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125 Cards in this Set
- Front
- Back
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Which agent has been shown to flush HIV out of latent resevoirs?
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Valproic acid
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Which NRTI doesnt require renal adjustment?
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abacavir
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Tenofovir has been linked to what adverse affect?
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renal toxicity
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Which NRTI is most likely to cause lipoatophy?
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stavudine
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Which ARV exhibits increased levels (requiring dosage adjustment) with tenofovir? What is the adjusted dose?
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didanosine
250 > 60 kg 200 < 60 kg |
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Which ARV exhibits reduced drug levels (requiring norvir boost) with tenofovir?
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atazanavir
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What are concerns when dispensing efavirenz?
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teratogenic, mania warning
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Nevirapine hepatotoxicity is increased in what population?
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men with CD4 > 400
and women with CD4 > 250 |
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Which ARV requires increase in dosage when administered with efavirenz? what is the new dose?
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lopinavir/ritonavir
600/150 BID (3tabs) |
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What changed with Kaletra when it became available in tablet form?
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take less pills (3 to 2) and keep at room temp
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What cannot be administered with Reyataz due to acidity requirments?
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ppi
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What BBW does tipranavir carry?
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hepatotoxicity and intracranial hemmorage
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Which ARV when boosted with Norvir is a p glycoprotien inducer?
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tipranavir
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What toxicities are associated with chronic PI therapy?
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Insulin resistance, hyperlipidemia, lipoatrophy
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Which PI when not boosted has the lowest risk of hyperlipidemia?
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reyataz
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Which ARV is associated with SQ nodules?
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fuzeon
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Which NRTI should not be taken with food
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didanosine, unless with tenofovir
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GI effects and mitochondrial toxicity occur least with which NRTI?
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tenofovir
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What side effects are common to zidovudine?
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insomnia, bm suppression, anemia, myopathy
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hypersensitivity reaction?
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abacavir
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what are signs of mitochondrial dammage? what class?
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NRTIs... lactic acidosis, hepatic steatosis, p.n., myopathy, pancreatitis, and lipoatrophy
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which are the d-drugs and what should you keep in mind?
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stavudine and didanosine. dont use them together b/c of increased risk of hepatic steatosis, lactic acidosis, p.n. and pancreatitis
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what can treat facial lipoatrophy?
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sculptra (inj polylactic acid)
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What are 4 reasons to decrease didanosine's dose?
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weight based, renal function, + viread, and peripheral neuropathy
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which 2 NRTIs should never be adminitered do to treatment failure? which demonstrate LT failure?
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zidovudine and stavudine
tenofovir and abacavir |
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Which NRTIs are often used as salvage regimen?
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lamivudine or emtricitibine
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Which is the 2nd gen NNRTI? What makes it special?
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etravirine... it displays no cross resistance between other NNRTIs. It is reserved for resistant patients
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What is the preferred NNRTI for inital therapy?
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sustiva (efavirenz)
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What NNRTI is most commonly associated with hepatotoxicity and SJS?
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nevirapine (VIRAMUNE)
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What is unique about the t 1/2 life of NNRTIs?
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nevirapine and efavirez have such long half lives that it can lead to resistance if all medications are stopped at once, mimicking monotherapy.... or it can allow for poor adherance on patient's part
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What ARV impairs OC effectivness?
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nevirapine, PIs
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What drug should be avoided when taking viramune due to additive hepatotoxicity?
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rifampin
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What drug induces viramune metabolism?
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rifampin
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what happens when sustiva or viramune is administered with reyataz?
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boost reyataz with norvir
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Which PI is never boosted?
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nelfinair (viracept)
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how is kaletra taken? when is the dose increased?
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2 tablets twice a day... in naive patients it can be given 4 tabs QD but diarrhea is worse. in preggers, with sustiva or viramune... always take 3 tabs BID
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which PI is taken QD?
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reyataz... atazanavir
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Which PIs are associated with increased bili?
