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44 Cards in this Set
- Front
- Back
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Maraviroc (MVC) |
CCR5 antagonist/Coreceptor blocking Coverage: -HIV Adverse: -none Other: -inactive against CXCR4-tropic virus (requires Trophile test) -maybe some P450 3A4 interactions |
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Enfuvirtide (ENF, T-20) |
FUSION INHIBITOR binds gp41 spike and prevents conformational changes required for fusion Coverage -HIV Adverse: -injection site reactions Other: -SUBQ INJECTION -36 AA peptide -high antiviral potency |
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Tenofovir + Emtricitabine (TDF/FTC) |
NRTI pair (nucleoside analog RT inhibitor) Coverage -HIV -HBV Adverse -nephrotoxicity -BM toxicity -NRTI MITO toxicity at high levels (neuropathy, myopathy, lactic acidosis/hepatic steatosis, pancreatitis, lipoatrophy) |
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Abacavir + Lamivudine (ABC/3TC) |
NRTI pair (nucleoside analog RT inhibitor) Coverage -HIV -Lamivudine alone used for Hep B Adverse -T4 hypersensitivity in HLA-B57 (DO NOT GIVE) -cardiovascular risk -NRTI MITO toxicity at high levels (glove/stocking neuropathy, myopathy, lactic acidosis/hepatic steatosis, pancreatitis, lipoatrophy) Other -INFERIOR option when viral load >100,000 |
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Efavirenz (EFV) |
NNRTI (non-nucleoside analog RT inhibitor) Coverage -HIV Adverse -CNS! vivid dreams, insomnia, hallucinations -NOT for suicidal/depressed -RASH/STEVENS-JOHNSON -teratogenic, not for moms -hepatotoxic Other -LONG HALF LIFE! must be given to COMPLIANT Pt to avoid monotherapy -may give FALSE POSITIVE WEED TEST -some P450 interactions |
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Rilpivirine (RPV) |
NNRTI Coverage -HIV Adverse -RASH/STEVENS-JOHNSON -depression/insomnia/HA -hepatotoxic -teratogenic Other -LONG HALF LIFE! must be given to COMPLIANT Pt to avoid monotherapy -some P450 interactions |
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Atazanavir (ATV) |
Protease Inhibitor Coverage -HIV Adverse -asymptomatic HYPERBILIRUBINEMIA (Pt will complain of yellow eyes if not warned) -nephrolithiasis -General PI (metabolic syndrome, N/diarrhea, central fat redistribution) Other -Lipid sparing (unlike other PI) -resistance through POL mutation (codes PI) |
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Lopinavir (LPV) |
Protease Inhibitor Coverage -HIV Adverse -General PI (metabolic syndrome, N/diarrhea, central fat redistribution) Other -always with RTV or COBI booster -resistance through POL mutation (codes PI) |
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Darunavir (DRV) |
Protease Inhibitor Coverage -HIV Adverse -Hepatotoxicity -Skin rash: erythema multiforme and Stevens-Johnson -General PI (metabolic syndrome, N/diarrhea, central fat redistribution) -resistance through POL mutation (codes PI) |
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Dolutegravir (DTG) |
Integrase Inhibitor Coverage -HIV Adverse -RHABDOMYELYSIS -HA -insomnia -rash/hypersensitivity -resistance by POL mutation (codes Integrase) Other -coformulate with ABC/3TC |
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Elvitegravir (EVG) |
Integrase Inhibitor Coverage -HIV Adverse -RHABDOMYELYSIS -decreased CrCl -increased risk of TDF-nephrotoxicity -N/diarrhea -resistance by POL mutation (codes integrase) Other -coformulated with TDF/FTC/COBI "quad pill"; requires CONSTANT RENAL MONITORING |
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Ritonavir (RTV) |
Pharmacokinetic Booster Primarily inhibit 3A4 Also protease inhibitor Use -HIV -HCV Adverse -no direct, but need to monitor drug interactions Other -doubles as protease inhibitor, although little therapeutic function at PK doses |
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Cobicistat (COBI) |
Pharmacokinetic Booster Decreases CrCl (without affecting GFR) Uses -HIV Adverse -not for patients with GFR<70 ml/min (jaundice, rash, ocular icterus, N) |
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Acyclovir (ACV) (Valacyclovir) (Famciclovir) |
Nucleoside DNA Pol Inhibitor Uses -HSV -VZV -EBV -NOT CMV!! Adverse -occasional acute renal failure (crystals) -rare neurotoxicity Other -POOR ORAL BIOAVAILABILITY (5x/day for PO) -VALACYCLOVIR: 5x oral bioavailability -FAMCYCLOVIR: increased bioavailability -requires viral THYMIDINE KINASE to activate; resitance via absent TK or altered DNA Pol |
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Ganciclovir (Valganciclovir) |
Guanosine analog Converted by CMV UL97 Kinase Uses -CMV!! -other herpes Adverse -BM suppression (thromobocytopenia, leukopenia) -Potential renal toxicity Other -resistance via UL97 kinase -resistance via DNA Pol mutations -IV ganciclovir for severe CMV and ocular -PO Valganciclovir for maintenance/proph. |
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Foscarnet |
Pyrophosphate analog, inhibits viral DNA Pol Uses -resistant CMV, HSV, VZV Adverse (VERY TOXIC) -Renal insufficiency 27% -electrolyte abnormalities -seizures -anemia -nausea Other -resistance via CMV UL54 (DNA Pol) -no resistance via TK or UL97 (since it binds DNA Pol directly) |
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Cidofovir |
