Indinavir - Crixivan - SEs - How to take it - Contact MD if - Storage

- 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

Kaletra - Forms - Storage - Take with - Which contain EtOH

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 ```

- 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

Kaletra - Lopinavir + Ritonavir - SEs

- Pancreatitis - Severe migraine like HA - Rash

- Kaletra - Lopinavir + Ritonavir: Susp Sol'n - Ritonavir - Norvir - Tiprinavir - Aptivus

Refrigeration - Kaletra - Lopinavir + Ritonavir: - Ritonavir - Norvir: - Retrovir - Zidovudine: - Tiprinavir - Aptivus: - Emtricitabine - Emtriva: - Enfuvirtide - Fuzeon: - Didanosine - Videx: - Viracept - Nelfinavir: - Stavudine - Zerit:

- 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

Ritonavir - Norvir - SE - Storage

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

- Saquinavir (Invirase) - Tiprinavir - Aptivus

Protease Inhibitors - Inhibitor of which CYP 450 - What need to monitor Q3M

- Inhibitor of 3A4 Monitor Q3M - LFT - Glucose - Cholesterol - Look for fat redistribution

HIV - Drugs/ADEs Flashcards by Christina Marie

Protease Inhibitors

SEs
DDIs

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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Indinavir - Crixivan

SEs
How to take it
Contact MD if
Storage

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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Kaletra

Forms
Storage
Take with
Which contain EtOH

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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With Food

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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Kaletra - Lopinavir + Ritonavir

Pancreatitis
Severe migraine like HA
Rash

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Contain Alcohol

Kaletra - Lopinavir + Ritonavir: Susp Sol’n
Ritonavir - Norvir
Tiprinavir - Aptivus

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Cause explosive diarrhea

Nelfinavir - Veracept

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Refrigeration

Kaletra - Lopinavir + Ritonavir:
Ritonavir - Norvir:
Retrovir - Zidovudine:
Tiprinavir - Aptivus:
Emtricitabine - Emtriva:
Enfuvirtide - Fuzeon:
Didanosine - Videx:
Viracept - Nelfinavir:
Stavudine - Zerit:

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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Ritonavir - Norvir

SE
Storage

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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Which drug contains:

Contain lactose => increase frequency of GI SEs

Saquinavir (Invirase)

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Saquinavir (Invirase)

SEs

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

CI
- Rifampin => severe hepatotoxicity

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Fatal hepatotoxicy

Saquinavir (Invirase)

- Tiprinavir - Aptivus

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Tiprinavir - Aptivus

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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A Prodrug

FoSAMprenavir (Lexiva)

- Prodrug of amprenavir

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FoSAMprenavir (Lexiva)

- SEs

Steven Johnson
Rash
Sulfa allergy
Hemophilia
Depression

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Drugs cause hemophilia

Tiprinavir - Aptivus

- FoSAMprenavir (Lexiva)

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

Atazanavir - Reyataz

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Protease Inhibitors

Inhibitor of which CYP 450
What need to monitor Q3M

Inhibitor of 3A4

Monitor Q3M

LFT
Glucose
Cholesterol
Look for fat redistribution

Abavavir - Ziagen

SEs
Generic Screening for

SEs

Severe hypersensitivity => can be fatal HLA B5701
Lactose acidosis

Generic screen
- HLA-B5701

Empty Stomach

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

Didanosine - Videx

- SEs

=> DAN Pham

Pancreatitis
Peripheral neuropathy
Retinal Pigmentation
Lactic acidosis

Cause eye problem

Didanosine - Videx

Zidovudine - Retrovir

SEs = do = red

=> Take with food to decrease nausea

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

Emtricitabine - Emtriva

Lactic acidosis
Flare up hepatitis B
Darkening of palm and soles which will resolve

NRTI - Class SEs - Without food - With food

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

NNRTI | - Class SEs

SEs - Rash - Hepatotoxicity => All take with foods

False cannabinoid test

- Efavirenz - Sustiva

Tenofovir - Viread | - SEs

- Lactic acidosis - Hepatotoxicity - Renal: acute renal failure/Fanconi syndrome

Fanconi syndrome

- Tenofovir - Viread | - Elvitegravir (part of Stribild)

Abacavir & Tenofovir | - Which class

- NRTI

Pregnant patient

- Zidovudine: 300 mg PO BID or 200 mg PO TID

During label

- Zidovudine: 2mg/kg IV LD in 1H => 1mg/kg continuous infusion

Infant

- Zidovudine syrup: 2mg/kg PO Q6H for 1st 6 weeks of life | - Starting within 8-12H of life

DO NOT COMBINE

SEE BOOK PG 15 HIV

Recommend regimen for post-exposure prophylaxis

- Truvada + Raltegravir

Recommend Vaccination

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

Vaccination NOT rec

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

Pneumocystis Pneumonia (PCP) - DOC - Alternative - Sulfa allergy

DOC - Bactrim + Prednisolone x 21d Alternative - Dapsone + Pentamidine + Leukovorin Sulfa allergy - Clinda + Primaquine + Prednisone x 21d

Toxoplasmosis - 1st line: - Alternative:

1st line - Bactrim 1 DS PO QD Alternative: Combo of 3 drugs - Pyrimethamine (Daparim): Inhibits parasitic dihydrofolate reductase - Leucovorine - Sulfadiazine - Dapsone

MAC | - DOC

Macrolides - Clarithromycin 500 mg PO BID - Azithromycin 1200mg PO QW

M. Kansasii | - DOC

=> Same as MAC Macrolides - Clarithromycin 500 mg PO BID - Azithromycin 1200mg PO QW

Treatment of CMV

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

Treatment regimen for latent PPD+

- INH (isoniazid) 300 mg + Pyridoxime (vit B6) 50 mg PO QD x 9M OR - INH 900 mg PO + Pyridoxine 100 mg BW x 9M

Treatment for diarrhea caused by: - Salmonellosis - Campylobacteriosis - Shigellosis

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