Term
| What drug is the only fusion inhibitor? |
|
Definition
Enfuvirtide/Fuzeon
Reconstitute at the same time - can cause inj site rxns |
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Term
| What drug is a CCR5 inhibitor? |
|
Definition
Maraviroc/Selzentry
**LOWER the dose with an inhibitor, RAISE the dose with an inducer |
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Term
| What protease inhibitor has the abbreviation ATV? |
|
Definition
Atazanavir/Reyataz
**The only PI with documented DI - PPIs. Can cause hyperbilirubinemia, PR prolongation |
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Term
| What protease inhibitor has the abbreviation DRV? |
|
Definition
Darunavir/Prezista
**Take with food, cannot take with sulfa |
|
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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 |
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Term
| What protease inhibitor has the abbreviation TPV? |
|
Definition
Tipranavir/Aptivus
**Take with food, cannot take with sulfa |
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|
Term
| What NRTI has the abbreviation ABC? |
|
Definition
Abacavir/Ziagen
**Goes through alcohol dehydrogenase in the liver |
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|
Term
| What NRTI has the abbreviation FTC? |
|
Definition
Emtricitabine/Emtriva
**An isomer of lamivudine, do not give together |
|
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Term
| What NRTI has the abbreviation 3TC? |
|
Definition
|
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Term
| What NRTI has the abbreviation TDF? |
|
Definition
Tenofovir/Viread
- Present in combivir
- Causes severe myalgia, nephrotoxic |
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Term
| What NRTI has the abbreviation AZT/ZDV? |
|
Definition
Zidovudine/Retrovir
**Very bad fatigue and malaise |
|
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Term
| What nNRTI has the abbreviation EFV? |
|
Definition
Efavirenz/Sustiva
- specific AE: Abnormal dreams, cannot give in 1st trimester, high TGs |
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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 |
|
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Term
| What nNRTI has the abbreviation RPV? |
|
Definition
Rilpivirine/Edurant
**Needs acid, do not give with PPIs |
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|
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 |
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|
Term
| What nNRTI produces drowsiness/bad dreams, and CANNOT be given in the first trimester of pregnancy? |
|
Definition
|
|
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
|
|
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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