HIV - Drugs/ADEs Flashcards Preview

Pass Naplex Now Book II > HIV - Drugs/ADEs > Flashcards

Flashcards in HIV - Drugs/ADEs Deck (44):
1

Protease Inhibitors
- SEs
- DDIs

SEs
- N/V/D/Flatulence
- Lipodystrophy - SQ fat wasting
- Hyperglycemia/insulin resistance
- Hyperlipidemia: avoid lovastatin & simvastatin
- Hepatotoxicity
- Incr transaminase elevation
- Incr risk of myocardial infarction
- Incr bleeding

DDIs
- 3A4 Inhibitors

2

Indinavir - Crixivan

- SEs
- How to take it
- Contact MD if
- Storage

- Kidney stone = nephrolithiasis
- Take on empty stomach or light meal
=> Drink > 1.5L of water/d
- Contact MD if FLANK pain
- Storage: very sensitive to moisture. MUST store in desiccant in container. W/o desiccant, capsules are good for 3 days

3

Kaletra

- Forms
- Storage
- Take with
- Which contain EtOH

Lopinavir + Ritonavir

Film coated tablet
- With or w/o food
- DO NOT REFRIGERATION

PO Sol'n
- With Food
- Refrigeration
=> throw away after 2 mo if @ RT
- Contain 42% EtOH

4

With Food

- All PI except Indinavir
- Zidovudine - Retrovir
- Rilpivirdine - Edurant
- Tenofovir - Viread
- Fosamprenavir - Lexiva: PO susp in children
- Complera - Emtricitabine + Tenofovir + Rilpivirine
- Stribild: Elvitegravir + cobicistat + emtricitabine + tenofovir disoproxil fumarate
- Ganciclovir - Cytovene

5

Kaletra - Lopinavir + Ritonavir

- SEs

- Pancreatitis
- Severe migraine like HA
- Rash

6

Contain Alcohol

- Kaletra - Lopinavir + Ritonavir: Susp Sol'n
- Ritonavir - Norvir
- Tiprinavir - Aptivus

7

Cause explosive diarrhea

- Nelfinavir - Veracept

8

Refrigeration
- Kaletra - Lopinavir + Ritonavir:
- Ritonavir - Norvir:
- Retrovir - Zidovudine:
- Tiprinavir - Aptivus:
- Emtricitabine - Emtriva:
- Enfuvirtide - Fuzeon:
- Didanosine - Videx:
- Viracept - Nelfinavir:
- Stavudine - Zerit:

- Kaletra - Lopinavir + Ritonavir: Susp Sol'n
- Ritonavir - Norvir: Cap needs fridge => OFF THE MARKET but not sol'n
- Retrovir - Zidovudine: Use dilution w/in 8H if refrigerated
- Tiprinavir - Aptivus: Cap fridge b/4 use
- Emtricitabine - Emtriva: Oral sol'n. At RT, use w/in 3M
- Enfuvirtide - Fuzeon: Fridge reconstitution sol'n & use w/n 24H
- Didanosine - Videx: Ped powder after mixing, refrigerate & use w/in 1M
- Viracept - Nelfinavir: PO powder if not use, need fridge
- Stavudine - Zerit: PO powder after reconstitute, need to fridge

9

Ritonavir - Norvir
- SE
- Storage

SEs
- Severe GI => taper up to prevent n/v
- Paresthesias: numbness
- Hyperlipidemia: highest among all PIs

Storage
- Cap: refrigerate or @ RT 30 days
- So'n/tablet: no refrigerate

10

Which drug contains:
Contain lactose => increase frequency of GI SEs

Saquinavir (Invirase)

11

Saquinavir (Invirase)
- SEs
- CI

SEs
- Contains lactose => increase GI SE
- HA
- Fatal hepatotoxicity
- Life threatening cardiac when used w/ Norvir

CI
- Rifampin => severe hepatotoxicity

12

Fatal hepatotoxicy

- Saquinavir (Invirase)
- Tiprinavir - Aptivus

13

Tiprinavir - Aptivus
- SEs
- CI
- BBW

- Fatal hepatotoxicity
- Intracranial bleeding
- Sulfa, rash
- Hemophilia

CI
- Hepatic failure

BBW
- Intracranial hemorrhage
=> It's imp to report any unusual bleeding especially if they are taking any blood thinner

14

A Prodrug

FoSAMprenavir (Lexiva)
- Prodrug of amprenavir

15

FoSAMprenavir (Lexiva)
- SEs

- Steven Johnson
- Rash
- Sulfa allergy
- Hemophilia
- Depression

16

Drugs cause hemophilia

- Tiprinavir - Aptivus
- FoSAMprenavir (Lexiva)

