HIV Study Notes and Key Counseling Points

Question 1

Atripla
Generic name
Class of drugs included

Answer 1

Efavirenz/Tenofovir disoproxil fumarate/Emtricitabine
2 NRTIs + 1 NNRTI
1 pill once daily

Question 2

Biktarvy
Generic name
Class of drugs included

Answer 2

Bictegravir/emtricitabine/tenofovir alafenamide
2 NRTIs + INSTI
1 pill once daily

Question 3

Atripla
Efavirenz/Tenofovir disoproxil fumarate/Emtricitabine
Key counseling points

Answer 3

Take on empty stomach at bedtime
aTRIPLa has 3 drugs
Tenofovir DF has bone and renal problems

Question 4

Biktarvy
Bictegravir/emtricitabine/tenofovir alafenamide
Key counseling points

Answer 4

INSTI - separate Al, Mg

Question 5

Complera

Generic name

Answer 5

Rilpivirine/Tenofovir disoproxil fumarage/Emtricitabine

Question 6

Complera
Rilpivirine/Tenofovir disoproxil fumarage/Emtricitabine
Key counseling points

Answer 6

Rilpivirine: take with water and meals (not protein drink)

Requires acidic gut for absorption; CI with PPIs, separate antacids, H2RAs

Question 7

Delstrigo
Generic name
Class of drugs included

Answer 7

Doravirine/Tenofovir disoproxil fumarage/Lamivudine

2 NNRTI + 1 NRTI

Question 8

Delstrigo
Doravirine/Tenofovir disoproxil fumarage/Lamivudine
Key counseling points

Answer 8

All NNRTIs can cause hepatotoxicity and rash

Question 9

Dovato
Generic name
Class of drugs included

Answer 9

Dolutegravir/Lamivudine

1 NRTI + 1 INSTI

Question 10

Dovato
Dolutegravir/Lamivudine
Key counseling points

Answer 10

Do not start if HIV RNA > 500,000 copies/mL or if HBV-positive

Question 11

Genvoya

Generic name

Answer 11

Elvitegravir/Cobicistat/Tenofovir alafenamide/Emtricitabine

Question 12

Genvoya
Elvitegravir/Cobicistat/Tenofovir alafenamide/Emtricitabine
Key counseling points

Answer 12

Take with food

CrCl <30 ml/min - do not use

Question 13

Juluca

Generic name

Answer 13

Dolutegravir/rilpivirine

Question 14

Juluca
Dolutegravir/rilpivirine
Key counseling points

Answer 14

Take with water and meal (rilpivirine)
Separate from Al, Mg (dolutegravir)
Must be virologically suppressed on stable ART for more than 6 months before starting (rilpivirine)

Question 15

Odefsey

Generic name

Answer 15

Rilpivirine/Emtricitabine/Tenofovir alafenamide

Question 16

Stribild
Generic name
Classes of drugs included

Answer 16

Elvitegravir/Cobicistat/Tenofovir disoproxil fumarate/Emtricitabine
INSTI + booster + 2 NRTI

Question 17

Stribild
Elvitegravir/Cobicistat/Tenofovir disoproxil fumarate/Emtricitabine
Key counseling points

Answer 17

Take with food
Avoid NSAIDS
Do not use CrCl < 50

Question 18

Difference between Stribild and Genvoya

Answer 18

Stribild has TDF

Genvoya has TAF

Question 19

Symfi

Generic name

Answer 19

Efavirenz/TDF/Lamivudine

Question 20

Symfi
Efavirenz/TDF/Lamivudine
Key counseling points

Answer 20

Take on empty stomach at bedtime (efavirenz)

Question 21

Symtuza

Generic name

Answer 21

Darunavir/Cobicistat/TAF/Emtricitabine

Question 22

Symtuza
Darunavir/Cobicistat/TAF/Emtricitabine
Key counseling points

Answer 22

Take with food (cobicistat)

Question 23

Triumeq
Generic name
Classes of drugs included

Answer 23

Dolutegravir/Abacavir/Lamivudine

2 NRTIs + INSTI

Question 24

Triumeq Dolutegravir/Abacavir/Lamivudine

Key counseling points

Answer 24

Test HLA-B*5701 prior to use (abacavir)

Question 25

NRTI class SE

Answer 25

lactic acidosis, hepatomegaly with steatosis

Question 26

Cimduo Drug class Generic names Key counseling points

Answer 26

NRTI Lamivudine/TDF Duo of 2 NRTIs

Question 27

Combivir Drug class Generic names Key counseling points

Answer 27

NRTI Zidovudine/Lamivudine Food not required, but helps to reduce GI upset (zidovudine)

Question 28

Descovy Drug class Generic names Key counseling points

Answer 28

NRTI TAF/Emtricitabine Test HLA-B*5701 prior to use (abacavir)

Question 29

Emtriva Drug class Generic names Key counseling points

Answer 29

NRTI Emtricitabine Hyperpigmentation palms of hand/soles of feet esp in children

Question 30

What medication should not be used with emtricitabine and why?

