Rx Files ARVs Flashcards
1
Q
Zidovudine brand
A
Retrovir
2
Q
Zidovudine common name
A
AZT
3
Q
Retrovir common name
A
AZT
4
Q
AZT mechanism of action
A
Thymidine analog which interferes with HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication.
5
Q
AZT dosing
A
200 mg PO TID
300 mg PO BID
6
Q
AZT has _____ CNS penetration. (___%)
A
good
60%
7
Q
What drugs increase AUC of AZT?
A
clarithromycin
VPA
Lamivudine
8
Q
AZT antagonizes what other ARV?
A
Stavudine (Zerit)
9
Q
Adverse effects of AZT
A
- severe anemia
- headache
- malaise
- GI upset
10
Q
When taking AZT at what lab value should it be discontinued?
A
Hgb < 7.5 g/dL
11
Q
Didanosine EC
A
Videx EC
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.
13
Q
Didanosine adverse effects
A
- peripheral neuropathy
- pancreatitis
- lipodystrophy
14
Q
Didanosine drug interactions
A
Truvada
15
Q
Stavudine brand
A
Zerit
16
Q
Stavudine mechanism of action
A
binds to and inhibits reverse transcriptase enzyme
17
Q
Stavudine dosing
A
weight based
- < 60 kg: 30 mg PO BID
- > 60 kg 40 mg PO BID
18
Q
Stavudine has ____ CNS penetration (___%)
A
good
30-40%
19
Q
Stavudine adverse effects
A
- peripheral neuropathy
- most likely of NRTIs to be associated with lactic acidosis and lipodystrophy
20
Q
Stavudine drug interactions
A
AZT
21
Q
Lamivudine brand
A
Epivir
22
Q
Lamivudine mechanism of action
A
phosphorylates, binds to, and inhibits reverse transcriptase
23
Q
Lamivudine has rapid resistance to what (more/less) viable viral form?
A
less
M184V
24
Q
What dosage form is Lamivudine available in?
A
oral solution and oral tablet
25
Lamivudine adverse effects
headache
26
Lamivudine has efficacy against what other virus? What dose?
Hep B
| Epivir-HBV 100 mg
27
Emtricitabine brand
Emtriva
28
Emtricitabine is the once daily analogue of what other ARV?
Lamivudine
29
Emtricitabine has efficacy against what other virus?
Hep B
30
Abacavir brand
Ziagen
31
Abacavir adverse effect
hypersensitivity (major)
32
Is it recommended to re-challenge abacavir hypersensitivity?
never
never
never
33
What are the nucleoSide reverse transcriptase inhibitors? NRTIs
- Zidovudine
- Didanosine
- Stavudine
- Lamivudine
- Emtracitabine
- Abacavir
34
What are the nucleoTide reverse transcriptase inhibitors?
- tenofovir
| - tenofovir alfenamide
35
Tenofovir brand
Viread
36
Tenofovir and tenofovir alfenamide have efficacy against what other virus?
Hep B
37
Tenofovir dosing
300 mg PO QD
38
Tenofovir drug interactions
- didanosine EC
| - atazanavir
39
Tenofovir should be used cautiously in what condition?
renal failure
40
What is the difference between tenofovir and tenofovir alfenamide?
```
TDF = higher dose, larger tablet, more adverse effects
TAF = higher intercellular concentrations with fewer adverse effects, smaller dose, smaller tablet
```
41
Tenofovir alfenamide is only available as what?
combination products
42
What are the combination products containing tenofovir alfenamide?
Descovy
Odefesy
Genvoya
43
What drugs are in Combivir?
300 mg AZT and 150 mg lamivudine
44
How is Combivir dosed?
BID
45
What drugs are in Trizivir?
150 mg lamivudine
300 mg AZT
300 mg abacavir
46
How is Trizivir dosed?
BID
47
What drugs are in Truvada?
200 mg Emtricitabine
| 300 mg Tenofovir
48
What drugs are in Descovy?
200 mg Emtricitabine
| 25 mg Tenofovir Alfenamide
49
Descovy has (more/fewer) adverse effects compared to Truvada. Why?
fewer - tenofovir alfenamide instead of tenofovir
50
What drugs are in Epzicom?
