Stavudine d4T Form: Capsules PO SLN WEIGHT BASED DOSING > 60kg: 40mg BID < 60kg: 30mg BID ————————————————- PANCREATITIS PERIPHERAL NEUROPATHY ``` Lactic Acidosis: MORE FREQUENT (CLASS) HEPATIC STEATOSIS (CLASS) HEADACHE (CLASS) ``` Lipodystrophy: SUBQ FAT WASTING, Central OBESITY, BREAST ENLARGEMENT, BUFFALO HUMP

didanOsine EYE EXAM NEEDED AFFECTS THE EYES FORMS: Delayed-Release Tablets WEIGHT BASED DOSING Admin: ONLY NRTI THAT NEEDS TO BE TAKEN ON AN EMPTY STOMACHE ———————————————— Pancreatitis - Avoid ALCOHOL - Monitor Amylase Q2-3 MONTHS - n/v/ Abdominal pain PERIPHERAL NEUROPATHY RETINAL PIGMENTATION: eye exam q 6 mo Lactic Acidosis Hepatomegaly w/ steatosis

HIV Drugs Flashcards by hannibal britton

Trogarzo

Ibalizumab-uiyk

MOA: Binds to CD4 Cell RECEPTORS

Treats: Multidrug-Resistant HIV-1 infection FAILING from current REGIMEN

FORM: IV Q 14 DAYS (2 weeks)

SE: DIZZINESS
Rash, Diarrhea
INCREASE URIC ACID

Storage: REFRIGERATE

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Maraviroc

Selzentry

PERFORM TROPOISM TEST TO SEE IF DRUG WILL WORK BEFORE USING

MOA: Binds to CCR5 co-receptors of HOST CELL

Dose: 300mg BID
150mg BID (if on CPY3A Inhibitors)
- Protease Inhibitors, antifungal azoles, macrolides

600mg BID (if on CYP3A Inducers)
  - Efavirenz, rifampin, Carbamazepine, Phenobarbital, Phenytoin

DO NOT TAKE ST. JOHNS WORT w/ selzentry
———————————————————————

-BBW: HEPATOTOXICITY

ORTHOSTATIC HYPOTENSION

**INFECTION (55%)

HEART PROBLEMS

CONTRAINDICATION: CrCl< 30mL/min + CYP3A4 Inhibitor

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Fuzeon

Enfuvirtide

MOA: gp41 INHIBITOR of viral cell

Form: SUBQ

DOSE: 90mg SQ BID

PRECAUTIONS: Infection

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NUCLEOSIDE Reverse Transcriptase Inhibitors (NRTI’s)

ZidovuDINE(AZT, ZDV): Retrovir

Abacavir(ABC): Ziagen

LamivuDINE(3TC): Epivir

EmtricitaBINE(FTC): Emtriva

StavuDINE(d4T): Zerit

Didanosine(ddl): Videx

Tenofovir is an NRTI, however it is a NUCLEOTIDE Reverse transcriptase inhibitor

Mneumonic: ZALES DT

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NRTI’s

SIDE EFFECT PROFILE

1) HEADACHE
2) Lactic Acidosis
3) Hepatic steatosis (FATTY LIVER)
4) RENAL

Take w/ or w/o FOOD except didanoSINE

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Retrovir

ZidovuDINE (AZT; ZDV)

Forms: 100mg Capsule
300mg TABLET
10mg/ mL PO Syrup
10mg/ mL IV SOLUTION

DOSE: 300mg BID W/O regards to food
——————————————————

**BBW: Myelosuppression (ANEMIA; NEUTROPENIA)
( DIVING INTO THE MARROW)

Lactic acidosis/ Hepatic STEATOSIS (BBW)

MYOPATHY: BBW**

Lipoatrophy: loss of subq fat

HEADACHE most common

Nausea/vomiting

Purple NAIL DISCOLORATION

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Ziagen

Abacavir (ABC)

Forms: 300mg TABLETS
SOLUTION

Dose: 300mg BID/ 600mg QD w or w/o FOOD

ONLY USE IF PT IS HLA-B*5701 NEGATIVE
————————————————

Epzicom: ABC + LamivuDINE: QD

TRIZIVIR: ABC+ LamivuDINE+ zidovudine: BID

TRIUMEQ: ABC+Lamivudine+Dolutegravir: QD
————————————————

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Epzicom

Abacavir + LamivuDINE

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Trizivir

Abacavir + lamivuDINE + zidovuDINE

1 PO BID

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TriuMEQ

Abacavir + Lamivudine + dolutegravir

ONCE DAILY

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Epivir

LamivuDINE(3TC)

Dose: 150mg BID
300mg BID
(RENAL DOSE ADJUSTMENT < 50)

Side Effects: Lactic acidosis
Hepatomegaly w/ STEATOSIS
HEADACHE

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Emtriva

EmtricitaBINE (FTC)

Dose: Emtriva capsules 200mg QD
Emtriva oral sln: 240mg (REFRIGERATE)

Side EFFECTS: Lactic acidosis
Steatosis w/ Hepatomegaly

FLARE-UPS of HEP-B; LFT!!

