HIV
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- Zidovudine Didanosine Zalcitabine Stavudine Lamivudine Emtricitabine Abacavir Tenofovir
- Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTI)
- Preferred NRTI's for naive patients
- Lamivudine, Epivir®, 3TC Emtricitabine, Emtriva®, FTC Abacavir, Ziagen®, ABC Tenofovir, Viread®, TDF
- What type of agent is Efavirenz (Sustiva)
- Non-nucleoside Reverse Transcriptase Inhibitors (NNRTI)
- What type of agent is Delavirdine (Rescriptor)
- Non-nucleoside Reverse Transcriptase Inhibitors (NNRTI)
- Preferred NNRTI for naive patients
- Efavirenze
- NNRTI used when resistence develops to all other drugs in class
- Etravirine
- Ritonavir, Norvir®, RTV Atazanavir, Reyataz®, ATV Fosamprenavir, Lexiva®, FPV Indinavir, Crixivan®, IDV Lopinavir/ritonavir, Kaletra®, LPV/r Nelfinavir, Viracept®, NFV Saquinavir, Invirase®, SQV Tipranavir, Aptivus®, TPV Darunavir, Prezist
- Protease inhibitors
- Enfuvirtide, Fuzeon
- Fusion inhibitor
- Maraviroc
- CCR5 antagonist
- Raltegravir
- Integrase inhibitor
- Truvada
- Tenofovir + emtricitabine
- epzicom
- abacavir + lamivudine
- combivir
- zidovudine + lamivudine
- trizivir
- zidovudine + lamivudine + abacavir
- atripla
- tenofovir + emtricitabine + efavirenz
- kaletra
- lopinavir + ritonavir
- side effect = peripheral neuropathy
- stavudine, didanosine
- side effect = bone marrow suppression
- zidovudine + ganciclovir
- Zidovudine drug interactions
- PD: Ganciclovir, bactrim, dapsone PK: Stavudine
- Do not administer with Fosamprenavir, unboosted atazanavir, tipranavir
- Etravirine
- Nevirapine adverse effect
- hepatoxicity
- Atazanavir + GERD medications interaction
- Need acidic environment for atazanavir absorption Give PPIs 12 hours apart H2 antagonists unseparated for naive patients Never increase more than 20 mg of omeprazole for naive patients
- Nelfinavir + Ritonavir drug interaction
- Inhibitis creation of active metabolite
- Antifungal drug interactions
- Ritonavir ↑ Voriconazole AUC 82% Itraconazole, ketoconazole, fluconazole: dose adjust and monitor
- Antimycobacterials
- Rifampin ↓ ↓ PI and NNRTI; ↑ by PI and ↓ by NNRTI; DON’T USE Rifabutin to a lesser extent - dose adjust to manage Clarithryomycin is substrate and inhibitor - dose adjust
- Oral contraceptive drug interaction with protease inhibitors
- PIs decrease ethinyl estradiol
- Methadone drug interactions
- ↑zidovudine AUC 40%, ↓didanosine 57% Efavirenz, nevirapine ↓ methadone; may cause withdrawal Variable effects with PI
- lipid lowering agent of choice because it does not go through the p450 pathway
- Pravastatin
- lipid lowering agents contraindicated with ALL patients on PIs
- simvastatin lovastatin
- lipid lowering agents that need to be dose-adjusted
- fluvastatin atorvastatin rosuvastatin
- Anticonvulsant agents that are contraindicated
- carbamazepine phenobarbital phenytoin
- preferred anticonvulsant agents
- methadone gabapentin lamotrigine levetiracetam
- NRTI class side effects
- MITOCHONDRIAL TOXICITY, pancreatitis, lactic acidosis, hepatic steatosis, peripheral neuropathy, fatigue, headache
- zidovudine adverse events
- anemia, myopathy, bone marrow suppression, finger nail color changes
- ____ should not be used with stavudine due to antagonistic effects
- zidovudine
- lamivudine should not be used with _____
- emtricitabine
- emtricitabine is also effective for
- hepatitis B
- adverse effects of stavudine
- peripheral neuropathy, lipoatrophy
- drug interaction of stavudine with didanosine
- peripheral neuropathy
- drug interaction of stavudine with zidovudine
- antagonistic effects
- tenofovir does what to the levels of atazanavir and didanosine?
- decreases Atazanavir levels increases Didanosine levels
- clinical manifestations of mitochondrial toxicities
- lactic acidosis, pancreatitis, hepatic steatosis, peripheral neuropathy, myopathies (cardiomyopathy), fat redistribution
- This NNRTI has increased absorption with high fat meals
- efavirenz
- What type of agent is Etravine (Intelence)
- Non-nucleoside Reverse Transcriptase Inhibitors (NNRTI)