hiv review from quiz Flashcards
(39 cards)
HIV Testing
As HIV progresses
- CD4 count( goes down )
- Viral load (Increase) is indicator of how well drug is working, as it should go down with drug therapy. HIV tx regimen reduce viral load to undetectable
- **gentic resistance testing **(means mutation or changes to genetic struct of HIV has occurred making virus resistant to certain med. mutation cause virus to replicated despite pt being on drug therapy
cd4 count of 192 with no allergy, what reccomendation you can make for prevention of opportunistic infection
Bactrim DS PO qd
opportunist infection
PCP
pneumocytosis pneumonia-
- CD4 <200
- DOC: Bactrim DS PO QD
- sulfa allergy: Dapsone, pentamidine or atovaquone (Mepron)
atovaquone
Mepron
opportunist infection
Toxoplasmosis
CD4< 100
DOC : Bactrim DS PO QD
Sufla:
-dapsone with pyrimethamine/Leucovorin
- Atovaquone
opportunist infection
Macobacterium Tuberculosid
CD4<50
Prophylaxis for Mac not recommended in pts with HIV on ART
- Only prevention given if they are not on ART and CD4<50
DOC:
- Azithromycin 1200mg once weekly
- Clarithromycin 500mg BID
Propylaxis agaoint toxoplasma only performed if in high endemic area
if
pt with cd4 45 and not on anteretroviral therapy. Pt does not live in high endemic area pt. is not seropositive for any opportunistic infection
Propylaxis against toxoplasma only performed if in
- high endemic area
- if pt. is seropositive
seropositve mean
- having or being a positive serum reaction especially in a test for the presence of an antibody.
- endemic: regularly occurring within an area or community.
Pneumocytosi jiroveci (PCP)
causes
PPX
TX
causes: fever, dry cough, sob, nighsweats
PPX: Bactrim DS PO QD
**Tx: Bactrim+ prednisone X 21 days **
Toxoplasmosis
PPX
TX
PPX: bactrim DS PO QD
sulfa allergy:
- atovaquone or
- dapsone + pyrimethamine/leucovorin
Treatment:
- sulfadiazine + pyrimethamine + leucovorin
leucovorin to protech against vit b def from pyrimethmine
Sulfadiazine
CMV TX
Ganciclovir (Cytovene)-
- IV , renal, seizure
Valganciclovir (prodrug of ganciclovir)
- Oral, renal
**Cifodovir **(vistide):
- IV, renal, neutropeia
**Foscarnet **(Foscavir):
- iV, seizrue, nephrotox
entry inhibitors
**cd4 receptor **
CCR5 or Cxcr4 co-receptor
NRTI
NNRTI
reverse transcriptaste Inhib
ZALES- DT
Intergrase Inhib
gravir
Protease Inhib
“navir”
lanD FirsT
B- D O G
A- T C S
Truvada: et - emtricitabine +TDF
Complera: ret- Rilviprine+ emtricita+ TDF
Stripla: ceet: colbi+emtricit+eletgravir+TDF
Atripla: et- Emtricit+ TDF + efavirenz
Descovy: et- emtricitabine + TAF
Odefsey: ret- Rilpiv +emtricit+ TAF
Genvoya: ceet: Colb+emtric+eltegrav+ TAF
Biktary: et- Emtricit+ TAF+ bictegravir
Symtuza: et- emtrict+TDF+ colb+ darunavir
efavirenz (sustiva)
rilpivrine ( edurant)
B- D O G
A- T C S
truvada : crcl< 30
complera: Crcl < 50
Strbild Crcl< 70
DOG crcl< 30
Atripla: empty stoma (efavirenz)
Odefsey: with food
Symtuza: with food
stribild: with food
Genvoya : with food
Julaca
dolutegravir + rilpivrine
- with food
- stepdown therapy
dovato
2 drug regimen
- dolutegravir + lamivudine
Cabenuva
Cabotegravir+ rilpivirne
- IM once monthly
- gluteal admin
- 2 inj : 1 cabotegravir+ 1 rilpivrine
Epzicom
Triumeq
Trizivir
Epzicom-Abacavir + lamivudine
triumeq: abacavir+lamivudine+dolutegrav
Trizivir: abacavir+lamivudine+ zidovudine
combivir
zidovudine + lamivudine
bactrim
- can be give to rena dysf pt but dose ajust
- cuase BMS (myelosupression)
NRTI SE
LHR
- L : lactic acidosis
- H: Hepatic steatosis (fat in liver)
- R: renal
Zidovudine
- causes myopahty
- cause myelosupression ( anemia and neutropenia) give epogen, darasnep for anemia and filgrastim, pegfigrastim for Neutropenia
- IV
- LHR
- take with food to dec nausea
- Pregnancy : doc