COMMON: HEADACHE, diarrhea, NAUSEA

Darkening of PALMS and SOLES may resolve over time

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Zerit

Stavudine d4T

Form: Capsules
PO SLN

WEIGHT BASED DOSING
> 60kg: 40mg BID
< 60kg: 30mg BID
————————————————-

*PANCREATITIS**
*PERIPHERAL NEUROPATHY**

Lactic Acidosis: MORE FREQUENT (CLASS)
HEPATIC STEATOSIS (CLASS)
HEADACHE (CLASS)

Lipodystrophy: SUBQ FAT WASTING, Central OBESITY, BREAST ENLARGEMENT, BUFFALO HUMP

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ViDEX

didanOsine

EYE EXAM NEEDED AFFECTS THE EYES

FORMS: Delayed-Release Tablets

WEIGHT BASED DOSING

Admin: ONLY NRTI THAT NEEDS TO BE TAKEN ON AN EMPTY STOMACHE
————————————————

*Pancreatitis **
- Avoid ALCOHOL
- Monitor Amylase Q2-3 MONTHS
- n/v/ Abdominal pain

**PERIPHERAL NEUROPATHY

**RETINAL PIGMENTATION: eye exam q 6 mo

Lactic Acidosis

Hepatomegaly w/ steatosis

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Viread (TDF)

Vemlidy (TAF)

tenOfOvir

only NRTI that is a nucleoTIDE inhibitor

TAF- LESS Bone/ KIDNEY tox

TDF- lower lipid levels than TAF
————————————————

Tenofovir disoproxil fumarate (TDF) (Viread)

 - Treats: HIV/ Hep-B
 - Tabs &amp; Oral Powder
 - Dose: Normal renal —> 300mg QD
               ADJUST AS FNX DECLINES

Precautions: 
1) Lactic Acidosis; Hepatic Steatosis
2) **ACUTE renal failure: FANCONI SYNDROME**
3) ***^ OSTEOPOROSIS RISK**
4) Post treatment HEP-B EXACERBATION
5) Hepatic impairment
———————————————-

Tenofovir aladenamide (TAF) (VEMLIDY)

Treats: Chronic hepatitis B

Form: 25mg tablets

Admin: 25mg PO QD w/ FOOD

PRECAUTIONS: Lactic Acidosis
Hepatic steatosis

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SIDE EFFECTS OF NRTI’s

ZALES-DT

1) **HEADACHE
2) Lactic Acidosis

3) Hepatomegaly w/ steatosis (FATTY LIVER)
- ddl, d4T, AZT cause the MOST

4) PANCREATITIS & PERIPHERAL NEUROPATHY only with ddl(didanoSINE) & d4T(Stavudine). These pts should AVOID ALCHOHOL**

TDF: RENAL TOXICITY & OSTEOPOROSIS

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Non-Nucleoside Reverse TRANSCRIPTASE INHIBITORS (NNRTI’s)

Rilpirivine(RVP): (Edurant)

Nevirapine(NVP): Viramune

Efavirenz(EFV): SUSTIVA

Etravirine(ETR): Intelence

Doravirine (Pifeltro)

Delavirdine(DLV): Rescriptor
———————————————
CLASS SIDE EFFECTS: RASH + HEPATOXICITY

Edurant

Rilpirivine (RPV)

Dose: 25mg WITH FOOD. REQUIRES ACIDIC ENVIRONMENT

- DRUGS THAT ^ pH may REDUCE ITS CONCENTRATION!!!

DI: CYP3A4 SUBSTRATE

SE: depression, insomnia, headache, RASH, QT prolongation, HEPATOTOXICITY

Viramune

Nevirapine(NVP)

Forms: 200mg IR tabs, XR TABLETS, PO SUSP,

Dose: w or W/O Food HOWEVER XR 400mg must be started after INITIAL period with IR FORMULATION

SE:

    1) Life-threatening HEPATOXICITY
    2) STEVEN-JOHNSON SYNDROME (RASH)

DI: CYP SUBSTRATE

NOT RECOMMENDED FOR TREATMENT NAIVE PATIENTS

Sustiva

EfaVIRENZ (EFV)

Forms: Capsules

Dose: 600mg QHS: EMPTY STOMACHE

Side EFFECTS

1) drowsiness
2) VIVID DREAMS/Hallucinations
3) FALSE CANNABINOID TEST
4) CLASS EFFECT: HEPATOTOXIC/ RASH

NOTE: ^ SUICIDALITY: NOT RECOMMENDED FOR PTS W/ MENTAL DISORDER

PREGANCY: AVOID IN 1ST TRIMESTER DUE TO FETAL HARM
—————————————————
COMBO: Atripla

Intelence

Etravirine

Form: 25,100, & 200mg tabs

Dose: 200mg BID AFTER A MEAL

KEEP IN ORIGINAL CONTAINER

SE: RASH(SJS/ TEN)

DI: CYP SUBSTRATE

Pifeltro

Doravirine (NNRTI)

Dose: W OR WO FOOD.

