HIV - DRUGS AND AGENTS Flashcards

1
Q

BIKTARVY COMPONENTS

A

INSTI - BICTEGRAVIR
NRTI - EMTRICITABINE
NRTI - TAF

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2
Q

TRIUMEQ COMPONENTS

A

INSTI - DOLUTEGRAVIR
NRTI - ABACAVIR
NRTI - LAMIVUDINE

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3
Q

DOVATO COMPONENTS

A

INSTI - DOLUTEGRAVIR

NRTI - LAMIVUDINE

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4
Q

STRIBILD COMPONENTS

A

INSTI - ELVITEGRAVIR
BOOSTER - COBICISTAT
NRTI - EMTRICITABINE
NRTI - TDF

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5
Q

GENVOYA COMPONENTS

A

INSTI - ELVITEGRAVIR
BOOSTER - COBICISTAT
NRTI - EMTRICITABINE
NRTI - TAF

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6
Q

ATRIPLA COMPONENTS

A

NNRTI - EFAVIRENZ
NRTI - EMTRICITABINE
NRTI - TDF

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7
Q

COMPLERA COMPONENTS

A

NNRTI - RILPIVIRINE
NRTI - EMTRICITABINE
NRTI - TDF

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8
Q

ODEFSEY COMPONENTS

A

NNRTI - RILPIVIRINE
NRTI - EMTRICITABINE
NRTI - TAF

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9
Q

EPZICOM COMPONENTS

A

NRTI - ABACAVIR

NRTI - LAMIVUDINE

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10
Q

DESCOVY COMPONENTS

A

NRTI - EMTRICITABINE

NRTI - TAF

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11
Q

TRUVADA COMPONENTS

A

NRTI - EMTRICITABINE

NRTI - TDF

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12
Q

ABACAVIR SINGLE AGENT BRAND NAME

A

ZIAGEN

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13
Q

EMTRICITABINE SINGLE AGENT BRAND NAME

A

EMTRIVA

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14
Q

LAMIVUDINE SINGLE AGENT BRAND NAME

A

EPIVIR

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15
Q

TDF SINGLE AGENT BRAND NAME

A

VIREAD

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16
Q

TAF SINGLE AGENT BRAND NAME

A

NONE FOR HIV

VEMLIDY FOR HBV

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17
Q

ZIDOVUDINE SINGLE AGENT BRAND NAME

A

RETROVIR

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18
Q

BICTEGRAVIR SINGLE AGENT BRAND NAME

A

NONE, ONLY AVAILABLE AS COMBO IN BIKTARVY

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19
Q

DOLUTEGRAVIR SINGLE AGENT BRAND NAME

A

TIVICAY

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20
Q

ELVITEGRAVIR SINGLE AGENT BRAND NAME

A

NONE, ONLY IN COMBO IN GENVOYA AND STRIBLID

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21
Q

RALTEGRAVIR SINGLE AGENT BRAND NAME

A

ISENTRESS

ISENTRESS HD

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22
Q

EFAVIRENZ SINGLE AGENT BRAND NAME

A

SUSTIVA

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23
Q

RILPIVIRINE SINGLE AGENT BRAND NAME

A

EDURANT

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24
Q

ATAZANAVIR SINGLE AGENT BRAND NAME

A

REYATAZ

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25
Q

DARUNAVIR SINGLE AGENT BRAND NAME

A

PREZISTA

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26
Q

RITONAVIR SINGLE AGENT BRAND NAME

A

NORVIR

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27
Q

COBICISTAT SINGLE AGENT BRAND NAME

A

TYBOST

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28
Q

MARAVIROC MOA

A

CCR5 ANTAGONIST

BLOCKS BINDING AND ENTERING (STAGE 1)

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29
Q

FOSTEMSEVIR MOA

A

ATTACHMENT INHIBITOR

BINDS ENVELOPE PROTEINS, BLOCKING STAGE 1

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30
Q

IBALIZUMAB-UIYK MOA

A

POST ATTACHMENT INHIBITOR

MAB THAT BINDS TO CD4 RECEPTOR - BLOCKS STAGE 1

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31
Q

ENFUVIRTIDE MOA

A

FUSION INHIBITOR

PREVENTS FUSION TO CD4 (STAGE 2)

32
Q

NRTI CLASS AGENTS

WHICH ONES ARE NOT LONGER RECOMMENDED?

A

ZDS - LATTE

ZIDOVUDINE
DIDANOSINE (XX)
STAVUDINE (XX)
LAMIVUDINE
ABACAVIR
TDF
TAF
EMTRICITABINE
33
Q

WHICH NRTIS REQUIRE RENAL DOSE ADJUSTMENT?

