Naplex Chapter 18 Hiv

Front 1

what is the adherence rate in order for ART to be effective in long run

Back 1

95%

Front 2

at what CD4 count should ART be started

Back 2

all HIV infected people should be on it (not really, maybe, possibly, wtf?)

best recc is cd4 <350 start

Front 3

whats preferred NNRTI based regimen

Back 3

efavirenz, tenofovir, emtricitabine

Front 4

preferred PI combo?

Back 4

(Ataz + Ritonavir) + tenofovir/emtrictitabine

(Darunavir + Ritonavir) + tenofovir/emtricitabine

Front 5

preferred regiment for preg

Back 5

lopinavir + ritonavir + zidovudine/lamivudine

Front 6

alternative INSTI based regimen

Back 6

raltagreavir + abacavir/lamivudine

Front 7

what is IRIS

How to tx?

Back 7

immune recon inflame syndrome

happens when you start ART in pt with low CD4

tx underlying disease and continue ART

Front 8

general SE/BBW for NRTIs

Back 8

BBW- lactic acidosis, hepatic steatosis,

sometimes fatal- stavudine, didanosine, zidovudine

Front 9

abacavir
brand name?
BBW?

Back 9

Ziagen

BBW- hypersens skin rxn - test 1st with HLA-B5701

Front 10

what are meds in trizivir?

Back 10

lamivudine/zidovudine/ abacavir

Front 11

Didanosine
Brand?
BBW?
SE?

Back 11

Videx
BBW-Pancreatitis (fatal)
SE- peripheral neuropathy, NVD!

Front 12

Should Videx EC be taken on an empty stomach or with food?

Back 12

take on an empty stomach 1 H before

Front 13

Emtrictiabine
Brand?
BBW?
SE?

Back 13

Emtriva
BBW- exacerbates HepB if med D/Ced
SE-hyperpigmentation of palms and soles

Front 14

what are meds in Truvada

Back 14

Emtricitabine + tenofovir


"Truth is ten's are tricky" to get in bed

Front 15

meds in Atripla

Back 15

Emtrictabine + tenofovir + efavirenz

3somes are a favorite, but tricky with tens

Front 16

Lamivudine
Brand?
BBW?

Back 16

Epivir

do NOT use Epiivir-HBV for HIV (lower dose)
exacerbates HepB if D/Ced

Front 17

Stavudine
Brand?
BBW?

Back 17

Zerit
Pancreatitis

Front 18

whats in Epzicom

Back 18

Lamivudine + abacavir

Ep + zia

Front 19

whats in combivir

Back 19

zidovudine + lamivudine

Z combs lams

Front 20

Zidovudine
brand?
BBW?

Back 20

Retrovir

BBW- bone marrow sup (neutropenia + anemia)

Front 21

Tenofovir
brand?
BBW?
SE

Back 21

Viread

BBW- may develop HepB, if D/Ced or HBV resistance can develop

SE- fanconi syndrome, renal insuff, osteomalacia + dec in bone density

Front 22

General stuff of Nukes
metabolism how?

avoid which 2 NRTIs in combo

Back 22

not hepatically- so few interactions

emtrictiabine + lamivudine (no benefit)

Front 23

NNRTIs
class SE

Back 23

rash, increase LFTs

Front 24

Efavirnez
Brands?
how to take?
SE?
C/I?

Back 24

Sustiva

Take on an empty stomach at bedtime
SE- CNS (impaired conc, vivid dreams, psych symptoms
Preg Cat D-Avoid

Front 25

Etravirine
brand?

Back 25

Intelence

Front 26

Nevirapine
Brand?
dosing how?
BBW?

Back 26

Viramune

need 14 day leading period - 200 daily, then 200 BID

BBW- severe hepatotoxicity-highest in 1st 6 wks
life threatening SJS, TENs

Front 27

rilpivirine
brand?
dosing?

Back 27

Edurant

take with a meal

Front 28

NNRTI metabolized how?

