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NAPLEX review 2024 RXPrep Book > Human Immunodeficiency Virus > Flashcards

Human Immunodeficiency Virus Flashcards

1
Q

AIDS diagnosed when…

A

CD4 count > 200 or patient has an AIDs-defining condition

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2
Q

HIV transmission

A

Direct contact with blood, semen, vaginal or rectal secretions or ingestion of breast milk.

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3
Q

High risk indicators for HIV are….

A

Sharing drug injection equipment
High risk sexual behavior: MSM, multiple partners, hx of STIs
Hx of hepatitis or TB infection

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4
Q

HIV antibody testing

A

can be detected in people 4-12 weeks after getting disease, but can take up to 6 months

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5
Q

OraQuick Test

A

OTC test that tells you instantly
have to get follow up test with HCP
should be used > 3 months after exposure, if sooner can be false negative

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6
Q

Which drug is CCR5 antagonist

A

Maraviroc

CCR5 co-receptor on CD4 cell that HIV stages to

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7
Q

Which drug is attachment inhibitor

A

fostemsavir

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8
Q

Which drug is a post-attachment inhibitor

A

ibalizumab-uiyk

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9
Q

Which drug is a fusion inhibitor

A

enfuvirtide

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10
Q

Which drugs are nucleoside reverse transcriptase inhibitors (NRTIs)

A

emtricitabine
tenofovir

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11
Q

Which drugs are non-nucleoside reverse transcriptase inhibitors (NNRTIs)

A

efavirenz
rilpivirine

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12
Q

Which drugs are Integrase strand Transfer inhibitors (INSTIs)

A

Bictegravir
Dolutegravir
Raltegravir

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13
Q

Which drugs are protease inhibitors (PIs)

A

Atazanavir
Darunavir

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14
Q

Which allele do you test for if considering using abacavir?

A

HLA-B*5701

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15
Q

Which assay do you perform if considering using maraviroc?

A

Tropism assay

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16
Q

Preferred initial ART treatment

A

Biktarvy, Triumeq, Dovato = 1 single pill

Tivicay + Descovy/Truvada = 2 pills once daily

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17
Q

Triumeq should not be taken if test for….

A

HLA-B*5701

contains abacavir

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18
Q

Which HIV meds should not be used if CrCl < 30

A

Biktarvy, Triumeq, Dovato, Truvada and Descovy

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19
Q

Which HIV medication is given IV to mother to protect baby?

A

Zidovudine

in patients with unknown HIV RNA lvl or > 1,000

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20
Q

list of NRTIs

A

Abacavir
Emtricitabine
Lamivudine
TDF
TAF
Zidovudine

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21
Q

Warnings for All NRTIs

A

lactic acidosis and hepatomegaly with fatty liver

all can cause N/D/HA inc LFTs

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22
Q

Emtricitabine side effecrts

A

hyperpigmentation of palms of hands or soles of feet

23
Q

TDF has higher risk for….

A

renal impairment
dec bone mineral density

24
Q

Abacavir boxed warnings

A

boxed warning for hypersensitivity reaction

Avoid with CVD due to inc risk of MI

25
Q

List of INSTIs

A

BRED

Bictegravir (in Biktarvy combo)
Raltegravir (Isentress)
Elvitegravir (In Genvoya/Stribild combo)
Dolutegravir (Tivicay)

26
Q

CrCl cut off for Stribild?

A

< 70 dont start
< 50 d/c

27
Q

CrCl cut off for Biktarvy and Genvoya

A

Dont start < 30

28
Q

Cabotegravir IM injection indicated for…

A

PrEP

29
Q

Cabotegravir PO is only used for….

A

lead in treatment before starting combo injection w/ rilpivirine

30
Q

Which drug is preferred in pregnancy for HIV treatment?

A

Dolutegravir

31
Q

INSTI and cations should be separated by…..

A

2hra before or after aluminum, calcium, magnesium and iron containing products

Dolutegravir/Bictegravir can be taken with calcium/iron if taken with food also**

32
Q

List of NNRTIs

A

REDEN

Rilpivirine
Efavirenz
Doravirine
Etravirine
Nevirapine

33
Q

Rilpivirine additional info

A

req acidic environment, dont sue with PPI, and separate from H2RA/antacids

Take w/ meal and water

34
Q

Efavirenz additional info

A

food inc bioavailability and risk of CNS effect, take on empty stomach at bedtime

35
Q

Best way to remember PIs

A

End in -navir

36
Q

Info about all PIs

A

take with a booster (ritonavir or cobicistat)
no renal dose adjust
take w/ food to dec GI upset

37
Q

Atazanavir requires a XXXX gut for absorption

A

acidic

38
Q

Drug interactions with PI

A

too many to remember

39
Q

Which PI can be used as boosters

A

Ritonavir
Cobicistat - products containing this should be taken with food

dont use together, not interchangeable and have many drug interactions

40
Q

When can you use Maraviroc

A

When of tropism assay and if HIV strain only binds to CCR5 co-receptor.

If binds CXCR4 or CXCR4/CCR5 then cant use

41
Q

Fostemsavir is indicated in….

A

combination with other ARTs in heavily treatment-experienced patients who are failing current therapy

42
Q

Cabenuva has to be preceded by 1 month of….

A

cabotegravir to asses tolerability

43
Q

Stribild and Genvoya should be taken with….

A

food

44
Q

TDF contain treatments shouldn’t be started in CrCl below what?

A

< 50

45
Q

TAF contain treatments should be started in CrCl below what?

A

< 30

46
Q

Which NNRTI based therapy should be taken with food?

A

Complera and Odefsey

47
Q

Which NNRTI based therapy should be taken on empty stomach?

A

Atripla, Symfi, Symfi Lo

48
Q

Which ART require HLA-B testing?

A

Epzicom
Trizivir

49
Q

AIDs defining conditions?

A

Opportunistic infections
Kaposi’s sarcoma
HIV wasting syndrome - can use dronabinol and megestrol to stim appetite

50
Q

Immune reconstitution inflammatory syndrome

A

IRIS

unexpected worsening of underlying condition once starting ART or changing to more effective therapy regimen

symptoms can range from mild-severe but self limiting and ART should be continued

51
Q

If breastfeeding with HIV, you should….

A

replace with formula to not pass on HIV to child

52
Q

PrEP treatment options

A

90 day supply of Truvada or Descovy

Cabotegravir (Apretude) monthly for 2 doses, then every 2 months

53
Q

What to know before starting PrEP

A

confirm person is HIV negative
CrCl > 60 for Truvada or > 30 for Descovy
screen Hep B n STI

have to have HIV test before each refill

54
Q

oPEP

A

occupational post-exposure prophylaxis

usually HCP needle stick

Start within 72hrs, take for 28 days

HIV test at 4-6wk, 3 months and 6 months after exposure

NAPLEX review 2024 RXPrep Book (71 decks)

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