A

DOSE DECREASE FOR ALL NRTIS

34
Q

WHICH NRTI IS GIVEN DURING LABOR AND DELIVERY TO PROTECT THE BABY?

A

ZIDOVUDINE

35
Q

WARNING FOR ALL NRTIS

THESE WARNINGS ARE ALSO BOXED WARNING FOR WHICH NRTI?

A

LACTIC ACIDOSIS
HEPATOMEGALY
(BOXED WARNING FOR Z D S)

36
Q

COMMON SIDE EFFECTS FOR NRTIS

A

N, D, HEADACHE

↑ LFTS

37
Q

HBV AND HIV CONINFECTION WARNING

A

SEVERE ACUTE HBV EXACERBATION CAN OCCUR IF EMTRICITABINE, LAMIVUDINE, OR TENOFOVIR PRODUCTS ARE DISCONTINUED

38
Q

WHICH NRTI HAS INCREASED RISK OF MI

A

ABACAVIR

39
Q

WHICH NRTI HAS RISK OF HYPERPIGMENTATION? WHERE DOES THIS HYPERPIGMENTATION OCCUR?

A

EMTRICITABINE
PLAMS OF HANDS
SOLES OF FEET

40
Q

TDF VS TAF, WHICH HAS HIGHER RISK OF ADVERSE EFFECTS

A

TDF HAS HIGHER RISK OF

  • RENAL IMPAIRMENT
  • OSTEOPOROSIS (BONE LOSS)
41
Q

RENAL IMPAIRMENT WITH TDF AND TAF

WHAT CRCL SHOULD AVOID ONE OR THE OTHER?

A

DO NOT START TAF < 30
DO NOT START TDF < 50
STRILBID, DO NOT START < 70
DC STRILBID < 50

42
Q

WHICH NRTI HAS RISK OF LIPID ABNORMALITIES?

A

TENOFOVIR PRODUCTS

TAF HAS HIGHER RISK COMPARED TO TDF

43
Q

WHICH NRTI HAS RISK OF HEMATOLOGIC TOXICITY?

A

ZIDOVUDINE
NEUTROPENIA
ANEMIA
(↑ MCV IS SIGN OF ADHERENCE)

44
Q

WHICH NRTI HAS RISK OF MYOPATHY?

A

ZIDOVUDINE

45
Q

INSTI CLASS AGENTS

A
BRED
BICTEGRAVIR
DOLUTEGRAVIR
ELVITEGRAVIR
RALTEGRAVIR
46
Q

COMMON SIDE EFFECTS FOR INSTIS

A

HA, INSOMNIA,
DIARRHEA, WEIGHT GAIN
DEPRESSION AND SI IN PATIENTS WITH PRE-EXISTING PSYCH CONDITIONS

47
Q

WHICH INSTI HAS THE LOWEST RISK OF DEPRESSION OR SI?

A

BICTEGRAVIR

48
Q

WHICH INSTIS CAN INCREASE SCR WITH NO EFFECT ON GFR?

A

BICTEGRAVIR

DOLUTEGRAVIR

49
Q

WHICH INSTIS INCREASE CPK, AND RISK OF MYOPATHY AND RHABDO?

A

RALTEGRAVIR

DOLUTEGRAVIR

50
Q

WHICH INSTI HAS RISK OF PROTEINURIA?

A

ELVITEGRAVIR

51
Q

WHICH INST HAS RISK OF HYPERSENSITIVITY REACTION?

A

DOLUTEGRAVIR

52
Q

WHICH INSTI HAS RISK OF NEURAL TUBE DEFECTS IN WOMEN?

A

DOLUTEGRAVIR

EVEN SO, IS STILL THE PREFERRED FOR PREGNANCY

53
Q

INSTI DRUG INTERACTION? WHICH INSTI SHOULD PROBABLY AVOID THIS INTERACTION ENTIRELY?

A

WITH POLYVALENT CATIONS

  • TAKE INSTIS 2 HOURS BEFORE OR 6 HOURS AFTER
  • THIS SEPARATION DOES NOT WORK WITH RALTEGRAVIR AND SHOULD BE AVOIDED IF POSSIBLE
54
Q

NNRTI CLASS AGENTS

WHICH ARE NO LONGER RECOMMENDED

A

RED
RILPIVIRINE
EFAVIRENZ
DELVIRDINE (XX)

55
Q

BETWEEN EFAVIRENZ AND RILPIVIRINE, WHICH SHOULD BE WITH FOOD VS EMPTY STOMACH?

A

RILPIVIRINE TAKE WITH FOOD TO CREATE ACIDIC ENVIRONMENT

EFAVIRENZ ON EMPTY STOMACH

56
Q

WHY IS IT RECOMMENDED FOR ONE NNRTI TO BE TAKEN ON AN EMPTY STOMACH?