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Crixivan and Reyataz
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which PIs contain sulfonamide moitey?
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tipranavir and darunavir
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what is used for hypertriglyceridemia?
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gemfibrozil, fenofibrate or for resistant fenofibrate +fish oil
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what is used for hypercholesterolemia?
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pravastatin, low dose atorvastatin, or crestor
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What are the most potent PI cyp inhibitors?
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ritonavir and lopinair/ritonavir
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what is the weakest PI cyp inhibitor?
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saquinavir
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What is the dose for Didanosine
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400mg EC QD for > 60 kg
250mg EC QD for < 60 kg |
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What is the dose for Lamivudine?
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150mg BID or 300mg QD
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what is the dose for stavudine
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40mg BID> 60kg
30mg BID< 60kg |
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zidovudine dose
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300mg BID
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combivir dose
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300mg ZDV and 150mg 3TC BID
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Ziagen dose
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300mg BID or 600mg QD
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Trizivir dose
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300mg ABA and 300mg ZDV and 150mg 3TC
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Emtriva dose
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200mg QD
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Tenofovir dose
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300mg QD
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Truvada dose
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200mg FTC and 300mg VRD
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Epzicom dose
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300mg 3TC and 600 mg ABA
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which NRTIs cause anemia
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LAMIVUDINE AND ZIDOVUDINE, also combivir (both), epzicom (3TC), trizivir (both)
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Which NRTI causes hyperpigmentation?
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emtricitibine
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which NRTIs shouldnt be combined due to SEP?
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lamivudine/emtricitabine and didanosine/stavudine
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which NRTI is well tolerated with no DIs but displays increased resistance?
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lamivudine
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which is the only nucleotide RTI? what does that mean?
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tenofovir... better for those who are resistant to the "-tides"
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what is the dose for delaviridine?
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400 TID
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what is the dose for nevirapine?
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200mg QD x 14d and then BID
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what is the dose for intellence?
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200mg BID with a meal
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what is the dose for sustiva?
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600mg QD at HS on empty stomach or with a low fat meal to reduce SEP
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why is rescriptor not used much?
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TID dosing and BBW for liver toxicity
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which NNRTIs are inducers?
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nevirapine and efavirenz
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which NNRTI is an inhibitor?
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delaviradine
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what are common SEs of sustiva?
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dizzy drowsy pschosis CNS vivid dreams 48 hr hangover
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when can you use 2 NNTRIs together?
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NEVER!!!
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what is the dose for Fuzeon?
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T20 enfuviritide
90mg SQ BID |
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what is the dose for Selzentry?
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150mg BID with PI or delaviradine
300mg BID with tip/rtv, nevirapine 600mg BID with efavirenz |
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what is the dose for raltegravir (istentress)?
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400mg BID with or without food
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what is the dose for atripla?
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sustiva 600mg
FTC 200mg VRD 300mg taken HS on empty stomach |
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what is the main issue with selzentry?
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you must have a CRR5 tropic strand of HIV
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what BBW does selzentry have?
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hepatotoxicity
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what warnings does maraviroc have?
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increased risk for MI or postural hypotension
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what are common side effects of UK 427, selzentry?
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cough, fever, upper RTI, rash, abd pain, dizzy, muscoskeletal, rhabdo
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what has a DI with isentress?
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rifampin only, decreases isentress levels
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which drugs can be used with intellence?
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darunavir, kaletra, isentress, fuzeon, selzentry
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How is MK0518 (Isentress) metabolized?
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glucuronidation
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how is fuzeon metabolized?
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hydrolysis
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Is fuzeon, isentress, or selzentry affected by food?
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NO!!!
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Which D-drug isnt used any more?
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HIVID (zalcitabine)
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which drugs worsen anemia that comes with AZT?
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bactrim, gancylcovir, 3TC, chemotherapy
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Food increases absorption of which NRTI?
