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HIV > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

What is the BBW of NRTIs?

A

lactic acidosis
hepatomegaly
steatosis

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2
Q

What is MOA of NRTIs?

A

terminates RNA to DNA reverse transcriptase

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3
Q

What is the brand of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate?

A

Stribild

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4
Q

What is the brand os elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide?

A

Genvoya

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5
Q

A HLA-B*5701 + patient should not use which medication? why?

A

abacavir

increased risk of hypersensitivity reaction

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6
Q

emtricitabine is interchangeable with?

A

lamivudine

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7
Q

Stribild should be used in which CrCl?

A

> =70

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8
Q

Genvoya should be used in which CrCl?

A

> =30

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9
Q

Which ART requires boosting?

A

protease inhibitors with ritonavir

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10
Q

What are the recommended NRTI combos in HIV naive preggers?

A

abacavir/lamivudine

tenofovir disoproxil fumarate/emtricitabine OR lamivudine

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11
Q

What are the recommended PI in HIV naive preggers?

A

atazanavir/ritonavir

darunavir/ritonavir

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12
Q

What is the recommended INSTI in HIV naive preggers?

A

raltegravir

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13
Q

Adherence of at least how many % is required for ART to be successful?

A

> =95%

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14
Q

When should HIV home tests be used and why?

A

at least 3 months after onset of symptoms b/c home tests only test for Ab which may take 4-8 weeks or as long as 6 months in some people. May lead to false negative.

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15
Q

What is the recommended regimen?

A

2 NRTIs + a PI w/ booster or INSTI

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16
Q

Which NRTIs have the greatest risk of BW of lactic acidosis, hepatomegaly w/ steatosis?

A

zidovudine, stavudine, didanosine

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17
Q

Which NRTI should be taken w/ food?

A

didanosine

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18
Q

Which NRTI does not require renal dose adjustment?

A

abacavir

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19
Q

Do NRTIs have any CYP interactions?

A

No

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20
Q

tenofovir toxicities

A

nephrotoxicity
osteoporosis
Fanconi syndrome

though to be less w/ alafenamide

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21
Q

Which NRTI will be removed from the market?

A

delavirdine

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22
Q

abacavir brand

A

Ziagen

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23
Q

abacavir + lamivudine

A

Epzicom

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24
Q

abacavir + lamivudine + dolutegravir

A

Triumeq

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25
Q

Patients taking abacavir receive what in addition to a ned guide?

A

a warning card summarizing symptoms of hypersensitivity reactions

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26
Q

What is the brand of lamivudine?

A

Epivir

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27
Q

BBW of lamivudine

A

do not use Epivir-HBV in HIV pts b/c lower dose pf lamuvidine may cause resistance

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28
Q

common SE of Epivir?

A

N/V/D

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29
Q

Emtriva generic

A

emtricitabine

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30
Q

Truvada generic

A

Emtricitabine

tenofovir disoproxil fumarate

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31
Q

Descovy generic

A

emtricitabine

tenofovir alafenamide

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32
Q

Complera generic

A

emtricitabine
tenofovir disoproxil
rilpivirine

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33
Q

Odefsey generic

A

emtricitabine
tenofovir alafenamide
rilpivirine

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34
Q

Atripla generic

A

emtricitabine
efavirenz
tenofovir disoproxil

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35
Q

All NRTIs including combos are qdaily except which ones?

A

Trizivir: lamivudine + zidovudine + abacavir
Combivir: lamivudine w/ zidovudine

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36
Q

How should Atripla be taken?

A

w/ food

preferable at bedtime

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37
Q

Which NRTI combos are taken w/ food?

A

Complera
Odefsey
Stribild
Genvoya

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38
Q

AE of emtricitabine containing meds

A 
dizziness
HA
N/V/D
rash
hyperpigmentation of soles and palms typically in children
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39
Q

tenofovir disoproxil fumarate brand

A

Viread

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40
Q

What is the dose of Viread?

A

300mg daily

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41
Q

BW for tenofovir alafenamide

A

not approved for HBV treatment

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42
Q

warnings for tenofovir

A

renal toxicity
Fanconi syndrome
osteomalacia
decreased BMD

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43
Q

common SE w/ tenofovir alafenamide

A

nausea

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44
Q

Which tenofovor containing product requires medguide?

A

Truvada

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45
Q

BW zidovudine

A 
hematologic toxicities (anemia and neutropenia)
prolonged use associated w/ symptomatic myopathy
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46
Q

AE zidovudine

A

myopathy, macrocytic anemia, increasing LFTs

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47
Q

zidovine should not be used w/ which NRTI? why?

A

stavudine b/c both are thymidine analogs

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48
Q

emtricitabine should be be used w/ which NRTI? why?