A

EFAVIRENZ
FOOD INCREASES BIOAVAILABILITY AND RISK FOR CNS SIDE EFFECTS
RECOMMENDED TO BE TAKEN ON EMPTY STOMACH AT NIGHT

57
Q

KEY DRUG INTERACTION FOR RILPIVIRINE?

A

RILPIVIRINE NEEDS ACIDIC ENVIRONMENT FOR ABSORPTION
DO NOT USE PPIS
SEPARATE FROM H2RAS BY ≥12H BEFORE OR 4H AFTER RILPIVIRINE
SEPARATE FROM ANTACID BY ≥2H BEFORE OR 4H AFTER RILPIVIRINE

58
Q

ALL NNRTI HAVE THIS WARNING

A

HEPATOTOXICITY

RASH - SJS/TENS

59
Q

COMMON SIDE EFFECT WITH NNRTI

A

PSYCHIATRIC SIDE EFFECT

DEPRESSION, SI

60
Q

EFAVIRENZ SPECIFIC SIDE EFFECTS?

A
CNS EFFECTS (ABNORMAL DREAMS, IMPAIRED CONCENTRATION, CONFUSION) WHICH RESOLVE IN 2-4 WEEKS
↑ TC AND TG
61
Q

RILPIVIRINE SPECIFIC SIDE EFFECTS?

A

↑ SCR WITH NO EFFECT ON GFR

62
Q

WHICH NNRTI SHOULD BE AVOIDED IF VIRAL LOAD IS TOO HIGH OR CD4 TOO LOW? WHY?

A

RILPIVIRINE - HIGH FAILURE RATE

AVOID IF VIRAL LOAD >100,000 AND/OR CD4 <200

63
Q

PROTEASE INHIBITOR CLASS AGENTS

A

ATAZANAVIR

DARUNAVIR

64
Q

ALL PROTEASE INHIBITORS ARE RECOMMENDED TO BE TAKEN WITH A…

A

BOOSTER

RITONAVIR OR COBICISTAT

65
Q

PROTEASE INHIBITORS SHOULD BE TAKEN WITH FOOD?

A

YES, TO AVOID GI UPSET

ATAZANAVIR ALSO NEEDS THE ACIDIC ENVIRONMENT

66
Q

PROTEASE INHIBITORS RENAL DOSE ADJUSTMENTS?

A

NONE NEEDED

67
Q

3 BIG WARNINGS WITH PROTEASE INHIBITORS

A
  • METABOLIC ABNORMALITIES (BG, LIPIDS, BODY FAT) RESULTING IN INCREASED CVD RISK
  • HEPATIC DYSFUNCTION (LFTS, HEPATITIS)
  • HYPERSENSITIVITY (RASH, SJS/TENS)
68
Q

WHICH PI IS KNOWN AS “BANANAVIR”? WHY?

A

ATAZANAVIR
ASSOCIATED WITH HYPERBILIRUBINEMIA (JAUNDICE AND YELLOWING OF SKIN AND EYES)
REVERSIBLE

69
Q

WHICH PI REQUIRES AN ACIDIC ENVIRONMENT?

A
ATAZANAVIR
AVOID PPIS WHEN UNBOOSTED
SEPARATE FROM PPI BY 12H IF BOOSTED
AVOID H2RAS OR TAKE ATAZANAVIR 2H BEFORE OR 10H AFTER
TAKE ATAZANAVIR 2H OR 1H AFTER ANTACIDS
70
Q

WHICH PI SHOULD EB AVOIDED IN SULFA ALLERGY?

A

DARUNAVIR

71
Q

PK BOOSTERS AGENTS

A

RITONAVIR

COBICISTAT

72
Q

HOW SHOULD RITONAVIR BE TAKEN?

A

WITH FOOD

73
Q

RITONAVIR ORAL SOLUTION?

A

CONTAINS 42% ALCOHOL

CAN TRIGGER DISULFIRAM REACTION WITH METRONIDAZOLE

74
Q

HOW SHOULD COBICISTAT BE TAKEN?

A

WITH THE BOOSTED DRUG AND WITH FOOD

75
Q

BOOSTERS INHIBIT WHICH ENZYME THAT MAKE THEM BENEFICIAL?

A

CYP3A4

ALSO INHIBIT CYP2D6, PGP, AND OTHER TRANSPORTERS

76
Q

WHICH DRUGS ARE CONTRAINDICATED WITH RITONAVIR AND COBICISTAT?

A
LOVASTATIN AND SIMVASTATIN
COLCHICINE
AZOLE ANTIFUNGALS
CV DRUGS
PDE5 INHIBITORS FOR PULMONARY HTN
TKI
CYP3A4 INDUCERS
ANY NARROW THERAPEUTIC INDEX DRUG