HIV treatments Flashcards by Hunter Harris

Zidovudine

Give to a woman who is pregnant if she is HIV positive

How well did you know this?

Not at all

Perfectly

How often do you test a healthcare worker exposed to needlestick

test at baseline, 6 weeks, 3 months, and 6 months.

This is in contrast to a patient who is tested before therapy and then every 3 to 6 months.

How well did you know this?

Not at all

Perfectly

What tx to give to an exposed healthcare worker

Tenofovir + emtricitabine + dolutegravir OR raltegravir
(triple therapy)

ralte = rally or Dolute = dilute,
Teno = Tense, + Emtric = Trick2G
Tense Trick2G rally or Tense Trick2G dilute

How well did you know this?

Not at all

Perfectly

What to give HIV positive if they test positive for TB?

Check CXR, start on isoniazid and pyridoxine 9-12 months
If CXR is pos for infiltrates, start four drug therapy under ID specialist

isoniazid = ice on a
Pyridoxine = Fire
Fire and Ice

How well did you know this?

Not at all

Perfectly

What is HAART?

combination therapy with at least three meds from two different classes to avoid resistance

How well did you know this?

Not at all

Perfectly

NRTI

abacavir, emtricitabine, lamivudine, zidovudine (retrovir)*, tenofovir

memorize abcavir, zidovudine (preg), tenofovir (PReP), emtricitabine

How well did you know this?

Not at all

Perfectly

NNRTI

Efavirenz, etravirine, nevirapine, rilpivirine, doravirine

-Rine, pine, renz

How well did you know this?

Not at all

Perfectly

PI (protease inhibitor)

fosamprenavir, lopinavir, nelfinavir, ritonavir, saquinavir, atazanavir, atazanavir/cobisctat, darunavir/ritonavir, darunavir/cobicistat, tipranavir/ritonavir

-NAVIR, with the exception of abcdavir, fostavir.
Don’t mistake this for integrase inhibitors which end in -Gravir

-last step of the HIV growth cycle. right before it gets clipeed. PI is like NAAAw

How well did you know this?

Not at all

Perfectly

characteristics of protease inhibitors

administered as combo therapy to boost other regimens. metabolized by P450. suppress HIV replication.

How well did you know this?

Not at all

Perfectly

Entry/fusion inhibitors

enfuvirtide (fusion inhibitors)
maraviroc (CCR5 antagonist)

Entry into “maraudon” like in WoW. Fuver = furvor, like passionate about entering maraudon

How well did you know this?

Not at all

Perfectly

entry fusion inhib characteristics

addon therapy

How well did you know this?

Not at all

Perfectly

Integrase strand transfer inhibitors

raltegravir, cabotegravir, dolutegravir

Dilute, rally, caboose
Gravir = Gravity pull you in. Like being pulled into a double helix DNA
-or like gratitude for being the quickest acting agent

How well did you know this?

Not at all

Perfectly

Characteristic of integrase inhibitors

allows for more rapid decrease in viral load versus other regimens

How well did you know this?

Not at all

Perfectly

New therapies HIV

fostemsavir- GP120 prevents entery
ibalizumab-uiyk- block CD4 receptors
capsid inhibior- interfere with HIV capsid
pharmokinetic enhancer- boosts others

fostemsavior = a foster parent that blocks the entrance of the bad guy into the house
iBall= block CD4 like in a soccer game, they get in front of the ball

How well did you know this?

Not at all

Perfectly

When to do labs for someone after changing their therapy?

Lab 1-2 months after change, and then once they stabilize, 3-6 months.

How well did you know this?

Not at all

Perfectly

Mucocutaneaous candidiasis oral

clotrimazole
fluconazole

Clothe, Fluke
The lucky clothing shopper who wins the free gift from the recipt, and wins white tic tacs

Mucocutanous candidiasis - fungal rash

topical clotrimazole 1%
topical ketoconazole 2%

Trim Clothes, keto diet
Think of getting new, smaller clothes from the keto diet.
A girl shopping in the mall, on a keto diet, with a rash.