Nucleotide analog (no viral kinase required) Uses -resistant CMV, HSV Adverse (VERY TOXIC) -Nephrotoxicity -N/V -Neutropenia (20%) |
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Oseltamivir (PO) Zanamivir (Inhaled) Peramivir (IV) |
Neuraminidase Inhibitors Uses -Influenza Adverse -OTV: N/V in 15%, rare peds. psychiatric -ZNV: LUNG DISEASE safety concerns -PRV: Diarrhea 8%, rare T4 hypersensitivity Other -Limited emergent resistance |
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Lamivudine |
NRTI Uses, -HBV Adverse -well tolerated |
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Adefovir |
NRTI Uses -monotherapy for LMV-resistant HBV Adverse -HA, abdominal pain |
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Entecavir |
NRTI Uses -LMV-resistant HBV -decompensated cirrhosis Adverse -HA, cough, fatigue Other -little resistance (1% 5-year rate) |
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Harvoni (Sofosbuvir and Ledipasvir) |
Sofosbuvir= NS5B NRTI Ledipasvir= NS5A inhibitor Coverage -HCV (genotype 1) Adverse -Fatigue, HA, nausea, -insomnia -not for ESRD patients |
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Veikira (Paritaprevir/Ritonavir, Ombitasvir, Dasabuvir) |
Paritaprevir= NS3 Protease inhibitor Ritonavir= PK booster Ombitasvir= NS5A inhibitor Dasabuvir= NS5B NNRTI Coverage -HCV Adverse -Fatigue, HA, N/D -insomnia -skin reaction -contraindicated in SEVERE LIVER DISEASE -FINE FOR ESRD!! |
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PEG-IFN (SQ or IV) |
Coverage -HBV -HCV Adverse (SEVERE TOXICITY) -Neutropenia/thrombocytopenia -Depression, anxiety -HA, fatigue, rigors, fever -alopecia -N/V/D, anorexia |
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Ribavirin (PO) |
Inhibits DNA/RNA viral replication Coverage -HCV Adverse -HEMOLYTIC ANEMIA -MI -teratogenic -fatigue, HA, fever |
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Artemisinins |
Artemether and Artesunate (anti-malarials) Coverage -PLASMODIUM FALCIPARUM (artemisinin combination therapy ACT is the first line malarial treatment worldwide) -other plasmodia Adverse -well tolerated Other -Very effective but very SHORT HALF-LIFE (often given with other longer lasting drugs) -Given PO for uncomplicated malaria and IV for severe malaria |
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Quinidine (IV, IM, or PO) |
Coverage -all plasmodia Adverse -CINCHONISM (severe headache and tinnitus) Other -given with DOXY (or CLINDA if child <8yrs) -longer half life than artesunate |
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Atovaquone-proguanil (Malarone) |
Coverage -Plasmodium, often for prophylaxis Other -CANNOT BE USED for treatment in patients who have EVER received Malarone for prophylaxis -Chewable tablets (for kids) |
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Chloroquinalone plus Primaquine |
Coverage -P. vivax and P. ovale (PRIMAQUINE is REQUIRED for the elimination of HYPNOZOITES in the liver) Adverse -hemolysis and anemia in patients with G6PD deficiency (must check BEFORE administering!) |
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TMP-SMX |
Coverage -Cyclospora -PREVENT Toxo in HIV when CD4<100 -PREVENT Pneumocystis in HIV when CD4<200 |
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Nitazoxinide |
Coverage -Cryptosporidosis in immunocompetent pts -Giardiasis |
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Metronidazole and Tinidazole (used separately, indentical coverage) |
Coverage -Extraintestinal Entamoeba histolytica (Amebic dysentary) -Giardiasis -Trichomonas |
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Paromomycin |
Coverage -Lumenal Entamoeba histolytica (Amebic dysentary) |
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Sodium Stibogluconate IV (pentavalent antimony) |
Coverage
-Cutaneous or mucosal Leishmaniasis |
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Liposomal Amphotericin B |
Coverage -VISCERAL Leishmaniasis |
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Miltefosine (PO) |
Coverage -Cutaneous, Mucosal, AND Visceral Leishmaniasis |
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Pyrimethamine sulfadiazine |
Coverage -Toxoplasmosis in living (not for fetus) |
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Spiramycin |
Coverage -Fetal Toxoplasmosis |
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Benznidazole |
Coverage -Acute Chagas (Trypanosoma cruzi) |
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Albendazole |
Coverage -Ascariasis -Enterobius vermicularis (pinworm) -Ancyclostoma duodenale (hookworm) -Necator americanus (hookworm) -Toxocara canis (visceral larval migrans) -Taenia soleum cysticercosis -Trichuria trichiuria (whipworm) |
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Mebendazole |
Coverage -Ascariasis -Trichinosis -Trichuria trichiuria (whipworm) |
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Praziquantel |
Coverage -Schistosoma -Taenia saginata (beef) |
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Ivermectin |
Coverage -Onchocerciasis -Strongylodiasis -Wucheria bancrofti (lymphatic filariasis) -Brugia malayi (lymphatic filariasis) |
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Diethylcarbamazine (DEC) |
Coverage -Wucheria bancrofti (lymphatic filariasis) -Brugia malayi (lymphatic filariasis) |
