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naplex pnn > hiv review from quiz > Flashcards

hiv review from quiz Flashcards

1
Q

HIV Testing

A

As HIV progresses

  • CD4 count( goes down )
  • Viral load (Increase) is indicator of how well drug is working, as it should go down with drug therapy. HIV tx regimen reduce viral load to undetectable
  • **gentic resistance testing **(means mutation or changes to genetic struct of HIV has occurred making virus resistant to certain med. mutation cause virus to replicated despite pt being on drug therapy
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2
Q

cd4 count of 192 with no allergy, what reccomendation you can make for prevention of opportunistic infection

A

Bactrim DS PO qd

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3
Q

opportunist infection
PCP

A

pneumocytosis pneumonia-
- CD4 <200
- DOC: Bactrim DS PO QD
- sulfa allergy: Dapsone, pentamidine or atovaquone (Mepron)

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4
Q

atovaquone

A

Mepron

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5
Q

opportunist infection
Toxoplasmosis

A

CD4< 100
DOC : Bactrim DS PO QD
Sufla:
-dapsone with pyrimethamine/Leucovorin
- Atovaquone

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6
Q

opportunist infection
Macobacterium Tuberculosid

A

CD4<50
Prophylaxis for Mac not recommended in pts with HIV on ART

  • Only prevention given if they are not on ART and CD4<50

DOC:
- Azithromycin 1200mg once weekly
- Clarithromycin 500mg BID

Propylaxis agaoint toxoplasma only performed if in high endemic area
if

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7
Q

pt with cd4 45 and not on anteretroviral therapy. Pt does not live in high endemic area pt. is not seropositive for any opportunistic infection

A

Propylaxis against toxoplasma only performed if in
- high endemic area
- if pt. is seropositive

seropositve mean
- having or being a positive serum reaction especially in a test for the presence of an antibody.
- endemic: regularly occurring within an area or community.

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8
Q

Pneumocytosi jiroveci (PCP)
causes
PPX
TX

A

causes: fever, dry cough, sob, nighsweats
PPX: Bactrim DS PO QD
**Tx: Bactrim+ prednisone X 21 days **

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9
Q

Toxoplasmosis
PPX
TX

A

PPX: bactrim DS PO QD
sulfa allergy:
- atovaquone or
- dapsone + pyrimethamine/leucovorin

Treatment:
- sulfadiazine + pyrimethamine + leucovorin

leucovorin to protech against vit b def from pyrimethmine
Sulfadiazine

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10
Q

CMV TX

A

Ganciclovir (Cytovene)-
- IV , renal, seizure

Valganciclovir (prodrug of ganciclovir)
- Oral, renal

**Cifodovir **(vistide):
- IV, renal, neutropeia

**Foscarnet **(Foscavir):
- iV, seizrue, nephrotox

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11
Q

entry inhibitors

A

**cd4 receptor **
CCR5 or Cxcr4 co-receptor

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12
Q

NRTI
NNRTI

reverse transcriptaste Inhib

A

ZALES- DT

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13
Q

Intergrase Inhib

A

gravir

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14
Q

Protease Inhib

A

“navir”

lanD FirsT

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15
Q

B- D O G

A- T C S

A

Truvada: et - emtricitabine +TDF
Complera: ret- Rilviprine+ emtricita+ TDF
Stripla: ceet: colbi+emtricit+eletgravir+TDF

Atripla: et- Emtricit+ TDF + efavirenz

Descovy: et- emtricitabine + TAF
Odefsey: ret- Rilpiv +emtricit+ TAF
Genvoya: ceet: Colb+emtric+eltegrav+ TAF

Biktary: et- Emtricit+ TAF+ bictegravir

Symtuza: et- emtrict+TDF+ colb+ darunavir

efavirenz (sustiva)
rilpivrine ( edurant)

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16
Q

B- D O G

A- T C S

A

truvada : crcl< 30
complera: Crcl < 50
Strbild Crcl< 70

DOG crcl< 30

Atripla: empty stoma (efavirenz)
Odefsey: with food
Symtuza: with food
stribild: with food
Genvoya : with food

