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HIV-1
Lecture 20
42
Pharmacology
Professional
03/12/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
What drug is the only fusion inhibitor?
Definition
Enfuvirtide/Fuzeon
Reconstitute at the same time - can cause inj site rxns
Term
What drug is a CCR5 inhibitor?
Definition
Maraviroc/Selzentry
**LOWER the dose with an inhibitor, RAISE the dose with an inducer
Term
What protease inhibitor has the abbreviation ATV?
Definition
Atazanavir/Reyataz
**The only PI with documented DI - PPIs. Can cause hyperbilirubinemia, PR prolongation
Term
What protease inhibitor has the abbreviation DRV?
Definition
Darunavir/Prezista
**Take with food, cannot take with sulfa
Term
What protease inhibitor has the abbreviation FPV?
Definition
Fosamprenavir/Lexiva
**Cannot take in a sulfa allergy. GI intolerance
Term
What protease inhibitor has the abbreviation RTV?
Definition
Ritonavir/Kaletra
**The drug of choice in pregnancy. Can cause severe nausea
Term
What protease inhibitor has the abbreviation TPV?
Definition
Tipranavir/Aptivus
**Take with food, cannot take with sulfa
Term
What NRTI has the abbreviation ABC?
Definition
Abacavir/Ziagen
**Goes through alcohol dehydrogenase in the liver
Term
What NRTI has the abbreviation FTC?
Definition
Emtricitabine/Emtriva
**An isomer of lamivudine, do not give together
Term
What NRTI has the abbreviation 3TC?
Definition
Lamivudine/Epivir
Term
What NRTI has the abbreviation TDF?
Definition
Tenofovir/Viread
- Present in combivir
- Causes severe myalgia, nephrotoxic
Term
What NRTI has the abbreviation AZT/ZDV?
Definition
Zidovudine/Retrovir
**Very bad fatigue and malaise
Term
What nNRTI has the abbreviation EFV?
Definition
Efavirenz/Sustiva
- specific AE: Abnormal dreams, cannot give in 1st trimester, high TGs
Term
What nNRTI has the abbreviation ETV?
Definition
Etravirine/Intelence
**Take with food
Term
What nNRTI has the abbreviation NVP?
Definition
Nevirapine/Viramune
- Specific AE: hepatotoxicity, rash
Term
What nNRTI has the abbreviation RPV?
Definition
Rilpivirine/Edurant
**Needs acid, do not give with PPIs
Term
What drug is an integrase inhibitor?
Definition
Raltegravir/Isentress
**New - Elvitegravir
Only documented interaction is with rifampin, must increase dose. Contraindicated in CrCl < 50
Term
What nNRTI produces drowsiness/bad dreams, and CANNOT be given in the first trimester of pregnancy?
Definition
Efavirenz/Sustiva
Term
What drugs does the K103N mutation knock out?
Definition
Efavirenz/Sustiva
Nevirapine/Viramune
Term
What are AEs of ALL nNRTIs?
Definition
- Rash up to and including steven-johnson syndrome, especially Nevirapine
- Hepatotoxicity w/ CD4 > 250
Term
What NRTI is hepatically metabolized?
Definition
Only abacavir/Ziagen, all others are renally cleared
Term
What are the components of the combo Truvada?
Definition
Emtricitabine(FTC) and Tenofovir(TDF)
Term
What are the components of the combo Combivir?
Definition
Zidovudine(AZT) and Lamivudine (3TC)
Term
What are the components of the combo Trizivir?
Definition
Zidovudine(AZT), Lamivudine(3TC), and Abacavir(ABC)
Term
What are the components of the combo Ebzicom?
Definition
Lamivudine(3TC) and abacavir(ABC)
Term
What are AEs in all NRTIs?
Definition
- Lactic acidosis - highest in zidovudine
- Lipodystrophy
Term
What NRTI requires allele screening?
Definition
Abacavir - screen for the HLA-B*5701. If positive, NEVER use this drug.
Term
What PI is the drug of choice in pregnancy?
Definition
Ritonavir/Kaletra
Term
What PIs cannot be taken with a sulfa allergy?
Definition
Fosamprenavir/Lexiva, Tipranavir/Aptivus, Darunavir/Prezista
Term
What are AEs of all protease inhibitors?
Definition
- All cause fat malabsorption - hyperlipidemia, lipodystrophy, can lead to MI. More likely w/ Efavirenz
- Many cause GI intolerance, take with food
- Risk of osteonecrosis, osteoporosis
Term
How do statins interact with protease inhibitors
Definition
- Lovastatin and simvastatin are CONTRAINDICATED
- Atorvastatin and Pravastatin are preferred. Pravastatin incr w/ Darunavir
- Crestor alternative, but interacts w/ Lopinavir/Ritonavir (incr conc)
Term
What protease inhibitor has the abbreviation LPV?
Definition
Lopinavir - used only in combo with ritonavir for the combo Kaletra
Term
What is first line in HIV for treating TG > 500?
Definition
- Fenofibrate 48 or 145
- Gemfibrozil 600 mg BID
Term
What rare AEs are caused by protease inhibitors?
Definition
- facial wasting - sunken temporal lobes, protruding cheeks
- Buffalo hump
Term
How can H2A/PPIs be used in patients using atazanavir/Reyataz?
Definition
- Naive patients: Can use low dose H2As simultaneously, or take ATV 12 hours after
- treatment experienced: May only take LOWER dose H2As, no PPIs
Term
What type of HIV drugs cause lactic acidosis?
Definition
NRTIs - specifically zidovudine. More common in women. Lactate is through the roof.
Term
What type of HIV drugs cause Hepatotoxicity?
Definition
- NRTIs - steatosis from zidovudine
- nNRTIs - Nevirapine/Viramune causes severe hepatitis in first 18 weeks, esp in higher CD4 counts
- PI - Tipranavir, ritonavir, sometimes darunavir
**Always an incr risk in concomitant hep B and C
Term
What HIV drugs can cause insulin resistance and diabetes?
Definition
- Zidovudine
- Kaletra/Ritonavir
Term
How do inhaled corticosteroids interact with HIV drugs?
Definition
Drug induced cushing syndrome w/ protease inhibitors. May use beclomethasone
Term
How do antianxiety meds interact w/ protease inhibitors?
Definition
- Xanax, Halcion, Versed all increased by ritonavir
- Ativan, oxazepam, temazepam are safer
- Can use zolpidem, Lunesta
**Methadone decreased by efavirenz and nevirapine. Always change methadone
Term
How do HIV medications interact with antipsychotics?
Definition
Olanzapine and Clozapine will decrease w/ ritonavir
Risperidone and haloperidol safe
**Oral contraceptive doses low, use extra protection. Do not use St. John's Wort.
Term
Who should be screened for HIV?
Definition
- All patients 13-64
- IVDU, unprotected sex
- homosexuals
- Prostitutes
- Treated for STDs
- Received blood transfusions between 1975-1985
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