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HIV DRUGS Flashcards

1
Q

initial monitoring

A

CD4, Viral load, Pregnancy, Hep B and C, HLA-B *5701 (abacavir), Tropism (maraviroc)

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2
Q

CD4 count less than 200

A

OI: PCP

Txt: Bactrim DS qd or SS qd or DS 3x per wk
Dapsone
Atovaquone

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3
Q

CD4 count <100

A

OI: Toxoplasma gondii encephalitis (IgG + Pt)

Txt preferred: Bactrim DS tab qd

Txt Alternative: Bactrim DS 3x/week or SS po qd or (Dapsone + pyrimethamine + Leucovorin) or Atovaquone +/- pyrimethamine + leucovorin

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4
Q

CD4 count <50

A

OI: Mycobacterium Avium Complex

TXT preferred: Bactrim DS qd

TXT Alternative: Azithromycin 1,200mg po weekly or clarithromycin 500 mg po BID or Azithromycin 600 mg po twice weekly.

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5
Q

Abacavir (ABC)

Brand and BBW

A

Brand: Ziagen, Epzicom (+3TC), Triumeq (+3TC, DTG)

BBW: Test for HLA-B *5701 gene positive due to hypersensitivity. Do not rechallenge

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6
Q

NRTI’s

A

Class BBW: lactic acidosis and hepatomegaly with steatosis (Fatty LIVER)

No renal Adjustment besides abacavir

No CYP interactions

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7
Q

Abacavir/Lamuvidine (ABC, 3TC)

Brand

A

Brand: Epzicom

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8
Q

Abacavir/Lamuvidine/Dolutegravir (ABC/3TC/DTG)

Brand

A

Triumeq

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9
Q

Lamuvidine (3TC)

Brand, BBW, SE:

A

Brand: Epivir

BBW: Do not use Epivir-HBV for txt of HIV (Has lower dose)

SE: N/V/D

avoid 3TC and FTC (both antagonize the cytosine analogs)

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10
Q

Lamuvidine/Zidovudine

Brand

A

Combivir

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11
Q

Emtricitabine (FTC)

Brand and BBW

A

Emtriva

BBW: acute HBV Exacerbations

SE: n/v/d, HA, rash, Insomnia, hyperpigmentation

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12
Q

TDF/FTC

Brand, Use

A

Truvada

use: Prep

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13
Q

TAF/FTC

A

Descovy

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14
Q

TDF/FTC/RPV

A

Complera

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15
Q

TAF/FTC/RPV

A

Odesfey

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16
Q

TDF/FTC/cobicistat/EVG

A

Stribild

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17
Q

TAF/FTC/cobicistat/EVG

A

Genvoya

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18
Q

TDF/EFV/FTC

A

Atripla

Take on empty stomach and qhs

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19
Q

TDF

Brand, BBW, SE

A

Viread

BBW: ALL Tenofovir containing products can exacerbate HBV. D/C with HBV infections.

SE: Renal Tox, Fanconi Syndrome , Oseteomalacia and decrease bone mineral density

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20
Q

TAF

A

BBW: Not approved for txt of chronic HBV

SE: less incidents of TDF Side effects; Fanconi syndrome, decrease bone mineral density, renal toxicity, osteomalacia

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21
Q

Zidovudine (ZDV, AZT)

Brand and Box warnings

A

Retrovir

BBW: Hemotologic toxicities

22
Q

Didanosine (ddl)

A

Videx

BBW: Pancreatitis

23
Q

Efavirenz

Brand, BBW, SE, counseling points

A

Sustiva

BBW: Serious psychiatric and CNS symptoms, convulsions, QT prolongation

SE: CNS effects (impaired concentration, abnormal dreams, confusion, dizziness) rash

Take on empty stomach and qhs

24
Q

Rilpvirine (RPV)

Brand, CI, SE, what is it in?

