HIV Adverse Effects/Monitoring

Question 1

Abacavir (ABC)

Answer 1

HLA-B*5701 negative test first
Questionable increased risk MI
Hypersensitivity reaction
Dose adjustment if hepatic insufficiency

Question 2

Didanosine (ddI)

Answer 2

Pancreatitis, peripheral neuropathy, lactic acidosis, N/V, insulin resistance/DM, ? risk MI, portal hypertension, retinal changes, optic neuritis
Dose adjustment if renal insufficiency

Question 3

Emtricitabine (FTC)

Answer 3

Low toxicity, hyper pigmentation (palms, soles)

Dose adjustment renal insufficiency

Question 4

Lamivudine (3TC)

Answer 4

Low toxicity

Dose adjustment renal insufficiency

Question 5

Stavudine (d4T)

Answer 5

Pancreatitis, peripheral neuropathy, lactic acidosis, N/V, insulin resistance/DM, hyperlipidemia, lipoatrophy
Dose adjustment renal insufficiency

Question 6

Tenofovir alafenamide (TAF)

Answer 6

N/D, HA, osteomalacia (decrease BMD), renal insufficiency (Fanconi syndrome, less than TDF)
Not recommended CrCl <30

Question 7

Tenofovir disoproxil fumarate (TDF)

Answer 7

Renal insufficiency (Fanconi syndrome), proximal renal tubulopathy, osteomalacia, asthenia, NA, N/V/D, flatulence
Dose adjustment renal insufficiency

Question 8

Zidovudine (ZDV)

Answer 8

Bone marrow suppression, lactic acidosis, nail pigmentation, insulin resistance/DM, hyperlipidemia, lipoatrophy, myopathy, N/V, HA, insomnia, asthenia
Dose adjustment renal insufficiency

Question 9

Efavirenz (EFV)

Answer 9

Rash, HA, neuropsych symptoms, increased LFTs, hyperlipidemia, teratogenic
Take on empty stomach
No dose adjustment

Question 10

Etravirine (ETR)

Answer 10

Rash (including SJS), nausea, hypersensitivity
No dose adjustment
Taken with food

Question 11

Nevirapine (NVP)

Answer 11

Rash (including SJS), hepatitis, hepatic necrosis (esp ARV-naive females with CD4 >250 and males CD4 >400)

Question 12

Rilpivirine (RPV)

Answer 12

Rash, depression, insomnia, headache, hepatotoxicity

Eat with full meal

Question 13

Atazanavir (ATV)

Answer 13

Indirect hyperbilirubinemia, PR interval prolongation, hyperglycemia, cholelithiasis, nephrolithiasis, elevated transaminases, hyperlipidemia, skin rash
Take with food

Question 14

Darunavir (DRV)

Answer 14

Skin rash (sulfa, SJS), hepatotoxicity, N/D, HA, hyperlipidemia, elevated LFT, hyperglycemia, fat maldistribution

Question 15

Fosamprenavir (FPV)

Answer 15

Skin rash, N/V/D, HA, hyperlipidemia, elevated LFT, hyperglycemia, nephrolithiasis

Question 16

Indinavir (IDV)

Answer 16

Nephrolithiasis, nausea, hepatitis, HA, fat maldistribution, metallic taste, anemia, indirect hyperbilirubinemia, hyperlipidemia, hyperglycemia

Question 17

Lopinavir (LPV/r)

Answer 17

N/V/D, asthenia, hyperlipidemia, hyperglycemia, insulin resistance

Question 18

Nelfinavir (NFV)

Answer 18

Diarrhea, hyperlipidemia, hyperglycemia, elevated transaminases, fat maldistribution
Take with food

Question 19

Ritonavir (RTV)

Answer 19

N/V/D, paresthesia, hyperlipidemia, asthenia, taste perversion, hyperglycemia
Take with food

Question 20

Saquinavir (SQV)

Answer 20

N/D, HA, elevated transaminases, hyperlipidemia, hyperglycemia, fat maldistribution, QT prolongation

Question 21

Tipranavir (TPV)

Answer 21

Hepatotoxicity, skin rash (sulfa moiety), hyperlipidemia, hyperglycemia, ICH

Question 22

Dolutegravir (DTG)

Answer 22

Hypersensitivity rxn, HA, insomnia, depression (rare, usually if pre-existing psych)

Question 23

Elvitegravir (EVG)

Answer 23

Nausea, diarrhea, depression (rare, usually if pre-existing psych)

Question 24

Raltegravir (RAL)

Answer 24

Rash (inc SJS/TEN), N/D, HA, pyrexia, CK elevations, myopathy, rhabdo, insomnia

Question 25

Maraviroc (MVC)

Answer 25

Abd pain, cough, dizziness, ask symptoms, rash, URI, orthostatic hypotension, hepatotoxicity

Question 26

Enfuvirtide (ENF)

Answer 26

Injection site reactions

Question 27

Cobicistat (COBI)

Answer 27

N/D, fatigue, increased SCr (no impact on GFR)