Oral Hairy Leukoplakia

caused by EBV
no specific treatment, it resolves with ART

Genital herpes tx

acyclovir
famciclovir
valacyclovir

Valhala, Famsick, Ace
The valhala warrior who comes and goes. Is fame sick. Famous. And she “aced’ because she slept with someone to boot.

Herpes zoster shingles

famiciclovir
valacyclovir
consider live attenuated zoster vaccine Zostavax or inactivated Shingrix only for patients 51+ with CD4 count less than 200

Fame sick, Valhala

Singles is so painful, its as painful as being a famous warrior from valhala

Herpes is like the valhala warrior, going into valhala and coming back out

molluscum contagiosum

treated topically with liquid nitrogen
imiquimod topical

Imitate = imiqui
It imitates molluscs, look alike

Pneumocystis Jiroveci Pneumonia - everything

most opportunistic infectio
fungal
AIDS defining
perihilar infiltrates
Wright Giemsa stain or direct fluorescence antibody testing
Rx - trimethoprim sulfamethoxazole DS (Bactrim DS) + prednisone
prophylaxis for CD4 count less than 200

Back/Trim Prednisone (Red Nose)
A gardener (trimming) w/ a red nose
The bushes are the perihilar infiltrates

esophageal candidiasis (C. albicans)

fluconazole

fluke is luck or a rare occurance. imagine a “fluke” popping up in your esophagus, by suprise when they do the EGD.

Kaposi’s Sarcoma

Resolves with ART
caused by HHV8

Wasting syndrome

ART, megestrol acetate, dronabinol, medical cannabis, anabolic steroids (testosterone). ## Footnote Megastore, Drone-able Wasting like a machine employed store that is commericialized and wasteful

Mycobacterium avium

-causes fevers and weight loss, affects multiple organs clarithromycin + ethambutol (combo due to emerging resistance) prophylaxis offered less than 50 treated for 12 months at least. may be discontinued if CD4 count exceeds 100 for 6 months. ## Footnote Clear + Ethane - think of breathing it in and it makes you sick makes you very very sick to breath in ethane fumes

Cryptococcal Meningitis

Cryptococcus neoformans, encapsulated budding yeast found in pidgeon and soil Dx gram positive of CNS fluid for budding, encapsulated fungi IV liposomal amphoetericin B with PO flucytosine PO fluconazole one year ## Footnote IV loposomal amphoetericin - am poetic like coldplay fly on + flucytosine flew sight or scene, flew with blue Cryptococcal comes from pidgeons so A pidgeon flying in the sky is poetic, and the other flying on w/ blue.

Cytomegalovirus Retinitis

Ganciclovir + Valganciclovir ## Footnote Gandolf (too old and can't see) + Valley (a valley that he cannot see)

Toxoplasmosis

Parasite pyrimethamine + sulfadiazine + leucovorin Prophylaxis when CD4 count less than 100 (Bactrim) ## Footnote Prophylaxsis is back in cat poop meth on fire + sulfur + Corvin (werewolf) so cat poop smells like sulfur and meth on fire plus a dog

Tuberculosis

Annual TB and prophylaxis HIV treatment for a person with a latent TB infection

Coccidiomycosis

Annual IgG and IgM serologic screening Prophylactic fluconazole if positive, until **250 for 6 months ## Footnote Fluconazole = flying in the sky, with no one to hide

Pneumocystitis

CD4 200 TMP SMX in all patients for prophylaxis, discontinue when greater than **200 ## Footnote Back/Trim Prednisone (Red Nose) A gardener (trimming) w/ a red nose The bushes are the perihilar infiltrates

Histoplasmosis

CD4 less than 150 Limited data to support itraconazole prophylaxis consider hyperendemic areas discontinue when CD4 is more than **150 for 6 months

Toxoplasmosis

CD4 100 TMP-SMX prophy if less than 100 and positive IgG serology Discontinue when above **200 for 3 months ## Footnote Bactrim + cat - Back in cat poop

Cryptococcus

When CD4 less than 100 prophylaxis not recommended due to side effects and resistance to therapy

Mycobacterium avium complex

50 or less check blood cultures first, then prophy w/ azithromycin if cultures neg. discontinue when CD4 is greater than **100 for three months