A

lamivudine b/c both are cytosine analogs

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49
Q

rank risk of lipoatrophy among NRTIs

A

stavudine > zidovudine > others

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50
Q

When is IV zidovudine used?/

A

pregnant HIV pts undergoing labor and viral count >1000 or unknown

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51
Q

What should be monitored in zidovudine pts?

A

MCV

if MCV not elevated them may mean poor adherence

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52
Q

How long is the oral soln of stavudine stable in refrigerator?

A

30 days and shake vigorously before use

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53
Q

What AE of stavudine?

A 
lipoatrophy
N/V/D
increasing LFTs
peripheral neuropathy
hyperbilirubinemia
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54
Q

which NRTIs have a BBW of pancreatitis

A

stavudine and didanosine

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55
Q

Which NRTIs are taken on an empty stomach?

A

Atripla

didanosine

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56
Q

AE didanosine

A

peripheral neuropathy
increasing amylase
N/V/D

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57
Q

Why should didanosine and stavudine not be given together?

A

increased risk of pancreatitis, lactic acidosis and peripheral neuropathy

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58
Q

contraindications didanosine

A

allopurinol and ribavirin

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59
Q

why should didanosine not be used w/ tenofovir products?

A

resistance and increased didanosine concentrations

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60
Q

why should didanosine and zidovudine not be used together?

A

increased risk and severity of anemia

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61
Q

methadone can increase conc. of which NRTI?

A

zidovudine

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62
Q

tenofovir alafenamide should be avoided with which drugs and why?

A

st. johns wart and rifampin
P-gp substrate

watch our for combos

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63
Q

efavirenz brand

A

Sustiva

64
Q

Whats the dose of efavirenz?

A

600mg daily

65
Q

How should efavirenz be taken?

A

empty stomach in the evening

66
Q

BBW efavirenz

A

CNS toxicities, QT prolongation, convulsions

67
Q

efavirenz and CYP?

A

CYP inducer more than inhibitor

68
Q

rilpivirine and CYP?

A

substrate

69
Q

Do NNRTIs require renal dose adjustment?

A

No

70
Q

Common SE with NNRTIs

A

hepatotoxicity
rash
SJS/TENs

nelvirapine > NNRTIs

71
Q

Which NNRTIs should be taken with food?

A

rilpivirine (with food)

etravirine (after food)

72
Q

rilpivirine brand

A

Edurant

73
Q

how should rilpivirine be stored?

A

in original container away from light

74
Q

Edurant contraindication

A

PPIs and strong CYP3A4 inducers

75
Q

What kind of environment does Edurant need for absorption

A

acidic

space from H2RAs and antacids

76
Q

AE Edurant

A

depressive disorders, mood changes, insomnia

77
Q

Why does nevirapine need a 14 day lead in period?

A

may reduce rash and hepatotoxicity

78
Q

BBW nevirapine

A

hepatotoxicity
rash
SJS/TENs

79
Q

nevirapine should not be initiated in which HIV pts?

A

CD4 > 400 in F
CD4 > 200 in M

increases risk of hepatotoxicity

80
Q

methadone and hormonal contraceptives may be decreased by which NNRTIs?

A

nevirapine and efavirenz

81
Q

Do PIs have to be renally adjusted?

A

No

82
Q

PIs and CYP?

A

CYP450 inhibitors

83
Q

BW of PIs

A

hepatotoxicity

84
Q

which PIs have least risk for hyperlipidemia and lipohypotrophy?

A

atazanavir

ritonavir

85
Q

which PIs have highest risk of insulin resistance/hyperglycemia?

A

indinavir

lopinavir/ritonavir

86
Q

which PI has least CVD risk

A

atazanavir

darunavir

87
Q

PI should be taken w/ food except?

A

fosamprenavir

lopinavir/ritonavir

88
Q

darunavir brand

A

Prezista

89
Q

Which PI should be used w/ caution in pts w/ sulfa allergy?

A

darunavir

90
Q

warnings darunavir

A

drug-induced hepatitis

SJS/TENS

91
Q

which booster is FDA approved with darunavir for once daily dosing?

A

cobicistat

92
Q

Which booster with PI should not be used w/ tenofovir disoproxil if CrCl <70?

A

cobicistat

93
Q

How is Evotaz given?

A

once daily

94
Q

Evotaz generic

A

atazanavir + cobicistat

95
Q

Prezcobix generic

A

darunavir + cobicistat

96
Q

warnings Reyataz

A 
severe skin reactions
hyperbilirubinemia
cholelithiasis
nephrolithiasis
prolonged P-R interval
hepatotoxicity
97
Q

which drug is associated with”bananavir”. why?

A

atazanavir b/c jaundice and scleral ictus

98
Q

SE Reyataz

A 
cholelithiasis
hyperbilirubinemia
myalgia
depression
severe skin reactions
99
Q

Which PIs do you monitor for ECG changes?

A

atazanivir
lopinavir
saquinavir

100
Q

which ART do you need to watch out with acid suppressive agents?

