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Pass Naplex Now Book II > HIV - Drugs/ADEs > Flashcards

HIV - Drugs/ADEs Flashcards

1
Q

Protease Inhibitors

  • SEs
  • DDIs
A

SEs

  • N/V/D/Flatulence
  • Lipodystrophy - SQ fat wasting
  • Hyperglycemia/insulin resistance
  • Hyperlipidemia: avoid lovastatin & simvastatin
  • Hepatotoxicity
  • Incr transaminase elevation
  • Incr risk of myocardial infarction
  • Incr bleeding

DDIs
- 3A4 Inhibitors

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2
Q

Indinavir - Crixivan

  • SEs
  • How to take it
  • Contact MD if
  • Storage
A
  • Kidney stone = nephrolithiasis
  • Take on empty stomach or light meal
    => Drink > 1.5L of water/d
  • Contact MD if FLANK pain
  • Storage: very sensitive to moisture. MUST store in desiccant in container. W/o desiccant, capsules are good for 3 days
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3
Q

Kaletra

  • Forms
  • Storage
  • Take with
  • Which contain EtOH
A

Lopinavir + Ritonavir

Film coated tablet

  • With or w/o food
  • DO NOT REFRIGERATION
PO Sol'n
- With Food
- Refrigeration 
  => throw away after 2 mo if @ RT
- Contain 42% EtOH
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4
Q

With Food

A
  • All PI except Indinavir
  • Zidovudine - Retrovir
  • Rilpivirdine - Edurant
  • Tenofovir - Viread
  • Fosamprenavir - Lexiva: PO susp in children
  • Complera - Emtricitabine + Tenofovir + Rilpivirine
  • Stribild: Elvitegravir + cobicistat + emtricitabine + tenofovir disoproxil fumarate
  • Ganciclovir - Cytovene
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5
Q

Kaletra - Lopinavir + Ritonavir

  • SEs
A
  • Pancreatitis
  • Severe migraine like HA
  • Rash
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6
Q

Contain Alcohol

A
  • Kaletra - Lopinavir + Ritonavir: Susp Sol’n
  • Ritonavir - Norvir
  • Tiprinavir - Aptivus
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7
Q

Cause explosive diarrhea

A
  • Nelfinavir - Veracept
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8
Q

Refrigeration

  • Kaletra - Lopinavir + Ritonavir:
  • Ritonavir - Norvir:
  • Retrovir - Zidovudine:
  • Tiprinavir - Aptivus:
  • Emtricitabine - Emtriva:
  • Enfuvirtide - Fuzeon:
  • Didanosine - Videx:
  • Viracept - Nelfinavir:
  • Stavudine - Zerit:
A
  • Kaletra - Lopinavir + Ritonavir: Susp Sol’n
  • Ritonavir - Norvir: Cap needs fridge => OFF THE MARKET but not sol’n
  • Retrovir - Zidovudine: Use dilution w/in 8H if refrigerated
  • Tiprinavir - Aptivus: Cap fridge b/4 use
  • Emtricitabine - Emtriva: Oral sol’n. At RT, use w/in 3M
  • Enfuvirtide - Fuzeon: Fridge reconstitution sol’n & use w/n 24H
  • Didanosine - Videx: Ped powder after mixing, refrigerate & use w/in 1M
  • Viracept - Nelfinavir: PO powder if not use, need fridge
  • Stavudine - Zerit: PO powder after reconstitute, need to fridge
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9
Q

Ritonavir - Norvir

  • SE
  • Storage
A

SEs

  • Severe GI => taper up to prevent n/v
  • Paresthesias: numbness
  • Hyperlipidemia: highest among all PIs

Storage

  • Cap: refrigerate or @ RT 30 days
  • So’n/tablet: no refrigerate
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10
Q

Which drug contains:

Contain lactose => increase frequency of GI SEs

A

Saquinavir (Invirase)

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11
Q

Saquinavir (Invirase)

  • SEs
  • CI
A

SEs

  • Contains lactose => increase GI SE
  • HA
  • Fatal hepatotoxicity
  • Life threatening cardiac when used w/ Norvir

CI
- Rifampin => severe hepatotoxicity

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12
Q

Fatal hepatotoxicy

A
  • Saquinavir (Invirase)

- Tiprinavir - Aptivus

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13
Q

Tiprinavir - Aptivus

  • SEs
  • CI
  • BBW
A
  • Fatal hepatotoxicity
  • Intracranial bleeding
  • Sulfa, rash
  • Hemophilia

CI
- Hepatic failure

BBW
- Intracranial hemorrhage
=> It’s imp to report any unusual bleeding especially if they are taking any blood thinner

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14
Q

A Prodrug

A

FoSAMprenavir (Lexiva)

- Prodrug of amprenavir

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15
Q

FoSAMprenavir (Lexiva)

- SEs

A
  • Steven Johnson
  • Rash
  • Sulfa allergy
  • Hemophilia
  • Depression
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16
Q

Drugs cause hemophilia

A
  • Tiprinavir - Aptivus

- FoSAMprenavir (Lexiva)

