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Flashcards in Anti-HIV therapy Deck (30):
1

what is considered a low risk of progression viral load?

<5000 copies/mL

2

what is considered high risk of progression viral load?

>30K-40K copies/mL
-likely to have drug resistant species

3

What are baseline labs to order when presented with HIV pt?

HIV test (western blot)
HIV antibody test (ELISA)
CD4 count
CBC, LFT
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

4

what is category A HIV?

asymptomatic dz
persistent generalized lymphadenopathy
acute/primary HIV illness

5

what is category B HIV?

symptomatic
-persistent candidiasis
-fever, diarrhea
-going below 200 CD4 count

6

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

7

when does CDC recommend using HAART>

all AIDS pts regardless of CD4 count
asymptomatic pts with CD4 counts below 350

8

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

9

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

10

what are the NRTIs that are used most?

abacavir
emtricitabine
tenofovir

11

what combo NRTIs are most used?

Truvada
Atripla
-reduces the pill burden

12

which NNRTIs are most used?

nevirapine
efavirenz,
etravirine
rilpivirine

13

which protease inhibitors are used most?

kaletra,
reyataz, atazanavir

14

what is the integrase inhibitors?

raltegravir (isentress)

15

what is the main fusion inhibitor?

enfuvirtide (injectable)

16

what is the number one preferred NNRTI regimen combination drug?

atripla

17

what is preferred PI based regimen combination for pregnant women?

lopinavir/ritonavir (BID) + zidovudine + lamivudine

18

what is a ritonavir boosted regimen?

ritonavir blocks liver metabolism of other drug so the other drug can stay around longer

19

what does the INSTI based regimen include?

raltegravir + TDF/FTC

20

which class of HIV drugs require renal adjustments?

NRTI except for abacavir

21

what side effects do NRTIs have?

lactic acidosis
hepatomegaly
steatosis

22

what side effects does zidovudine have?

anemia
nausea
HA

23

what side effects does tenofovir have?

renal issues

24

what side effects do didanosine and stavudine have?

mitochondrial toxicity

25

which nuc drug combinations are not given?

AZT, D4T
DDI/D4T
AZT/DDI
TDF/DDI
don't use didanosine

26

what side effects does efavirenz have?

category X, CNS problems, rash, must take on empty stomach

27

what side effects does have nevirapine?

hepatotoxicity
f must have CD4 <400

28

what are major toxicities of PI class of drugs?

metabolic toxicities (ie hyperlipidemia, osteoporosis)
all are CYP450 substrates and have many drug interactions

29

when should PIs be taken?

with food

30

when should NNRTIs and nucs be taken>

on an empty stomach

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