T4-HIV: Common Medications

Question 1

There are 4 combinations of commonly used drugs to help HIV patients. What is the backbone of each?

Answer 1

Emtricitabine & Tenofovir (both NRTIs)

Question 2

What are the common side effects of Emtricitabine and Tenofovir?

Answer 2

Diarrhea, nausea, skin rash
Dyslipidemia
Fat redistribution
Osteoporosis

Question 3

What are the rare side effects of Emtricitabine and Tenofovir?

Answer 3

Acute renal failure
Peripheral neuropathy
Pancreatitis

Question 4

What are the 2 BBW associated with Emtricitabine and Tenofovir?

Answer 4

Fatty liver disease that manifests as lactic acidosis

Hep B exacerbation (test before starting therapy)

Question 5

Emtricitabine and Tenofovir can be taken alone or in combo. The first combo is E&T + Efavirenz. What is the big point about this? What are the side effects?

Answer 5

Big point: TAKE AT NIGHT ON EMPTY STOMACH
Side effects are the same as the E & T side effects mentioned already

*There are also some CNS adverse effects associated: depression, paranoia, aggression, euphoria, hallucinations, sedation [this is why you take it at night–to minimize these effects]

Question 6

E & T is also used in combo with Rilpivirine. What are some points about this one? (3)

Answer 6

1. Take WITH FOOD
2. May see depression or dizziness (not as bad as efavirenz)
3. QT prolongation risk

Question 7

E&T is also used in combo with Elvitegravir and Cobicistat. What are the big points with this one? (4)

Answer 7

1. TAKE WITH FOOD
2. Cobicistat is only added to be used as a CYP inhibitor (to keep the rest of the drug in the system longer)
3. D/N [a little worse than the others’
4. CNS effects [a little better than the others]

Question 8

Which combo must be taken on an empty stomach?

Answer 8

Emtricitabine and Tenofovir with Efavirenz

Question 9

Which combo causes QT prolongation?

Answer 9

Emtricitabine and Tenor with Rilpivirine

Question 10

Which combo has a drug added just for the CYP interaction?

Answer 10

Emtricitabine and Tenofovir with Elvitegravir & Cobicistat

Cobicistat is the CYP inhibitor!!!

Question 11

Which combo do you take at night to minimize the CNS effects?

Answer 11

Emtricitabine and Tenofovir with Efavirenz

Question 12

Which combo do you take with food?

Answer 12

BOTH

-Emtricitabine and Tenofovir with Rilpivirine AND -Emtricitabine and Tenofovir with Elvitegravir and Cobicistat

Question 13

Which combo has D/N the worse than the others?

Answer 13

Emtricitabine and Tenofovir with Elvitegravir and Cobicistat

Question 14

Which combo has CNS effects that aren’t as bad as the others?

Answer 14

Emtricitabine and Tenofovir with Elvitegravir and Cobicistat

Question 15

Which combo has a skin rash that usually resolves after 1 month? Do we need to stop the drug if the rash develops?

Answer 15

E&T plus Efavirenz, NO

Question 16

What are three important client reminders?1

Answer 16

1. Can still infect others
2. Take med same time every day and don’t miss a doses! This prevents HIV from becoming resistant
3. Many significant drug interactions (including herbals); check with prescriber BEFORE adding new meds!!!!

Question 17

All the medications mentioned here are combo drugs. How many tabs do you take to get the effect and how many times a day?

Answer 17

ALL are formed into ONE tablet to be dosed just ONCE a day! #convenient