17

The only PI that has not been ass with increases in TC or fasting TG

Atazanavir - Reyataz

18

Protease Inhibitors
- Inhibitor of which CYP 450
- What need to monitor Q3M

- Inhibitor of 3A4

Monitor Q3M
- LFT
- Glucose
- Cholesterol
- Look for fat redistribution

19

Abavavir - Ziagen
- SEs
- Generic Screening for

SEs
- Severe hypersensitivity => can be fatal HLA B5701
- Lactose acidosis

Generic screen
- HLA-B5701

20

Empty Stomach

- Indinavir - Crixivan
- Didanosine - Videx
- Efavirenz - Sustiva
- Fosamrenavir - Lexiva: oral susp in adults
- Atripla - Efavirenz + Emtricitabine + Tenofovir

21

Didanosine - Videx
- SEs

=> DAN Pham
- Pancreatitis
- Peripheral neuropathy
- Retinal Pigmentation
- Lactic acidosis

22

Cause eye problem

- Didanosine - Videx

23

Zidovudine - Retrovir

- SEs = do = red

=> Take with food to decrease nausea

- Myelosuppression
=> Anemia: Epogen
=> Neutropenia: Neupogen
- Purple toe
- HA
- Myopathy
- Lactic acidosis

24

Emtricitabine - Emtriva

- SEs

- Lactic acidosis
- Flare up hepatitis B
- Darkening of palm and soles which will resolve

25

NRTI
- Class SEs
- Without food
- With food

Class SEs
- HA
- Lactic acidosis, hepatic steatosis

Without food
- Didanosine - Videx => at least 1H prior/2H after meal

With food
- Zidovudine - Retrovir to decrease N/V
- Tenofovir - Viread

26

NNRTI
- Class SEs

SEs
- Rash
- Hepatotoxicity

=> All take with foods

27

False cannabinoid test

- Efavirenz - Sustiva

28

Tenofovir - Viread
- SEs

- Lactic acidosis
- Hepatotoxicity
- Renal: acute renal failure/Fanconi syndrome

29

Fanconi syndrome

- Tenofovir - Viread
- Elvitegravir (part of Stribild)

30

Abacavir & Tenofovir
- Which class

- NRTI

31

Pregnant patient

- Zidovudine: 300 mg PO BID or 200 mg PO TID

32

During label

- Zidovudine: 2mg/kg IV LD in 1H => 1mg/kg continuous infusion

33

Infant

- Zidovudine syrup: 2mg/kg PO Q6H for 1st 6 weeks of life
- Starting within 8-12H of life

34

DO NOT COMBINE

SEE BOOK PG 15 HIV

35

Recommend regimen for post-exposure prophylaxis

- Truvada + Raltegravir

36

Recommend Vaccination

- Hep A
- Hep B
- Influenza
- Pneumococus
- DPT
- MMR: NOT OK w/ AIDs but ok w/ asymptomatic HIV with CD4 > 200

37

Vaccination NOT rec

- Varicella - Varivax
- Smallpox vaccine
- Live influenza (FluMist)
- HPV for W < 26 y.o
- Attenuated Polio but inactivated polio is OK

38

Pneumocystis Pneumonia (PCP)
- DOC
- Alternative
- Sulfa allergy

DOC
- Bactrim + Prednisolone x 21d

Alternative
- Dapsone + Pentamidine + Leukovorin

Sulfa allergy
- Clinda + Primaquine + Prednisone x 21d

39

Toxoplasmosis
- 1st line:
- Alternative:

1st line
- Bactrim 1 DS PO QD

Alternative: Combo of 3 drugs
- Pyrimethamine (Daparim): Inhibits parasitic dihydrofolate reductase
- Leucovorine
- Sulfadiazine - Dapsone

40

MAC
- DOC

Macrolides
- Clarithromycin 500 mg PO BID
- Azithromycin 1200mg PO QW

41

M. Kansasii
- DOC

=> Same as MAC

Macrolides
- Clarithromycin 500 mg PO BID
- Azithromycin 1200mg PO QW

42

Treatment of CMV

- Foscarnet - Foscarvir: Nephrotoxic, seizure
- Ganciclovir - Cytovene: Renal, sz
- Ganciclovir implants - Vitrasert:
- Cidofovir - Vistide: Renal
- Fomivirsen - Vitravene

43

Treatment regimen for latent PPD+

- INH (isoniazid) 300 mg + Pyridoxime (vit B6) 50 mg PO QD x 9M

OR

- INH 900 mg PO + Pyridoxine 100 mg BW x 9M

44

Treatment for diarrhea caused by:
- Salmonellosis
- Campylobacteriosis
- Shigellosis

- Salmonellosis
DOC: Ciprofloxacin x 2-4wks. May continue QD thereafter

- Campylobacteriosis
Azithromycin or cipro x 7d

- Shigellosis
DOC: quinolones