Back 28

hepatically CYP, many interactions

Front 29

how do protease inhib work

Back 29

prevent HIV from reaching mature phase by inhibiting the enzyme that cleaves gag-poly protein

Front 30

PI's
class SE

Back 30

hyperglycemia/insulin resistance
lipodystrophy/ loss of fat in face, buttocks, legs
buffalo hump
dyslipidemia
hepatitis
IRIS

Front 31

Atazanavir
Brand?
SE
Dosing

Back 31

Reyataz

SE- PR interval prolong, indirect hyperbillirubinemia
nephrolithiasis (tk with 48 oz H20 to dec risk)

Take with food, 10 H after H2A, or 1H after antacids

Front 32

Darunavir
Brand?
SE
Dosing
cautions

Back 32

Prezista

severe NVD, rash (SJS)
take with food, swallow whole

caution in sulfa allergy pt's

Front 33

Fosamprenavir
brand

Back 33

lexiva

Front 34

Indinavir
brand?
SE
dispensing note

Back 34

Crixivan

Nausea, nephrolithiasis
must dispense in original container-has desiccant-protects from moisture

Front 35

Nelfanavir
brand
note

Back 35

Viracept

diarrhea
contains phenylalanine

Front 36

Ritonavir
brand?
Dosing?
SE?
NOTES
soln has how much alcohol?

Back 36

Norvir

take with food

SE-NVD, paresthesis,"", altered taste, PR prolong
caps-need refrigeration, can be room temp x 30 D
Tabs-store room temp
soln-contains 43% alcohol

Front 37

whats in kaletra

Back 37

lopinavir + ritonavir

Front 38

Saquinavir
brand?
CI

Back 38

Invirase
QT prolong-monitor with ECG

Front 39

Tipranaivr
brand
bbw
caps stored
soln stored

Back 39

aptivus

BBW-intracranial hemorrhage, hepatitis
caps-refrigerate, can be out for 60 D
soln-room temp

Front 40

how do fusion inhibitors work

Back 40

block attachment of HIV to CD4 cell-cause change in gp41

Front 41

enfuvirtide
brand
SE
place in tx

Back 41

fuzeon
SE-given SC, so local injection rxn in 100%-pain, redness

salvage tx

Front 42

CCR5 Antagonist work how

Back 42

bind go CCR5 co receptor on CD4 prevent HIV entry

Front 43

maraviroc
brand?
BBW
SE
Monitorijg

Back 43

selzentry

BBW-hepatotoxicity
SE-rash, SJS
monitor crcl <30 ml/min
only works in ccr5 tropic HIV- so do tropism test before starting

Front 44

how do integrase inhibitors work

Back 44

blocks enzyme needed for viral DNA to enter cell nucleus

Front 45

raltegravir
brand
monitor

Back 45

isentress

cpk

if using with ripamin, use high dose 800 mg BID

Front 46

what is PrEP

Back 46

pre-exposure prophylaxis

truvada given to patients w/o HIV, but have risk of developing HIV

Front 47

occupational PREP

Back 47

basically if less than 1500 viral load do:
combivir or truvada x 28 days

if >1500 viral load do:
(combivir or truvada) + kaletra x 28 days

Front 48

how to use Oraquick

Back 48

do not eat or brush teeth 20 mins before

HIV test-open test stick + swab upper gums and lower gums, pop off test tube and put stick into soln and wait 20 mins.

IF line at C and no line at F= negative
IF line at C and F=******, positive

If no C line, test is invalid
need to do western blot to confirm

Front 49

whats dumb about Oraquick

Back 49

need to wait 3 months from exposure to test, cause this tests for HIV antigens

hopefully ppl don't use few days after and think they are clean

Front 50

if CD4 <200 what OI need to worry about

how to tx

Back 50

PCP Pneumocystis Pneumonia

use bactrm DS, OR dapsone if sulfa allergy

Front 51

CD4 <100 what OI need to be careful of

Back 51

toxoplasma Gondi

Bactrim DS
or
Dapsone + leucovorin + pyrimethamine

Front 52

cd4 <50 OI
tx?

Back 52

MAC
use a mac-azithromycin 1200 mg Weekly

Front 53

what 3 meds need to be careful using if HepB

Back 53

lamivudine, emtricitabine, tenofovir

Front 54

HIV replication steps

Back 54

1) HIV fuzes to CD4
3) Viral RNA, and its enzymes enter cell
3) virus uncoats and RNA turns into DNA via revertranscriptase
4) Viral DNA joins nucleus and integrates with cell DNA
5) New viral RNA made
6) viral RNA + proteins move to cell surface and form new HIV
7) virus matures by protease, releasing individual HIV proteins