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NAPLEX > HIV DRUGS > Flashcards

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
Q

NNRTIs

A

No renal dose adjustment except for atripla and complera

Heptatox and rash including SJS/TENS with the NNRTI

Efavirenz before food.

26
Q

Protease Inhibitors

A

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
Q

Darunavir (DRV)

Brand, Caution, notes

A

Prezista

Caution with sulfa allergy, drug induced hepatitis, SJS/TENS

Must be given with ritonavir or cobicistat

28
Q

DRV/Cobicistat

Brand

A

Prezcobix

29
Q

Atazanavir (ATV)

A

ReyATAZ

SE: Indirect bilirubinemia

Avoid acid supressive agents (H2RA, PPI etc)

30
Q

ATV/cobicistat

Brand

A

EvoTAZ

1 t QD dosing

31
Q

Lopinavir + Ritonavir (LPV/r)

A

Kaletra

Solution contains alcohol

32
Q

Drug interactions with PIs

A

Since they are ALL 3A4 substrates…

Avoid 3A4 inducers, dronedarone (Multaq)
direct Xa Oral agents, alfuzosin

Alter INR (many decrease)

33
Q

Boosters (RItonavir + Cobicistat)

A

Ritonavir (Norvir) & Cobicistat (Tybost)

Take with food for all boosters.

Interacts with many drugs

34
Q

INSTIs

A

ends in -tegravir
Increase CPK
Headaches + Insomnia
avoid polyvalent cations

35
Q

Elvitegravir (EVG)

Renal dosage, SE

A

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
Q

Dolutegravir (DTG)

Brand and SE

A

Tivicay

SE: Insomnia and HA. Increase Scr without affecting GFR

37
Q

Raltegravir (RAL)

A

Issentress, Issentress HD

SE: CPK, myopathy, rhado

38
Q

Drug interations with INSTIs

A

Taken 2 h before or 6 hours after cation-containing products

39
Q

Maraviroc

A

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
Q

Enfuvirtide (T20)

A

Fuzeon

SE: Local injection site rx 98%

41
Q

PrEP

A

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
Q

nPEP

A

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
Q

PEP

A

Start within 72 hours

Should be a 3 drug regiment

Raltegravir (RAL) (Issentress) + Truvada for 4 weeks

44
Q

Megastrol

A

Megace

Use: Anorexia or cachexia associated with HIV

45
Q

Dronabinol

A

Marinol

Use: AIDS related anorexia

46
Q

Poly-L-Lactic Acid

A

Sculptra (SC)

Use: Lipoatrophy (facial)

47
Q

Calcium Hydroxyalpatite

A

Radiesse, Radiesse plus (IM)

Use Lipoatrophy (facial)

48
Q

Initial HIV naive treatment

INSTI Based

A

INSTI base:
Triumeq (ABC/DTG/3TC)
Stribild
Genvoya
Truvada + Issentress (RAL) or Tivicay (DTG)
Descovy + Issentress (RAL) or Tivicay (DTG)

49
Q

Intial HIV naive treatment

PI based

A

PI BASED:
Truvada + Prezista (DRV) + Norvir (r)
Descovy + Preszista (DRV) + Norvir(r)

50
Q

Pregnancy HIV Naive Treatment

A

Epzicom (ABC/3TC) + Atanazavir/(r) or Issentress (RAL)

Truvada (TDF/FTC) + Prezista (DRV)/(r) BID

NAPLEX (13 decks)

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