A

atazanavir

rilpivirine

101
Q

Warnings fosamprenavir

A

sulfa allergy

102
Q

AE fosamprenavir

A

rash

103
Q

Lexiva generic

A

fosamprenavir

104
Q

Reyataz generic

A

atazanavir

105
Q

how to take PIs with ritonavir component?

A

w/ food and 48 oz. of water

106
Q

warnings indinavir

A

nephrolithiasis/urolithiasis

107
Q

AE indinavir

A

N/V/D
HA
nephrolithiasis

108
Q

How should indinavir be dispensed?

A

in original container w/ dessicant

109
Q

Crixivan generic

A

indinavir

110
Q

Kaletra generic

A

lopinavir/ritonavir

111
Q

dose of Kaletra

A

naive:
800/200 daily
OR 400/100 BID

112
Q

How should Kaletra solution be taken?

A

with food

113
Q

How should Kaletra solution be stored?

A

refrigerator x 2 months

114
Q

Kaletra solution contains what?

A

42% alcohol content

115
Q

AE Kaletra

A

N/V/D

hyperlipidemia especially TG

116
Q

Kaletra should be avoided in what?

A

carbamazepine
phenytoin
phenobarbital
pregnancy

117
Q

Nelfinavir warning

A

diarrhea (up tp 20%)

118
Q

nelfinavir boosting?

A

No, reaches adequate conc. on its own

119
Q

nelfinavir administration

A

take w/ food

120
Q

DDI nelfinavir

A

PPIs

121
Q

Which PIs must be given w/ ritonavir?

A

saquinavir
lopinavir
tipranavair

122
Q

AE saquinavir

A

nausea

123
Q

BW tipranavir

A

intracranial hemorrhage
hepatitis
hepatic decompensation

124
Q

which antiarrythmics are contraindicated w/ PIs?

A

dronedarone w/ all

amiodarone w/ some

125
Q

which antiplatelets/anticoagulants should be avoided w/ PIs?

A

adoxaban edoxaban rivaroxaban ticagrelor

126
Q

Which direct-acting antiviral is contraindicated w/ PIs?

A

simeprevir

127
Q

Alfuzosin is contrraindicated w/ which ART class?

A

PI

128
Q

PI and warfarin

A

decrease INR because of 2C9 induction

129
Q

hormonal contraceptives with these two active ingredients are particularly susceptible to DDI w/ PIs.

A

ethinyl estradiol and norethindone

130
Q

PDE5 inhibitors w/ PIs

A

can increase PDE5 inhibitor levels may increase causing toxicity

sildenafil used for PAH is contraindicated

131
Q

Which statins are contraindicated with PIs?

A

simvastatin and lovastatin

132
Q

which statins are preferred with PIs?

A

atorvastatin

rosuvastatin

133
Q

which drugs can have their conc. decreased by PI mainly due to induction?

A

methadone
warfarin
hormonal contraceptives

134
Q

cobicistat brand

A

Tybost

135
Q

ritonavir brand

A

Norvir

136
Q

AE Tybost?

A

increasing SCr

137
Q

does cobicistat have ARV activity?

A

No

138
Q

What does ritonavir solution contain and must be shaken well?

A

43% alcohol

139
Q

Do INSTIs require renal dose adjustment?

A

no

140
Q

Any major CYP interactions with INSTI?

A

no

141
Q

which INSTI has the greatest risk of increasing CPK?

A

raltegravir

142
Q

INSTI can be taken w/o regards to food except?

A

elvitegravir

143
Q

What is the dosing of Stribild and Genvoya?

A

one tablet daily

144
Q

What are the SE of elvitegravir?

A

proteinuria, headache, insomnia

145
Q

Dolutegavir brand?

A

Tivicay

146
Q

CI Tivicay?

A

coadministration w/ dofetilide

147
Q

SE Tivicay

A

insomnia, headache, increasing SCr w/o affecting GFR

148
Q

raltegravir brand

A

Isentress

Isentress HD

149
Q

dosing frequency of Isentress and Isentress HD

A

Isentress is BID

Isentress HD is once daily

150
Q

SE raltegravir?

A

increasing CPK
myopathy
rhabdomyolysis

151
Q

INSTI and polyvalent cations

A

take 2 hours before or 6 hours after

152
Q

CCR5 antagonist

A

maraviroc (Selzentry)

153
Q

Before taking Maraviroc, pts must take a tropism test to test for what?

A

CCR5-tropic disease NOT for CXCR4 or dual/mixed-tropic disease

154
Q

BBW for Maraviroc

A

hepatotoxicity

155
Q

Fusion inhibitor

A

Enfuvirtide (Fuzeon)

156
Q

How is Fuzeon administered

A

SC

157
Q

SE of Fuzeon

A

98% of pts get injection site reactions

HIV (1 decks)

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