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HuntsClinMed1B > HIV treatments > Flashcards

HIV treatments Flashcards

1
Q

Zidovudine

A

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

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2
Q

How often do you test a healthcare worker exposed to needlestick

A

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.

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3
Q

What tx to give to an exposed healthcare worker

A

Tenofovir + emtricitabine + dolutegravir OR raltegravir
(triple therapy)

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

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4
Q

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

A

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

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5
Q

What is HAART?

A

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

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6
Q

NRTI

A

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

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

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7
Q

NNRTI

A

Efavirenz, etravirine, nevirapine, rilpivirine, doravirine

-Rine, pine, renz

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8
Q

PI (protease inhibitor)

A

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

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9
Q

characteristics of protease inhibitors

A

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

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10
Q

Entry/fusion inhibitors

A

enfuvirtide (fusion inhibitors)
maraviroc (CCR5 antagonist)

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

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11
Q

entry fusion inhib characteristics

A

addon therapy

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12
Q

Integrase strand transfer inhibitors

A

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

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13
Q

Characteristic of integrase inhibitors

A

allows for more rapid decrease in viral load versus other regimens

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14
Q

New therapies HIV

A

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

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15
Q

When to do labs for someone after changing their therapy?

A

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

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16
Q

Mucocutaneaous candidiasis oral

A

clotrimazole
fluconazole

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

17
Q

Mucocutanous candidiasis - fungal rash

A

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.

18
Q

Oral Hairy Leukoplakia

A

caused by EBV
no specific treatment, it resolves with ART

19
Q

Genital herpes tx

A

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.

20
Q

Herpes zoster shingles

A

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

21
Q

molluscum contagiosum

A

treated topically with liquid nitrogen
imiquimod topical

Imitate = imiqui
It imitates molluscs, look alike

22
Q

Pneumocystis Jiroveci Pneumonia - everything

A

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

23
Q

esophageal candidiasis (C. albicans)

A

fluconazole

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

24
Q

Kaposi’s Sarcoma

A

Resolves with ART
caused by HHV8

25
Q

Wasting syndrome

A

ART, megestrol acetate, dronabinol, medical cannabis, anabolic steroids (testosterone).

Megastore, Drone-able
Wasting like a machine employed store that is commericialized and wasteful

26
Q

Mycobacterium avium

A

-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.

Clear + Ethane - think of breathing it in and it makes you sick
makes you very very sick to breath in ethane fumes

27
Q

Cryptococcal Meningitis

A

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

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.

28
Q

Cytomegalovirus Retinitis

A

Ganciclovir + Valganciclovir

Gandolf (too old and can’t see) + Valley (a valley that he cannot see)

29
Q

Toxoplasmosis

A

Parasite
pyrimethamine + sulfadiazine + leucovorin
Prophylaxis when CD4 count less than 100 (Bactrim)

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

30
Q

Tuberculosis

A

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

31
Q

Coccidiomycosis

A

Annual IgG and IgM serologic screening
Prophylactic fluconazole if positive, until **250 for 6 months

Fluconazole = flying in the sky, with no one to hide

32
Q

Pneumocystitis

A

CD4 200
TMP SMX in all patients for prophylaxis, discontinue when greater than **200

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

33
Q

Histoplasmosis

A

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

34
Q

Toxoplasmosis

A

CD4 100
TMP-SMX prophy if less than 100 and positive IgG serology
Discontinue when above **200 for 3 months

Bactrim + cat - Back in cat poop

35
Q

Cryptococcus

A

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

36
Q

Mycobacterium avium complex

A

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

HuntsClinMed1B (19 decks)

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