17
Q

Julaca

A

dolutegravir + rilpivrine
- with food
- stepdown therapy

18
Q

dovato

A

2 drug regimen
- dolutegravir + lamivudine

19
Q

Cabenuva

A

Cabotegravir+ rilpivirne
- IM once monthly
- gluteal admin
- 2 inj : 1 cabotegravir+ 1 rilpivrine

20
Q

Epzicom
Triumeq
Trizivir

A

Epzicom-Abacavir + lamivudine

triumeq: abacavir+lamivudine+dolutegrav

Trizivir: abacavir+lamivudine+ zidovudine

21
Q

combivir

A

zidovudine + lamivudine

22
Q

bactrim

A
  • can be give to rena dysf pt but dose ajust
  • cuase BMS (myelosupression)
23
Q

NRTI SE

A

LHR

  • L : lactic acidosis
  • H: Hepatic steatosis (fat in liver)
  • R: renal
24
Q

Zidovudine

A
  • causes myopahty
  • cause myelosupression ( anemia and neutropenia) give epogen, darasnep for anemia and filgrastim, pegfigrastim for Neutropenia
  • IV
  • LHR
  • take with food to dec nausea
  • Pregnancy : doc
25
Q

*

efavirenz

A

sustiva
- vivid dreams
- false cannaboid tes
- empty stomach
- Preg Cat D
- CY3A4 Inducer

Note: if women who present with 1st trimester already with efavirenz and who has adeq viral supression efavirenz may be continued, changing regimen may lead to loss of viral control & risk of perineateal transmission

26
Q

rilpivrine

A

edurant

27
Q

PrEP ( pre exposure ppx)

A

Truvada Crcl <60 don’t use

Descovy Crcl <30 don’t use

**Cabotegravir **( Apretude) IM once every 2 months
- consider using when Crcl <30

28
Q

PEP

A

Post- exposure prophylaxis
start ASAP

Regiment includes
- Truvada +
- Raltegravir or Dolutegravir

29
Q

evotaz

A

darunavir + colbicstat

30
Q

NNRTI SE

A

Hepatoxicity, Rash

  • rilpivrine (edurant)
  • efavirenz (sustiva)
  • etravirine (Intelence)
31
Q

NRTI
zales- DT

A

zidovudine ( Retrovir) ZDV, AZT
abacavir (ziagen) ABC
Lamivudine ( epivir- epivr HBV)- 3TC
Emtricitabine (emtriva): FTC
Stavudine ( Zerit): d4T ; cap, PO sol
Didanosine (videx): ddI
Tenfovir (TDF -viread) TAF: vemildy

abacavir : HSR , HLA 5701

32
Q

tenOFovir

A

TDF: viread - HIV

TAF- Vemildy- HBV**

Side Effect
- Fanconi sx
- osteoperosis

33
Q

Maviroc

A

selzentry
- work on CCR5 on human CD4 cell.
- oral
- Hepatoxicity: BBW
- 150mg bid if on cyp3a4 inhi
- 600mg BID if on cyp3a4 inducer
- St. john wart not recommended to take with selzentry

34
Q

```

~~~

Enfuvritide

A

binds to gp41 inhibiting fusion
- monitor for sign/sx of pnemoia and infection
- sub Q injection

35
Q

ELISA VS WESTERN BLOT

A

ELISA: hiv screening

western blot: confirming HIV diagnosis

36
Q

vaccination for HIV pt

A
  • influenza (not flumist which is live)
  • Tdap
  • HPV (papilloma virus)
  • Pneumococcal vaccination
  • hep B vaccine (if no immune)
  • MMR ok if cd4 > or equal to 200. if cd4 <200 (AIDS) no MMR in AIDS pt.
  • varicella ok in HIV not in AIDS
37
Q

**

Raltegravir is metabolized by

A

UGT (1A1)

  • does not inhibit, induce nor substrate of CYp1a2, cyp2d6, cyp3a4
38
Q

what HIV med can be take on empty stomach?

A
  • efaviren (sustiva)
  • didanosine
  • Indinavir (crixiban)
39
Q

HIV med take once daily

A

truvada
complera
Atripla
Stribild
Dolutegravir
Eltegravir

Raltegravir (isentress ) taken BID

naplex pnn (12 decks)

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