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Rx Files ARVs Flashcards

1
Q

Zidovudine brand

A

Retrovir

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2
Q

Zidovudine common name

A

AZT

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3
Q

Retrovir common name

A

AZT

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4
Q

AZT mechanism of action

A

Thymidine analog which interferes with HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication.

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5
Q

AZT dosing

A

200 mg PO TID

300 mg PO BID

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6
Q

AZT has _____ CNS penetration. (___%)

A

good

60%

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7
Q

What drugs increase AUC of AZT?

A

clarithromycin
VPA
Lamivudine

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8
Q

AZT antagonizes what other ARV?

A

Stavudine (Zerit)

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9
Q

Adverse effects of AZT

A
  • severe anemia
  • headache
  • malaise
  • GI upset
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10
Q

When taking AZT at what lab value should it be discontinued?

A

Hgb < 7.5 g/dL

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11
Q

Didanosine EC

A

Videx EC

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12
Q

Didanosine mechanism of action

A

Converted within cells to the mono, di, and triphosphates of dideoxyadenosine (dda). These dda phosphates bind to and inhibit reverse transcriptase.

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13
Q

Didanosine adverse effects

A
  • peripheral neuropathy
  • pancreatitis
  • lipodystrophy
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14
Q

Didanosine drug interactions

A

Truvada

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15
Q

Stavudine brand

A

Zerit

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16
Q

Stavudine mechanism of action

A

binds to and inhibits reverse transcriptase enzyme

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17
Q

Stavudine dosing

A

weight based

  • < 60 kg: 30 mg PO BID
  • > 60 kg 40 mg PO BID
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18
Q

Stavudine has ____ CNS penetration (___%)

A

good

30-40%

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19
Q

Stavudine adverse effects

A
  • peripheral neuropathy

- most likely of NRTIs to be associated with lactic acidosis and lipodystrophy

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20
Q

Stavudine drug interactions

A

AZT

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21
Q

Lamivudine brand

A

Epivir

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22
Q

Lamivudine mechanism of action

A

phosphorylates, binds to, and inhibits reverse transcriptase

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23
Q

Lamivudine has rapid resistance to what (more/less) viable viral form?

A

less

M184V

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24
Q

What dosage form is Lamivudine available in?

A

oral solution and oral tablet

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25
Q

Lamivudine adverse effects

A

headache

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26
Q

Lamivudine has efficacy against what other virus? What dose?

A

Hep B

Epivir-HBV 100 mg

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27
Q

Emtricitabine brand

A

Emtriva

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28
Q

Emtricitabine is the once daily analogue of what other ARV?

A

Lamivudine

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29
Q

Emtricitabine has efficacy against what other virus?

A

Hep B

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30
Q

Abacavir brand

A

Ziagen

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31
Q

Abacavir adverse effect

A

hypersensitivity (major)

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32
Q

Is it recommended to re-challenge abacavir hypersensitivity?

A

never
never
never

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33
Q

What are the nucleoSide reverse transcriptase inhibitors? NRTIs

A
  • Zidovudine
  • Didanosine
  • Stavudine
  • Lamivudine
  • Emtracitabine
  • Abacavir
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34
Q

What are the nucleoTide reverse transcriptase inhibitors?

A
  • tenofovir

- tenofovir alfenamide

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35
Q

Tenofovir brand

A

Viread

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36
Q

Tenofovir and tenofovir alfenamide have efficacy against what other virus?

A

Hep B

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37
Q

Tenofovir dosing

A

300 mg PO QD

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38
Q

Tenofovir drug interactions

A
  • didanosine EC

- atazanavir

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39
Q

Tenofovir should be used cautiously in what condition?

A

renal failure

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40
Q

What is the difference between tenofovir and tenofovir alfenamide?

A 
TDF = higher dose, larger tablet, more adverse effects
TAF = higher intercellular concentrations with fewer adverse effects, smaller dose, smaller tablet
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41
Q

Tenofovir alfenamide is only available as what?

A

combination products

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42
Q

What are the combination products containing tenofovir alfenamide?

A

Descovy
Odefesy
Genvoya

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43
Q

What drugs are in Combivir?

A

300 mg AZT and 150 mg lamivudine

44
Q

How is Combivir dosed?

45
Q

What drugs are in Trizivir?

A

150 mg lamivudine
300 mg AZT
300 mg abacavir

46
Q

How is Trizivir dosed?

47
Q

What drugs are in Truvada?

A

200 mg Emtricitabine

300 mg Tenofovir

48
Q

What drugs are in Descovy?

A

200 mg Emtricitabine

25 mg Tenofovir Alfenamide

49
Q

Descovy has (more/fewer) adverse effects compared to Truvada. Why?

A

fewer - tenofovir alfenamide instead of tenofovir

50
Q

What drugs are in Epzicom?

A

300 mg Lamivudine

600 mg abacavir

51
Q

How is Epzicom dosed?