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viread (tenofovir)
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Which two drugs can increase ddI toxicity?
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viread and ribaviron
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Atazanavir interacts with HTN drugs?
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CCBS- decrease doses of diltiazem and verapamil
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How is OCP affected by PIs?
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EE levels drop... use back up method
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PIs decrease levels of which narcotic?
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methadone
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How does food affect the Crixivan?
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Decreases Abs
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which PI prolongs PR interval causing cardiac disturbances?
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reyataz
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which PI causes kidney stones?
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indinavir
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which PI causes rash?
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atazanavir, tipranavir, fosamprenavir, amprenavir
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what side effects seen with Fuzeon (other than inj site rxn)?
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constipation, pn, depression, pneumonia, loss of appetite, weakness
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what side effects seen with selzentry?
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pruritis, sweating, GI, rhabdo
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which statins are safe to take with ARV? (PIs)
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crestor, lipitor, pravachol
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when should you take 2 PIs together?
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NEVER!!
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what are the preferred and alternative choices for NNRTI?
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sustiva and then viramune
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what are the preferred NRTIs?
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VRD/FTC or ABA/3TC
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what are the alternative NRTIs?
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AZT/3TC or ddI/(3TC or FTC)
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what is the dose for indinavir?
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800mg BID w/100-200mg RTV
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what is the dose for nelfinavir?
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1250mg BID (2tabs)
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what is the dose for Saquinavir-HGC,SGC
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HGC- 1000/100mg BID (2 tabs)
SGC-1600/100mg QD |
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amprenavir dose
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600/100mg BID
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fosamprenavir dose
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exp:700/100mg BID
or for naive: 1400/100mg QD |
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kaletra dose
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400/100 BID (2 tabs)or 600/150 BID (3tabs) if given with sustiva/viramune
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tipranavir dose
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500/200 BID (2 caps)
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atazanavir dose
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400 QD (2caps) or 300/100 QD
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darunavir dose
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600/100 BID or 800/100 QD
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which PI causes oral parasthesia?
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norvir
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which is known for causing GERD?
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saquinavir
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what are darunavirs SEs?
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HA, cold, diarrhea, nausea
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which PI is refrigerated?
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tipranavir
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which PIs must be taken on empty stomach or with a light meal?
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indinavir
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which PIs must be taken with food?
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nelfinavir,ritonavir,saquinavir,tipranavir, atazanavir, darunavir
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which PI is taken with or without food?
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amprenavir, fosamprenavir
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What other interactions exist with Reyataz?
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Increased: amiodorone, warfarin, TCA, trazodone, flonase, clarithromycin, diltiazem, ED drugs
Decreased: EE |
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which drugs decrease effect of reyataz?
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ppi, antacids, h2 blockers, viramune, rifabutin
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what PIs are absorbed better w food?
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Ritonavir, Saquinavir, and Nelfinavir
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which NRTIs have generics?
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didanosine and zidovudine
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what drugs are CI with Reyataz? (14)
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Rifampin, Irinotecan, Triazolam, Midazolam, Dihydroergotamine,
ergotamine,ergonovine, methylergonovine, Cisapride, St. John’s wort, Lovastatin, Simvastatin, Pimozide, Indinavir |
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Which drugs interact with boosted PIs?
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Trazodone- decrease dose
SSRIs- levels drop with darunavir and increase with other PIs |
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What are the dosage adjustments for ED drugs given with Reyataz?
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reduce doses to
Viagra 25 q48hr Cialis 10 q 72hr Levitra 2.5 q24hr |
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What is the adjusted dose for Rifabutin when given with Reyataz?
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150mg QOD or TIW
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How is Flonase affected by Reyataz?
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avoid due toincreased levels and risk for cushings
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How are seizure meds and immunosuppressants affected by Reyataz?
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anticonvulsants- inducers, monitor levels
Immunosuppressives-levels of -limus and cylcosporine increase |
