Opportunistic infections Flashcards
How do you prophylax for PCP?
How do you prophylax for toxoplasma gondii?
How do you prophylax for MAC?
When white cells <200, discontinue when >200 for >3 months. Do it with Bactrim or dapsone or dapsone +pyrimethamine+ leucovorin.
<100 CDC. Bactrim or dapsone + P + L
<50, If >100 for >3 months stop. Azithromycin.
How do you treat candidiasis?
Cryptococcal meningitis?
CMV?
Fluconazole or itraconazole
Ampho B + Flucytosine
Valganciclovir or Ganciclovir, Foscarnet or Cidofovir.
How do you treat MAC?
How do you treat PCP?
How do you treat Toxoplasmosis?
Clarithromycin or azithromycin + ethambutol
Bactrim or pentamidine IV
Pyrimethamine + leucovorin + sulfadiozine. Bactrim.
What’s NRTI backbone therapy?
What’s regimens for antiretroviral naive pregnant women?
INSTI + 2 NRTI.
2 NRTI + either a boosted PI or INSTI.
What’s in ATRIPLA?
What’s in Complera?
What’s in Stribild?
TDF + Emtricitabine + Efavirenz.
TDF + Emtricitabine + Rilpivirine
TDF + emtricitabine +elvitegravir + cobicistat
What’s in Genvoya?
What’s in Triumeq?
What’s in Tivicay + Truvada?
TAF + elvitegravir + emtricitabine + cobicistat
Dolutegravir + abacavir + lamivudine
Dolutegravir + emtricitabine/TDF
What’s in Isentress?
Is Juluca ever used for initial treatment?
What’s in Epzicom?
Raltegravir + emtricitabine/tdf or taf
NO
Abacavir + Lamivudine
What’s in Truvada?
What’s Abacavir’s warnings?
What’s Lamivudine’s BBW?
Emtricitabine + TDF
Screen for HLAB5701(CI’d if positive). Serious hypersensitivity reactions, do not re challenge. Warning card.
Do not use for treatment of HIV(Epivir- HBV). Severe acute exacerbation of HBV can occur. Side effects are N/V/D.
What are Emtriciabine’s BBW and warnings?
What to know about TDF(Viread)?
What are Zidovudine and Stavudine’s warnings?
200 mg daily. Exacerbation of HBV,. PrEP for patients HIV negative prior to initiating and every 3 months during use. N/V/D, rash, dizziness, HA, insomnia, hyperpigmentation.
300 mg. HBV exacerbation. Renal toxicity, fanconi syndrome, osteomalacia, and decrease density. TD causes decreased bone mineral and renal impairment. TA causes nausea. Lower rates of bone and renal with TA.
Hematologic toxicities(anemia), myopathy, increased LFT’s. MCV. IV zidovudine should be used in labor of HIV infected women. 30 days in fridge for stavudine. N/V/D, peripheral neuropathy( can be irreversible), Increased LFT’s, hyperbilirubinemia, lipoatrophy.
What is Didanosine’s warnings?
What is Efavirenz(sustiva)’s warnings?
What to know about Rilpivirine?
Pancreatitis(sometimes fatal), 30 days in fridge, N/V/D, peripheral neuropathy, increased amylase, pruritus and rash.
600 mg daily. Serious psychiatric symptoms, cns symptoms, convulsions, qt prolongation. CNS effects/
with a meal, requires acidic environment so CI’d with PPI’s. Depressive disorders, mood changes, insomnia. Higher rates of failure if viral load >100,000 copies.
What’s the BBW of Nevirapine and Efavirine?
What to know about Darunavir(Prezista)?
What to know about Atazanavir(Reyataz)?
Hepatoxicity, serious skin reacions(SJS/TEN). Do not initiate therapy in women with CD4 counts >250 or men >400, rash(including SJS/TEN).
Swallow whole, treatment naive is daily. Watch for drug induced hepatitis and SJS/TEN. Caution in sulfa allergy. Must be given with ritonavir or cobicistat, N/V/D,rash, increased lft’s, headache.
PR interval prolongation, severe skin reactions, hyperbiliruinemia, hepatoxicity, nephrolithiasis, and cholethiasis. Induced hyperbilitubinemia(bananavir due to jaundice)- reversible, cholethiasis, HA, N/V/D, severe skin reactions, depression, myalgia. Caution with acid suppressive therapy
Do you take fosamprenavir with food?
Do you take Idinavir with food?
What to know about Lopinavir + ritonavir?
NO, caution in sulfa allergies.
YES and 48 oz of water, watch for nephro/urolithiasis, N/V/D< HA, nephrolithiasis.
Watch for N/V/D, hyperlipidemia(especially TG). Treatmend naive is 800/200 daily ir 400/100 BID). with food, refrigerate, contains 42% alcohol.
What to know about Nelfinavir?
What to know about saquinavir?
What to knwo about Tipranavir?
Diarrhea, boosting with ritonavir not recommend
Must be given with ritonavir, nausea.
Must be given with ritonavir, Clinical hepatitis and hepatic decompensation, intracranial hemorrhage, caution with a sulfa allergy.
What to know about Ritonavir(Norvir) and cobicistat(tybost)?
What to know about eltegravir?
What to know about Dolutegravir(Tivicay?
Interations with many meds, potentially serious or life threatning adverse events. Antiretroviral activity, Strong p glycoprotein inhibition. Watch for cyp3A4(st johns wart, phenytoin, amiodarone, lovastatin, etc. Take cobicistat with food and can be co formulated, ritonavir is difficult to.
Stribild is 1 tab daily. Proteinuria, HA, insomnia, Do not start if CrCL is <70 and D/C if <50. Genvoya do not start CrCl <30. 1 tab daily.
Insomnia, HA, increased SCr without affecting GFR.
What to know about Raltegravir(isentress, isentress HD)?
What to know about Maraviroc?
What to know about Enfuviritide and is Trogorzo IV?
BID, HD: 1200 mg daily. Watch for increased CPK, myopathy and rhabdomyolsis.
Only CCR5, only work in patients with CCr5 tropic disease(must under go tropism test prior to therapy), Hepatoxicity.
Local injection site reaction in 98% of patients, only fusion inhibitor, SQ. YES aka ibalizumab-uiyk