300 mg Lamivudine
| 600 mg abacavir
51
How is Epzicom dosed?
daily
52
What drugs are in Atripla?
200 mg Emtricitabine
300 mg Tenofovir
600 mg Efavirenz
53
How is Atripla dosed?
daily at bedtime
54
What drugs are in Complera?
200 mg Emtricitabine
300 mg Tenofovir
25 mg Rilpivirine
55
How is Complera dosed?
daily
56
What is Complera nicknamed?
B-tripla in reference to its similarity to Atripla
57
What drugs are in Stribild?
200 mg Emtricitabine
300 mg Tenofovir
150 mg elvitegravir
150 mg cobicistat
58
What is the function of cobicistat in Stribild?
favorable drug interaction
59
How is Stribild dosed?
daily
60
What is the nickname of Stribild?
QUAD
61
What drugs are in Triumeq?
300 mg Lamivudine
600 mg Abacavir
50 mg dolutegravir
62
How is Triumeq dosed?
daily
63
What drugs are in Genvoya?
200 mg Emtricitabine
25 mg Tenofovir alfenamide
150 mg elvitegravir
150 mg cobicistat
64
Genvoya is the tenofovir alfenamide replacement for which combo product?
Stribild
65
What drugs are in Odefesy?
200 mg Emtricitabine
25 mg Tenofovir alfenamide
25 mg rilpivirine
66
Odefesy is the tenofovir alfenamide replacement for which combo product?
Complera
67
Saquinavir brand
Invirase
68
How must saquinavir be taken?
with a high fat meal or favorable drug interaction
69
What drug creates a favorable drug interaction with saquinavir?
ritonavir (CP 450 system)
70
What is the typical dose of saquinaivir?
500 mg BID with ritonavir 100 mg
71
Ritonavir brand
Norvir
72
Saquinavir adverse effects
GI intolerance
73
What are the drug interactions with saquinavir?
- terfenadine
- cisapride
- astemizole
- triazolam
- midazolam
- ergot derivatives
- rifampin
- rifabutin
74
What are the adverse effects of Ritonivir?
- GI intolerance
- circumoral and peripheral parathesias
- increase in total cholesterol and TG levels
75
Ritonivir is a very potent what?
enzyme inhibitor
76
Indinavir brand
Crixivan
77
Nelfinavir brand
Viracept
78
Fosamprenavir brand
Lexiva
79
Lopinavir/Ritonavir brand
Kaletra
80
What is the most common side effect with Nelfinavir and how is it treated?
GI upset
| OTC loperamide
81
With Indinavir use, what lab value is often altered?
10% of patients experience increase in indirect dilirubin
82
Atazanavir brand
Reyataz
83
When should atazanavir be discontinued?
LFTs > 5x normal
84
Atazanavir/Cobicistat
Evotaz
85
Tipranavir brand
Aptivus
86
Darunavir brand
Prezista
87
Darunavir/Cobicistat
Prezcobix
88
What are the Protease Inhibitors (PIs)?
- Saquinavir
- Ritonavir
- Indinavir
- Nelfinavir
- Fosamprenavir
- Lopinavir/Ritonavir
- Atazanavir
- Tipranavir
- Darunavir
89
Nevirapine brand
Viramune
90
Nevirapine mechanism of action
binds to and inhibits the reverse transcriptase enzyme without requiring phosphorylation
91
Nevirapine dosing
200 mg PO QD x 2 weeks than 200 mg PO BID
92
When should Nevirapine be discontinued?
rash - risk of SJS
93
Nevirapine drug interactions
- indinavir
- saquinavir
- oral contraceptives
94
Nevirapine black box warning
hepatic failure
95
Efavirenz brand
Sustiva
96
Efavirenz dosing
600 mg Qhs
97
Efavirenz adverse drug reactions
- CNS disengagement
| - vivid nightmares
98
Etravirine brand
Intelllence
99
Etravirine dosing
200 mg PO BID
100
Etravirine adverse drug reactions
- rash
| - diarrhea
101
What is Etravirine's place in therapy
salvage therapy
102
What are the Non-nucleoside reverse transcriptase inhibitors (NNRTIs)?
- Nevirapine
- Efavirenz
- Etravirine
103
Cobicistat brand
Tybost
104
Cobicistat inhibits what enzymes?
CP 450
105
HIV counselling points
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
