NRTIs

Question 1

NRTIs general class side effects

Answer 1

lactic acidosis, severe sometimes fatal hepatomegaly (e.g. stavudine, didanosine, zidovudine), hepatic steatosis

Question 2

Ziagen

Answer 2

Abacavir (ABC)

Question 3

Abacavir BBW

Answer 3

Serious, possibly fatal hypersensitivity reaction. Test for HLA-B*5701 before starting

Question 4

Epzicom

Answer 4

Abacavir + Lamivudine

Question 5

Trizivir

Answer 5

Lamivudine + Abacavir + Zidovudine (LAZ)

Question 6

Videx EC

Answer 6

Didanosine (ddl)

Question 7

Didanosine (ddl) BBW

Answer 7

Dose-related fatal pancreatitis

Question 8

Didanosine ADR

Answer 8

Peripheral neuropathy (~20%)
Retinal pigmentation 
Lactic acidosis

Question 9

Didanosine’s Pt Counseling

Answer 9

Take on empty stomach, avoid alcohol due to risk of pancreatitis, advise sx of neuropathy, eye exam q6-12 months

Question 10

Emtriva

Answer 10

Emtricitabine

Question 11

Truvada

Answer 11

Emtricitabine + Tenofovir (ET)

Truvada is ET needs renal adjusted

Question 12

Atripla

Answer 12

Tenofovir +Emtricitabine + Efavirenz (TEE)
Perform TEE on Atrium (Atripla)
Take on empty stomach
Need renal adjust

Question 13

Emtriva BBW

Answer 13

May exacerbate HBV once drug d/c HBV resistance may develop

Question 14

Emtriva ADR

Answer 14

Skin discoloration (Hyperpigmentation of the palms/or soles after 3 months use)

Question 15

Epivir

Answer 15

Lamivudine (3TC)

Question 16

Combivir

Answer 16

Lamivudine + Zidovudine (AZT, ZDV)

Question 17

Retrovir

Answer 17

Zidovudine (AZT, ZDV)

Question 18

Epivir BBW

Answer 18

Do not use Epivir-HBV for treatment of HIV

HBV resistance may develop

Question 19

Epivir ADR

Answer 19

Headache, fatigue, n/v/d neutropenia, peripheral neuropathy

Question 20

Zerit

Answer 20

Stavudine (d4T)

Renal adjust, decrease dose if CrCl <50

Question 21

Zerit BBW

Answer 21

Fatal pancreatitis seen in combo with didanosine

Question 22

Zerit ADR

Answer 22

Hyperbilirubinemia, Increase LFTs peripheral neuropathy

Dont combine w/ Zidovudine (antagonistic-decrease efficacy of both drugs)

Question 23

Zerit Contraindication

Answer 23

Stavudine is contraindicated w/ zidovudine

Stallion does not like the Zebra

Question 24

Retrovir

Answer 24

ZIdovudine

Question 25

Retrovir BBW

Answer 25

Bone marrow suppression, advanced pancytopenia, myopathy, myositis
ADR: purple toenails

Question 26

Viread

Answer 26

Tenofovir

Question 27

Viread BBW

Answer 27

May exacerbate HBV once drug is d/c

Question 28

Viread ADR

Answer 28

Fanconi syndrome, renal insufficiency, osteomalacia

Question 29

Videx Contraindication

Answer 29

Didanosine is contraindicated with Stavudine (Zerit)
Increase risk of hepatic failure & lactic acidosis (women)
The donkey (didanosine) cannot make w/ the Stallion (Stavudine)

Question 30

Which NRTIs required dose reduction if CrCl <50 ml/min?

Answer 30

LSD

Lamivudine (3TC, Epivir), Stavudine (d4T, Retrovir), Didanosine (ddl, Videx)

Question 31

Which only NRTIs require taking w/food

Answer 31

Zidovudine

The rest can be taken with or without food

Question 32

Which only NRTIs take on empty stomach

Answer 32

Didanosine

Question 33

Which NRTIs cause severe myelosuppression?

Answer 33

Retrovir