Answer 30

Lamivudine | Both can cause HA

Question 31

Epivir Drug class Generic names Key counseling points

Answer 31

NRTI Lamivudine Also used to treat hepatitis B virus (HBV)

Question 32

Epzicom Drug class Generic names Key counseling points

Answer 32

NRTI Abacavir/Lamivudine Only use if negative for HLA-B*5701 (abacavir)

Question 33

Retrovir Drug class Generic names Key counseling points

Answer 33

NRTI Zidovudine Myopathy, neutropenia, anemia, food not required but can decrease GI upset, can increase CPK

Question 34

How should you treat anemia caused by Zidovudine (Retrovir)

Answer 34

Erythropoietin

Question 35

Temixys Drug class Generic names

Answer 35

NRTI | TDF/Lamivudine

Question 36

Trizivir Drug class Generic names Key counseling points

Answer 36

NRTI Abacavir/Zidovudine/Lamivudine Food not required but helps GI upset, monitor for anemia and neutropenia Only use for negative HLA-B*5701

Question 37

Truvada Drug class Generic names Key counseling points

Answer 37

NRTI TDF/Emtricitabine Used for PrEP and PEP

Question 38

``` Didanosine Drug class Key counseling points ```

Answer 38

NRTI Pancreatitis, severe hepatomegaly with steatosis No alcohol

Question 39

Viread Drug class Generic names Key counseling points

Answer 39

NRTI TDF Do not take tenofovir with didanosine and do not suddenly stop if Hep-B positive

Question 40

``` Stavudine Drug class Key counseling points ```

Answer 40

NRTI | Pancreatitis, severe hepatomegaly with steatosis

Question 41

Ziagen Drug class Generic names Key counseling points

Answer 41

NRTI Abacavir Only use if negative HLA-B*57-1 If hypersensitivity reaction, do not rechallenge

Question 42

Isentress Drug class Generic names Key counseling points

Answer 42

``` INSTI Raltegravir Preferred if taken with Descovy or Truvada Isentress is BID Isentress HD is once daily ```

Question 43

Tivicay Drug class Generic names Key counseling points

Answer 43

INSTI Dolutegravir Preferred if taken with Descovy or Truvada Dolutegravir might have small increase in neural tube defects, but remains preferred Caution females with child-bearing capacity

Question 44

Edurant Drug class Generic names Key counseling points

Answer 44

NNRTI Rilpivirine Take with water and a meal - do not replace meal with protein drink

Question 45

NNRTI class SE

Answer 45

Rash, liver damage | DYP substrates, including CYP3A4 - many drug interactions

Question 46

Intelence Drug class Generic names Key counseling points

Answer 46

NNRTI Etravirine Take after meal

Question 47

Pifeltro Drug class Generic names Key counseling points

Answer 47

NNRTI Doravirine If using rifabutin, take BID instead of daily

Question 48

Rescriptor Drug class Generic names Key counseling points

Answer 48

NNRTI Delavirdine Not as bad as nevirapine for causing liver damage and rash, but still high risk

Question 49

Sustiva Drug class Generic names Key counseling points

Answer 49

``` NNRTI Efavirenz CNS effects, including abnormal dreams and confusion Can cause depression/suicidality CNS effect often goes away in 2-3 weeks Take on empty stomach at bedtime ```

Question 50

Viramune Drug class Generic names Key counseling points

Answer 50

NNRTI Nevirapine High risk liver damage and rash

Question 51

PI class SE

Answer 51

Metabolic abnormalities (hyperlipidemia, hyperglycemia, lipohypertrophy), hepatotoxicity, drug interactions, diarrhea, nausea

Question 52

Aptivus Drug class Generic names Key counseling points

Answer 52

PI Tipranavir BBW for liver damage, intracranial hemorrhage Caution with sulfa allergy

Question 53

Which antivirals contain sulfa and should be cautioned in sulfa allergy

Answer 53

Tipranavir Darunavir Fosamprenavir

Question 54

Crixivan Drug class Generic names Key counseling points

Answer 54

``` PI Indinavir Not used much Kidney stones, high BG Take on empty stomach with a light, low-fat snack ```

Question 55

Evotaz Drug class Generic names Key counseling points

Answer 55

PI Atazanavir/Cobicistat Separate atazanavir from acid-suppressing drugs

Question 56

Invirase Drug class Generic names Key counseling points

Answer 56

PI Saquinavir Not used much; QT prolongation

Question 57

Kaletra Drug class Generic names Key counseling points

Answer 57

``` PI Lopinavir/Ritonavir Take on empty stomach Solution contains high amount of alcohol Do not take with metronidazole, tinidazoel, disulfiram ```

Question 58

Lexiva Drug class Generic names Key counseling points

Answer 58

PI Fosamprenavir Caution if sulfa allergy; take solution on an empty stomach

Question 59

Norvir Drug class Generic names Key counseling points

Answer 59

``` PI Ritonavir Take with food Used in low booster doses Solution is high in alcohol ```

Question 60

Prezcobix Drug class Generic names Key counseling points

Answer 60

PI Darunavir/Cobicistat Take with food

Question 61

Prezista Drug class Generic names Key counseling points

Answer 61

``` PI Darunavir Take with food Take with booster Caution with sulfa allergy ```

Question 62

Reyataz Drug class Generic names Key counseling points

Answer 62

PI Atazanavir Take with ritonavir or cobicistat Take with food

Question 63

Viracept Drug class Generic names Key counseling points

Answer 63

PI Nelfinavir Take with food

Question 64

``` Selzentry Drug class Generic names Key counseling points ```

Answer 64

Entry and Attachment inhibitors Maraviroc Requires tropism assay; must have CCR5 coreceptor type only

Question 65

Fuzeon Drug class Generic names Key counseling points

Answer 65

Entry and attachment inhibitors Enfuvirtide SC injection, requires reconstitution, painful, rotate injection site

Question 66

Trogarzo Drug class Generic names Key counseling points

Answer 66

Entry and attachment inhibitors Ibalizumab-uiyk monoclonal antibody, infusion related reactions not self-administered