Flashcards in Anti-HIV therapy Deck (30)
what is considered a low risk of progression viral load?
what is considered high risk of progression viral load?
-likely to have drug resistant species
What are baseline labs to order when presented with HIV pt?
HIV test (western blot)
HIV antibody test (ELISA)
SCr, BUN, electrolytes
lipids and blood glucose (if suspect DM)
STD and Hep panals
Plasma HIV RNA if VL > 1000 to determine genotype of HIV
what is category A HIV?
persistent generalized lymphadenopathy
acute/primary HIV illness
what is category B HIV?
-going below 200 CD4 count
what is category C? full blown AIDS
CD4s well below 200
symptoms caused by opportunistic infections
-KS, CMV, HSV, PCP, MAC
-usually have a few months to live
when does CDC recommend using HAART>
all AIDS pts regardless of CD4 count
asymptomatic pts with CD4 counts below 350
what should an HIV pt get with CD4 counts between 350 and 500?
A2 recommended HAART therapy (moderate strength)
-good evidence suggests that you should start
what should an HIV pt get with CD4 counts above 500?
B3 recommended HAART therapy (weak)
-no good evidence suggests that this therapy will help
what are the NRTIs that are used most?
what combo NRTIs are most used?
-reduces the pill burden
which NNRTIs are most used?
which protease inhibitors are used most?
what is the integrase inhibitors?
what is the main fusion inhibitor?
what is the number one preferred NNRTI regimen combination drug?
what is preferred PI based regimen combination for pregnant women?
lopinavir/ritonavir (BID) + zidovudine + lamivudine
what is a ritonavir boosted regimen?
ritonavir blocks liver metabolism of other drug so the other drug can stay around longer
what does the INSTI based regimen include?
raltegravir + TDF/FTC
which class of HIV drugs require renal adjustments?
NRTI except for abacavir
what side effects do NRTIs have?
what side effects does zidovudine have?
what side effects does tenofovir have?
what side effects do didanosine and stavudine have?
which nuc drug combinations are not given?
don't use didanosine
what side effects does efavirenz have?
category X, CNS problems, rash, must take on empty stomach
what side effects does have nevirapine?
f must have CD4 <400
what are major toxicities of PI class of drugs?
metabolic toxicities (ie hyperlipidemia, osteoporosis)
all are CYP450 substrates and have many drug interactions
when should PIs be taken?