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56 Cards in this Set
- Front
- Back
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How does HIV enter the cell?
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By attaching to Gp120 and anchors to GP41
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What do antiretroviral meds do?
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control viral replication and slow HIV disease progression
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What is HAART?
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a highly active combination of 3 or more ARTs
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What is a side effect of the NRTIs?
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Upset stomach-DDI
Pancreatitis-DDI, d4T Peripheral neuropathy-DDI |
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Define adherance
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The willingness and ability to start and take medications as prescribed
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What do protease inhibitors do?
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prevent HIV from being assembled and released from infected CD4 cells
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What do fusion inhibitors do?
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prevent GP120 from binding to CD4 cells
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what was the first antiretroviral?
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Zidovudine (AZT,Retrovir)1987
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What is the dose for Fuzeon (T-20)?
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90mg SC BID
Local site Rxn: induration, nodules, cysts, redness, pain |
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Which NRTI is NOT renally excreted?
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Abacavir, so you don't have to dose adjust
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What is the MOA of NRTIs?
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incorporates into DNA and causes chain termination
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What is the dose for retrovir(AZT)?
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300 mg/BID
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Which drug should you NOT combine with retrovir?
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Stavudine-(d4T)Zerit
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What is the dose of Zerit (d4T)
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40mg BID if >60kg
30mg BID if <60kg |
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What is the dosing for Abacavir (ABC)
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600mg/day
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What is the MOA of NNRTIs?
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inhibit RT by noncompetitively attaching to and inhibiting RT
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Which drug causes a hypersensitivity reaction?(skin rash)
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Abacavir
The rash has to be reported |
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Which NRTI causes > cholesterol and > triglycerides?
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Stavudine (d4T)
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Which NRTI causes anemia, neutropenia, and muscle weakness?
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Zidovudine (Retrovir, AZT)
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Which statin causes lactic acidosis?
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Metformin
So don't give this in combination with NRTIs |
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Name the NNRTIs
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Efavirenz (EFV)
Nevirapine (NVP) Delavirdine (DLV) |
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What is the dose for Nevirapine(NVP)?
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200 mg/daily x 14 days
then 400 mg/daily |
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Is Nevirapine and inhibitor or inducer?
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Inducer
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What is the dose of Efavirenz?
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600 mg/daily in the morning(to prevent nightmares)
Do NOT take with food |
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Is Efavirenz an inducer or inhibitor?
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Both
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What are the side effects of NNRTIs?
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Rash
CNS toxicity-Efavirenz (confusion, nightmares, dizziness) Liver toxicity |
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What is the MOA of Protease Inhibitors?
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prevent HIV from being successfully assembled and released from infected CD4 cells
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What is the dose of Saquinavir(SQV)?
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Only boosted w/ RTV:
2000/100 mg/daily Taken within 2hrs of meals |
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What is the dose of Ritonavir?
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600 mg
twice daily as sole PI As booster: 100-200 mg once-twice daily |
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A VERY powerful inhibitor
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Ritonavir
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What is the biggest side effect of Indinavir?
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Kidney stones, so take this pill with 48oz of water
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Do not take this PI w/ food except when taken w/ RTV;
Do not combine w/ ATV, and take it with lots of water |
Indinavir
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Which drug do you NOT combine
w/ IDV? |
Atazanivir (ATV)
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What is the dose of Fosampremavir (f-APV)?
(Very popular drug) |
1400/200 mg/daily boosted with RTV
Do not combine with APV |
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What is the dose of Tipranavir (Aptivus)
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ONLY boosted:
500/200 mg/BID |
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What are the side effects of Protease inhibitors?
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>Glucose-Indinavir
>Cholesterol-Ritonavir Diarrhea-Nefinavir Lipodystrophy-buffalo hump, >breast size |
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Which PI > cholesterol?
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Ritonavir
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Your pt has >cholesterol, which PI would you prescribe?
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atazanavir (cholesterol friendly)
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What are the side effects of Protease Inhibitors?
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> Glucose (Indinavir)
> Cholesterol (Retonavir) Rash-(don't give to sulfa allergic) APV, f-APV, Tipranavir > Bilirubin- IDV, ATV Kidney stones- IDV |
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Which drug increases the levels of Didanosine causing toxicity?
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Tenofovir
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Which drug should you avoid taking with Lamivudine?
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Emtricitabine
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Which drugs decrease Atazanavir levels?
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Efavirenz
Tenofovir |
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how should you take Didanosine?
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Take at least 30 minutes before or 2 hrs after a meal, except when taken with tenofovir
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How much does food decrease the levels of Didanosine?
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It decreases levels by 55%
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How does food effect Efavirenz?
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Cmax increases 39-79% w/ high-fat/caloric meals
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T/F Efavirenz should be taken on an empty stomach
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TRUE
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How does food effect unboosted Indinavir and how should it be taken?
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decreases levels by 77%
Take 1 hour before or 2 hrs after a meal, except when taken with ritonavir |
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When would you start ART?
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All patients with AIDS
CD4 count <200 Offer Tx: CD4 >200 - <350 |
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Which combo would you give a naive ART pt?
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Efavirenz + Lamivudine + Tenofovir
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what are the side effects of Indinavir?
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Kidney stones
>Glucose >Bilirubin |
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Describe the PIs
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PIs- Prevents assembly and release of HIV
Fosamprenavir- Do NOT combine with APV(prodrug) Dose: 1400/200 with RTV Ritonavir- > Triglycerides; Inhibitor Dose: 600mg/BID as sole PI or 100-200 as booster (take with food) Indinavir- S.E:Kidney stones, >glucose, >Bili; Food > by 77%-take 1hr B4 or 2hr after meals Saquinavir- Only boosted 2000/100mg/daily; take w/in 2hrs of meal Amprenavir- Do NOT combine with f-APV Atazanavir- Cholesterol friendly; >Bilirubin Nelfinavir- Diarrhea Tipramavir- Only boosted 500/200 BID |
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Describe the NRTIs
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NRTI- Incorporates into DNA causing chain termination
Abacavir- H.S.Rxns; needs no renal adjst Dose: 600mg/daily Zidovudine- Anemia, neutropenia; do NOT combine with d4T; prevents perinatal transmission Dose: 300mg/BID Tenofovir- NucleoTIDE; >DDI levels; used for HBV Dose: 300mg/daily Didanosine- Food < 55%, take 30min B4 of 2hrs after meals; many side effects Lamivudine(3TC)- do NOT combine with FTC Stavudine- >cholesterol, >triglycerides; do NOT combine with AZT Dose: 40mg/BID >60kg, 30mg/BID <60kg |
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Describe the NNRTIs
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NNRTI- Inhitbit RT by attaching to enzyme
Efavirenz- Both Inhibitor/Inducer; CNS symptoms, nightmares Dose: 600mg/daily in AM; do NOT take with food Nevirapine- Inducer Delavirdine |
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What are the side effects of PIs?
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>cholesterol- Ritonavir
>Glucose- Indinavir Diarrhea- Nelfinavir Lipodystrophies- Fat accumulation |
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What are the side effects of NRTIs?
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Stomach upset- DDI
Head ache Pancreatitis- DDI + d4T Peripheral neuropathy- DDI Lactic Acidosis- DDI, d4T Lipoatrophy- d4T + DDI |
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What are the side effects of NNRTIs?
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CNS- Efavirenz
Liver Toxicity- Nevirapine Rash- Nevirapine |