52
Q

What drugs are in Atripla?

A

200 mg Emtricitabine
300 mg Tenofovir
600 mg Efavirenz

53
Q

How is Atripla dosed?

A

daily at bedtime

54
Q

What drugs are in Complera?

A

200 mg Emtricitabine
300 mg Tenofovir
25 mg Rilpivirine

55
Q

How is Complera dosed?

56
Q

What is Complera nicknamed?

A

B-tripla in reference to its similarity to Atripla

57
Q

What drugs are in Stribild?

A

200 mg Emtricitabine
300 mg Tenofovir
150 mg elvitegravir
150 mg cobicistat

58
Q

What is the function of cobicistat in Stribild?

A

favorable drug interaction

59
Q

How is Stribild dosed?

60
Q

What is the nickname of Stribild?

61
Q

What drugs are in Triumeq?

A

300 mg Lamivudine
600 mg Abacavir
50 mg dolutegravir

62
Q

How is Triumeq dosed?

63
Q

What drugs are in Genvoya?

A

200 mg Emtricitabine
25 mg Tenofovir alfenamide
150 mg elvitegravir
150 mg cobicistat

64
Q

Genvoya is the tenofovir alfenamide replacement for which combo product?

65
Q

What drugs are in Odefesy?

A

200 mg Emtricitabine
25 mg Tenofovir alfenamide
25 mg rilpivirine

66
Q

Odefesy is the tenofovir alfenamide replacement for which combo product?

67
Q

Saquinavir brand

68
Q

How must saquinavir be taken?

A

with a high fat meal or favorable drug interaction

69
Q

What drug creates a favorable drug interaction with saquinavir?

A

ritonavir (CP 450 system)

70
Q

What is the typical dose of saquinaivir?

A

500 mg BID with ritonavir 100 mg

71
Q

Ritonavir brand

72
Q

Saquinavir adverse effects

A

GI intolerance

73
Q

What are the drug interactions with saquinavir?

A
  • terfenadine
  • cisapride
  • astemizole
  • triazolam
  • midazolam
  • ergot derivatives
  • rifampin
  • rifabutin
74
Q

What are the adverse effects of Ritonivir?

A
  • GI intolerance
  • circumoral and peripheral parathesias
  • increase in total cholesterol and TG levels
75
Q

Ritonivir is a very potent what?

A

enzyme inhibitor

76
Q

Indinavir brand

77
Q

Nelfinavir brand

78
Q

Fosamprenavir brand

79
Q

Lopinavir/Ritonavir brand

80
Q

What is the most common side effect with Nelfinavir and how is it treated?

A

GI upset

OTC loperamide

81
Q

With Indinavir use, what lab value is often altered?

A

10% of patients experience increase in indirect dilirubin

82
Q

Atazanavir brand

83
Q

When should atazanavir be discontinued?

A

LFTs > 5x normal

84
Q

Atazanavir/Cobicistat

85
Q

Tipranavir brand

86
Q

Darunavir brand

87
Q

Darunavir/Cobicistat

88
Q

What are the Protease Inhibitors (PIs)?

A
  • Saquinavir
  • Ritonavir
  • Indinavir
  • Nelfinavir
  • Fosamprenavir
  • Lopinavir/Ritonavir
  • Atazanavir
  • Tipranavir
  • Darunavir
89
Q

Nevirapine brand

90
Q

Nevirapine mechanism of action

A

binds to and inhibits the reverse transcriptase enzyme without requiring phosphorylation

91
Q

Nevirapine dosing

A

200 mg PO QD x 2 weeks than 200 mg PO BID

92
Q

When should Nevirapine be discontinued?

A

rash - risk of SJS

93
Q

Nevirapine drug interactions

A
  • indinavir
  • saquinavir
  • oral contraceptives
94
Q

Nevirapine black box warning

A

hepatic failure

95
Q

Efavirenz brand

96
Q

Efavirenz dosing

A

600 mg Qhs

97
Q

Efavirenz adverse drug reactions

A
  • CNS disengagement

- vivid nightmares

98
Q

Etravirine brand

A

Intelllence

99
Q

Etravirine dosing

A

200 mg PO BID

100
Q

Etravirine adverse drug reactions

A
  • rash

- diarrhea

101
Q

What is Etravirine’s place in therapy

A

salvage therapy

102
Q

What are the Non-nucleoside reverse transcriptase inhibitors (NNRTIs)?

A
  • Nevirapine
  • Efavirenz
  • Etravirine
103
Q

Cobicistat brand

104
Q

Cobicistat inhibits what enzymes?

105
Q

HIV counselling points

A
  1. Adherence is critical
  2. do not stop taking any medication unless directed to do so
  3. Talk to healthcare professionals before starting any other med
  4. Use caution when taking alternative or herbal remedies
  5. These drugs are NOT cures for HIV/AIDS
  6. Always encourage safe sex
  7. Length of treatment is indefinite

Naplex (8 decks)

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