Rescriptor

Delavirdine

TID W or W/O Food.

ANTACIDS DECREASE ABSORPTION.

SE: RASH/ HEPATOXICITY

3A4 INHIBITOR: ^ PI (conc)

NOT USED MUCH DUE TO RAPID RESISTANCE

Integrase INHIBITORS

Raltegravir (Isentress)

Bictegravir
Biktarvy = Emtriva+ TAF+ Bictegravir

Elvitegravir
1) Cobicistat+TDF+Emtriva+ int = STRIBILD

2) Cobicistat+TAF+Emtriva+int = GENVOYA

Dolutegravir (TiviCAY)

CLASS EFFECTS OF - **INTEGRASE INHIBITORS**

GI: diarrhea/ Nausea CNS: HA, Insomnia, & dizziness Fatigue ——————————————— COUNSELING POINTS: 1) W OR W/O FOOD 2) SEPERATE FROM ALL ANTACIDS

Isentress

Raltegravir Forms: chewables, 100mg packet, tablets Dose: 400mg BID or 1200mg QD W OR WITHOUT food. **SEPERATE FROM ALUMINUM/Mg 2+. ORIGINAL CONTAINER HAS DESICCANT!! S/E: myopathy/ rhabdomyolysis,^^CPK ^^ALT, ^^GLU

Tivicay

DolueteGRAVIR DOSE: 50mg QD w or w/o FOOD; SEPERATE FROM ANTACIDS - Potent 3A4 inducers: efavirenz/ rifampin: 50mg BID - oxcarbazepine, Carbamazepine, rifampin, Phenytoin, St. Johns wort should be AVOIDED SE: Hypersensitivity Rxns **DO NOT USE IN PREGNANCY** ^ LFT, ^ GLUCOSE *Insomnia; HA*

Protease Inhibitors

LopiNAVIR/RitoNAVIR: KALETRA AtazaNAVIR: Reyataz w/ cobicistat *NelfiNAVIR: Viracept DaruNAVIR: Prezista / prezcobix * FosampreNAVIR: Lexiva * Indinavir: Crixivan RitoNAVIR(RTV): Norvir * SaquiNAVIR: Invirase * TipraNAVIR: Aptivus MNEMONIC: LAND FIRST

Protease Inhibitor CLASS SIDE EFFECTS

GI: N/V/D, gas LIPODYSTROPHY: SubQ fat wasting, Central obesity, peripheral fat wasting, buffalo hump ^ Hyperglycemia ^ Hyperlipidemia ^Risk of Myocardial INFARCTION ^ Bleeding in hemophiliacs ``` - HEPATOXICITY & ALT ————————————- DRUG INTERACTIONS - Rifampin is contraindicated with PI’s - MOST TAKEN W/ FOOD ```

Kaletra

Lopinavir + Ritonavir Forms: film coated TABLETS PO SOLN- RefriGERATE!!! Precaution: 3A4 inihibtor Ritonavir (Inhibitor) ^ lopinavir by 100 folds

Reyataz

Atazanavir (AZT) Dose: Qd w/ FOOD Acid needed for ABSORPTION: Seperate from PPI’s and ANTACIDS PRECAUTIONS: ^ MONITOR EKG 1) Nephrolithiasis/ cholelithiasis Benefit: IMPROVE LIPID PROFILES THAN OTHER PPI’s ————————————— Inducers: RIFAMPIN/ st JOHNS WORT/ SUSTIVA DECREASE REYATAZ LEVELS VIREAD CAN DECREASE REYATAZ LEVELS AND REYATAZ CAN INCREASE VIREAD LEVELS REDUse CLARITHROMYCIN BY 50%

Viracept

NELFINAVIR (PPI) MAJOR GI ISSUES WITH FOOD. Cannot he boosted

PrezistA

Darunavir (SULFA DRUG) W/ ritonavir or cobistat Combos: Symtuza: darunavir; cobistat; emtricitabine/ TAF PRECOBIX: darunavir plus cobicistat

Combivir

Zidovudine + lamivudine

Trizivir

Zidovudine + lamivudine + Abacavir

Epizicom

Abacavir + Lamivudine

Triumeq

Abacavir + Lamivudine + DoluteGRAVIR

Atripla

Efavirenz + emtricitabine + tenofovir QD on EMPTY STOMACHE

Complera

Rilpivirine + TDF + Emtricitabine 1 tab W/ FOOD

Odefsey

Rilpirivine + TAF + Emtricitabine

Stribild

Elvitegravir + cobicistat + emtricitabine + TDF** 1 tab w/ FOOD

Genvoya

Elvitegravir + cobicistat + TAF + emtricitabine 1 tab W/ FOOD