Infectious Disease Flashcards
(49 cards)
When to start HIV therapy based on CD4 count
<500, or in pts w/ detectable viral load even if CD4 >500, or symptomatic pts w/ any CD4 count or viral load
Which pregnant pts should be treated for HIV?
All of them, any stage of pregnancy, any CD4 count.
Protease inhibitor suffix and major side-effects
-navir. hyperglycemia, hyperlipidemia.
Integrase inhibitor suffix and MOA
Suffix: -gravir (raltegravir, elvitegravir, dolutegravir)
MOA: prevents HIV genome from being incorporated into CD4 cell
Efavirenz (class & s/e)
non-nucleoside RTI
avoid in pregnancy and mental illness. More prone to drug resistance.
nevirapine (class)
non-nucleoside RTI
etravirine (class)
non-nucleoside RTI
rilpivirine (class)
non-nucleoside RTI
Non-nucleoside RTI side effects
drowsiness.
Avoid in mental illness.
Zidovudine - class & s/e
nucleoside RTI
anemia
Didanosine - class & s/e
nucleoside RTI
pancreatitis and peripheral neuropathy
Stavudine - class & s/e
nucleoside RTI
pancreatitis and neuropathy
Lamivudine - class and s/e
nucleoside RTI
no s/e
Abacavir - class & s/e
nucleoside RTI
rash (HLA B5701 - test for mutation prior to starting)
Emtricitabine - class
nucleoside RTI
tenofovir - class & s/e
nucleoside RTI
renal toxicity/RTA (disoproxil form), bone demineralization
Maraviroc - class
blocks CCR5 (where GP120 attaches for HIV to enter human cell)
Standard of care for HAART
two nucleoside RTI and an integrase inhibitor
Preexposure ppx
2-drug combo of tenofovir and emtricitabine before exposure
Post-exposure ppx (needlestick, unprotected sex)
ART for a month, start w/in 72hrs of exposure.
2 nucleoside RTIs and an integrase inhibitor (do not use abacavir b/c HLA test not immediately available.
PCP ppx - when to start. what meds
Bactrim. Atovaquone or dapsone if rash develops.
Start for CD4 <200
MAC ppx
CD4 <50
Azithromycin one a week oral
PCP Clinical presentation
Dry cough, SOA, hypoxia, increased LDH
PCP CXR
CXR w/ b/l interstitial infiltreates