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17
Q

The only PI that has not been ass with increases in TC or fasting TG

A

Atazanavir - Reyataz

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18
Q

Protease Inhibitors

  • Inhibitor of which CYP 450
  • What need to monitor Q3M
A
  • Inhibitor of 3A4

Monitor Q3M

  • LFT
  • Glucose
  • Cholesterol
  • Look for fat redistribution
19
Q

Abavavir - Ziagen

  • SEs
  • Generic Screening for
A

SEs

  • Severe hypersensitivity => can be fatal HLA B5701
  • Lactose acidosis

Generic screen
- HLA-B5701

20
Q

Empty Stomach

A
  • Indinavir - Crixivan
  • Didanosine - Videx
  • Efavirenz - Sustiva
  • Fosamrenavir - Lexiva: oral susp in adults
  • Atripla - Efavirenz + Emtricitabine + Tenofovir
21
Q

Didanosine - Videx

- SEs

A

=> DAN Pham

  • Pancreatitis
  • Peripheral neuropathy
  • Retinal Pigmentation
  • Lactic acidosis
22
Q

Cause eye problem

A
  • Didanosine - Videx
23
Q

Zidovudine - Retrovir

  • SEs = do = red
A

=> Take with food to decrease nausea

- Myelosuppression
  => Anemia: Epogen
  => Neutropenia: Neupogen
- Purple toe
- HA
- Myopathy
- Lactic acidosis
24
Q

Emtricitabine - Emtriva

  • SEs
A
  • Lactic acidosis
  • Flare up hepatitis B
  • Darkening of palm and soles which will resolve
25
Q

NRTI

  • Class SEs
  • Without food
  • With food
A

Class SEs

  • HA
  • Lactic acidosis, hepatic steatosis

Without food
- Didanosine - Videx => at least 1H prior/2H after meal

With food

  • Zidovudine - Retrovir to decrease N/V
  • Tenofovir - Viread
26
Q

NNRTI

- Class SEs

A

SEs

  • Rash
  • Hepatotoxicity

=> All take with foods

27
Q

False cannabinoid test

A
  • Efavirenz - Sustiva
28
Q

Tenofovir - Viread

- SEs

A
  • Lactic acidosis
  • Hepatotoxicity
  • Renal: acute renal failure/Fanconi syndrome
29
Q

Fanconi syndrome

A
  • Tenofovir - Viread

- Elvitegravir (part of Stribild)

30
Q

Abacavir & Tenofovir

- Which class

A
  • NRTI
31
Q

Pregnant patient

A
  • Zidovudine: 300 mg PO BID or 200 mg PO TID
32
Q

During label

A
  • Zidovudine: 2mg/kg IV LD in 1H => 1mg/kg continuous infusion
33
Q

Infant

A
  • Zidovudine syrup: 2mg/kg PO Q6H for 1st 6 weeks of life

- Starting within 8-12H of life

34
Q

DO NOT COMBINE

A

SEE BOOK PG 15 HIV

35
Q

Recommend regimen for post-exposure prophylaxis

A
  • Truvada + Raltegravir
36
Q

Recommend Vaccination

A
  • Hep A
  • Hep B
  • Influenza
  • Pneumococus
  • DPT
  • MMR: NOT OK w/ AIDs but ok w/ asymptomatic HIV with CD4 > 200
37
Q

Vaccination NOT rec

A
  • Varicella - Varivax
  • Smallpox vaccine
  • Live influenza (FluMist)
  • HPV for W < 26 y.o
  • Attenuated Polio but inactivated polio is OK
38
Q

Pneumocystis Pneumonia (PCP)

  • DOC
  • Alternative
  • Sulfa allergy
A

DOC
- Bactrim + Prednisolone x 21d

Alternative
- Dapsone + Pentamidine + Leukovorin

Sulfa allergy
- Clinda + Primaquine + Prednisone x 21d

39
Q

Toxoplasmosis

  • 1st line:
  • Alternative:
A

1st line
- Bactrim 1 DS PO QD

Alternative: Combo of 3 drugs

  • Pyrimethamine (Daparim): Inhibits parasitic dihydrofolate reductase
  • Leucovorine
  • Sulfadiazine - Dapsone
40
Q

MAC

- DOC

A

Macrolides

  • Clarithromycin 500 mg PO BID
  • Azithromycin 1200mg PO QW
41
Q

M. Kansasii

- DOC

A

=> Same as MAC

Macrolides

  • Clarithromycin 500 mg PO BID
  • Azithromycin 1200mg PO QW
42
Q

Treatment of CMV

A
  • Foscarnet - Foscarvir: Nephrotoxic, seizure
  • Ganciclovir - Cytovene: Renal, sz
  • Ganciclovir implants - Vitrasert:
  • Cidofovir - Vistide: Renal
  • Fomivirsen - Vitravene
43
Q

Treatment regimen for latent PPD+

A
  • INH (isoniazid) 300 mg + Pyridoxime (vit B6) 50 mg PO QD x 9M

OR

  • INH 900 mg PO + Pyridoxine 100 mg BW x 9M
44
Q

Treatment for diarrhea caused by:

  • Salmonellosis
  • Campylobacteriosis
  • Shigellosis
A
  • Salmonellosis
    DOC: Ciprofloxacin x 2-4wks. May continue QD thereafter
  • Campylobacteriosis
    Azithromycin or cipro x 7d
  • Shigellosis
    DOC: quinolones

Pass Naplex Now Book II (39 decks)

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