can cause rash (SJS/TEN)

50
Q

All INSTI agents and combo-medication with INSTI must….

A

Separate dose from polyvalent cation

51
Q

Complete Regimens (1 tab QD)

NNRTI-based agents

A
  • Atripla
  • Complera
  • Odefsey
52
Q

Complete Regimens (1 tab QD)

INSTI-based agents

A
  • Stribild
  • Genvoya
  • Biktarvy
  • Triumeq

HIV (1 decks)

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