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20 Cards in this Set
- Front
- Back
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OIs that occur when CD4 is from 200 to 500
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HSV, oral thrush, esophagitis, vaginitis, shingles, Kaposi's sarcoma, pneumonia, tuberculosis, community acquired diarrhea
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OIs that occur for CD4s <200 but > 50
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PCP, toxoplasmosis, cryptococcal meningitis, cryptosporidosis, PML caused by JC virus
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OIs that occur when CD4< 50
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MAC, CMV, AIDs dementia, lymphoma
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When to begin PCP prophylaxis? When to discontinue?
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CD4< 200, DC after CD4 > 200 for 3 mo
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What are prophylactic agents for PCP?
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TMP/Smz 1 SS QD, or 1 DS TIW,
Dapsone 100 mg QD Dapsone 50 mg QD + pyrimethamine 50 mg QW + leucovorin 25 mg QW Or Atovaquone 1500 QD or Aerosolized pentamidine 300 mg monthly |
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Treatment for PCP?
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TMP/SMZ 15-20 mg/kg/day
pentamidine 3-4 mg/lg/day IV atovaquone 750 mg BID Trimexate 45 mg/m2 IV/ leucovorin Clindamycin 600 mg IV q8 + primaquine |
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Toxoplasmosis-- when to begin prophylaxis? When to discontinue?
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CD4< 100 AND IgG antibody; DC after 200 for > 30 mo; stop secondary prophylaxis after 6 mo above 200
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Toxoplasmosis Prophylaxis therapies?
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TMP/SMX 1 DS po QD
Dapsone 50 mg QD + pyrimethamine 50 mg qw + leuocvorine 25 QWE or atovaquone 1500 mg QD |
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Toxoplasmosis treatment?
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Induction: Pyrimethamine 200 mg LD then 50-75 mg QD+ sulfadiazine 1000-1500 Q6 + leucovorin 10-20 mg QD
Maintain on pyrimethamine + sulfadiazine + leucovorin or clindamycin + pyrimethamine + leucovorine |
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What is the treatment for cryptococcal meningitis?
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Ampho B 0.7 mg/kg qd + flucytosine 25 mg q 6 h
Liposomal ampho B is 4 mg/kg Consolidation treatment: fluconazole 400 QD for 8 wks |
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What is secondary prophylaxis for cryptococcus? When to discontinue?
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Fluconazole 200 mg QD or Itraconazole 200 mg QD; DC after CD4> 100-200 for 6 mo; May do primary prophyalzis of same if CD4< 50
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What is primary prophylaxis for MAC? When to D/C?
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Azithromycin 1000-1200 Q week
Clarithromycin 500 BID DC if CD4> 100 for 3 mo |
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What is secondary prophylaxis for MAC? When to DC?
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Clarithromycin 500 BID + ethambutol 15-20 mg/kg/day QD
DC if CD4> 100 for 6 mo |
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What is treatment for disseminated MAC?
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Clarithromycin 500 bid or Azithromycin 500 QD + ethambutol 15 mg/kgd
Alternatives include rifampin, rifabutin, cipro (750 BID), or Amikacin 7.5-15 mg/kg IV QD |
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What is primary prophylaxis for CMV? When is it done?
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Ganciclovir 1 g po QD, for CD4<50
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What is secondary prophylaxis for CMV?
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valganciclovir 900 QD or foscarnet 90-120 mg/kg IV QD
May DC when CD4> 100-150 for 6 mo |
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What is treatment for CMV retinitis?
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Involves ganciclovir, valganciclovir, or foscarnet.
14 days of more intensive treatment, then switch to less. ganciclovir 5 mg/kg BID then 5 mg/kg q 5 days/week ganciclovir 5 mg/kg BID then valganciclovir 900 mg QD foscarnet 90 mg/kg BID then 90-120 mg/kg QD cidofovir 5 mg/kg weekly then every two weeks |
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What has to be given with foscarnet? What has to be given with cidofovir?
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1 L NS daily with foscarnet, and probenecid (2 gm 3 hr predose, then 1 g 2 hrs post and 8 hrs post) and 2 L NS with cidofovir
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How should CMV peripheral lesions be treated?
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valganciclovir 900 mg BID x 21 days then qd
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What dosages should be given for positive TB skin test in an HIV patient?
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Isoniazid 300 mg QD + pyridosine 50 mg QD x 9 mo
Isoniazid 900 mg + 100 mg BIW x 9 mo Rif 600 mg QD or BIW or rifbutin 300 mg QD or BIW x 4 mo PZA 15-20 mg/kg + RIF 600 mg QD x 2 mo |