A

Brand: Edurant

AVOID PPIs

SE: Depressive disorders, mood change, insomnia

Drug in Complera and Odefsey

25
NNRTIs
No renal dose adjustment except for atripla and complera Heptatox and rash including SJS/TENS with the NNRTI Efavirenz before food.
26
Protease Inhibitors
ends in -navir ALL PI's are metabolized in liver and are 3A4 sub and most are Strong inhibitors of 3A4 taken with boosters (Ritonavir and cobicistat) hepatotoxicity
27
Darunavir (DRV) | Brand, Caution, notes
Prezista Caution with sulfa allergy, drug induced hepatitis, SJS/TENS Must be given with ritonavir or cobicistat
28
DRV/Cobicistat | Brand
Prezcobix
29
Atazanavir (ATV)
ReyATAZ SE: Indirect bilirubinemia Avoid acid supressive agents (H2RA, PPI etc)
30
ATV/cobicistat | Brand
EvoTAZ | 1 t QD dosing
31
Lopinavir + Ritonavir (LPV/r)
Kaletra Solution contains alcohol
32
Drug interactions with PIs
Since they are ALL 3A4 substrates... Avoid 3A4 inducers, dronedarone (Multaq) direct Xa Oral agents, alfuzosin Alter INR (many decrease)
33
Boosters (RItonavir + Cobicistat)
Ritonavir (Norvir) & Cobicistat (Tybost) Take with food for all boosters. Interacts with many drugs
34
INSTIs
ends in -tegravir Increase CPK Headaches + Insomnia avoid polyvalent cations
35
Elvitegravir (EVG) | Renal dosage, SE
No single agent it is in Stribild and Genvoya CrCl <70 do not initiate Stribild (TDF; more renal toxic) CrCl < 30 do not initate Genvoya ( TAF; Less renal toxic) SE: HA and Insomnia (INSTI component)
36
Dolutegravir (DTG) | Brand and SE
Tivicay SE: Insomnia and HA. Increase Scr without affecting GFR
37
Raltegravir (RAL)
Issentress, Issentress HD SE: CPK, myopathy, rhado
38
Drug interations with INSTIs
Taken 2 h before or 6 hours after cation-containing products
39
Maraviroc
Selzentry BBW: Hepatox Test for tropism (testing for co-receptor) Will only work for CCR5-tropic disease Pt must be negative for CXCR4 or dual/mixed diease. Major 3A4 sub
40
Enfuvirtide (T20)
Fuzeon SE: Local injection site rx 98%
41
PrEP
People who do not have HIV Take truvada 1 po qd Confirm: HIV negative CrCl greater than 60, screen for HBV Follow up q 3 months
42
nPEP
Non occupational Post exposure prophy due to sexual activity, injection drug use. Within 72 hours Txt: INSTI-based or PI Based 1st line INSTI based: Truvada + Dolutegravir (DTG) PI-Based: Truvada + Darunavir + Ritonavir qd
43
PEP
Start within 72 hours Should be a 3 drug regiment Raltegravir (RAL) (Issentress) + Truvada for 4 weeks
44
Megastrol
Megace Use: Anorexia or cachexia associated with HIV
45
Dronabinol
Marinol Use: AIDS related anorexia
46
Poly-L-Lactic Acid
Sculptra (SC) Use: Lipoatrophy (facial)
47
Calcium Hydroxyalpatite
Radiesse, Radiesse plus (IM) Use Lipoatrophy (facial)
48
Initial HIV naive treatment | INSTI Based
INSTI base: Triumeq (ABC/DTG/3TC) Stribild Genvoya Truvada + Issentress (RAL) or Tivicay (DTG) Descovy + Issentress (RAL) or Tivicay (DTG)
49
Intial HIV naive treatment | PI based
PI BASED: Truvada + Prezista (DRV) + Norvir (r) Descovy + Preszista (DRV) + Norvir(r)
50
Pregnancy HIV Naive Treatment
Epzicom (ABC/3TC) + Atanazavir/(r) or Issentress (RAL) Truvada (TDF/FTC) + Prezista (DRV)/(r) BID

NAPLEX (13 decks)

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