flash cards

BCPS HIV HIV

Question Answer
Pneumocystis Carinii or Jirovecii Pneumonia (PCP) prophylaxis? Bactrim DS 1 tab po daily or SS po daily. Start when CD4<200. Stop when CD4>200 for 3 months on ART
Toxoplasma gondii prophylaxis? Bactrim DS 1 tab po daily. Start when CD4<100. Stop when CD4>200 for 3mo on ART
Mycobacterium avium complex (MAC) prophylaxis? Azithromycin 1200mg po weekly. Start when CD4<50. Stop when CD4>10 for 3mo on ART
Candidiasis treatment? Fluconazole
Cytomegalovirus (CMV) treatment? Valganciclovir or Ganciclovir
MAC treatment? Azithromycin or Clarithromycin + ethambutol
PCP treatment? Bactrim +/- prednisone
What HIV drug should not be used in HLA-B*5701? Abacavir
Stribild can only be used in pt with CrCl> than? Crcl>/= 70 ml/min
Lamivudine can be substituted with what other HIV drug? emtricitabine
NRTI black boxed warning? lactic acidosis, hepatomegaly with steatosis
NRTI are all renally dosed except…? Abacavir
What are the Nucleoside/tide Reverse Transcriptase Inhibitors (NRTI)? Abacavir, Didanosine, Emtricitabine, Lamivudine, Stavudine, Tenofovir, Zidovudine
NNRTI class side effects? Hepatotoxicity and rash (SJS, TEN)
nonnucleoside reverse transcriptase inhiibitors (NNRTI)? Efavirenz, Etravirine, Nevirapine, Delavirdine, Rilpivirine
Protease Inhibitors class side effects? hepatotoxicity, GI upset, CYP450 inhibitors
PI end in what? -navir
What is Truvada? tenofovir+ emtricitabine
Initial treatment of HIV? 2 nucleoside/nucleotide reverse transcriptase inhibitors + protease inhibitor or nonnucleoside reverse transcriptase inhibitor
Goal level of plasma HIV RNA? plasma HIV RNA<50 copies/mL
HIV post exposure treatment if exposed to urine or saliva? no treatment neccessary
HIV post exposure treatment if exposed to large-bore needle with blood? 2 NRTI + PI within 72hrs of exposure for 4 wks
Preferred HIV 3-drug PEP regimen? raltegravir (Isentress) + Truvada (tenofovir/emtricitabine)
When does opportunistic infections usually take place in HIV pt? CD4<200
Opportunistic infections involving CD4 200-500? candidiasis (Thrush)
Opportunistic infections involving CD4 200-100? PJP, Histoplasmosis, PML
Opportunistic infections involving CD4 50-100? toxoplasmosis, cryptosporidiosis
Opportunistic infections involving CD4 <50? cryptococcosis, MAC, CMV
What is the only drug from the NRTI that is NOT renally adjusted? abacavir
Abacavir requires what type of testing and why? HLA-B*5701 because of hypersensitivity reactions
Do not combine emtricitabine with what other NRTI because they are related? lamivudine
Do not combine stavudine with what other NRTI because they are related? zidovudine
Which NRTI cause peripheral neuropathy? didanosine, stavudine, zalcitabine
Class side effect of NRTI? lactic acidosis
Pregnancy ART regimen? zidovudine + lamivudine + nevirapine
What class is efavirenz? NNRTI
Why is efavirenz dosed at night on empty stomach? risk of psychosis; high fat meal increases bioavailability
Which drug can cause false (+) for marijuana? efavirenz
Efavirenz is preg cat? Preg Cat D- neural tube defects
Nevirapine side effects? skin rash, hepatotoxicity
Class effect of Protease Inhibitors? inhibits 3A4, increase lipids and glucose
Why does atazanivir have a DDI with PPI? atazanivir requires acidic pH for absorption
Fusion inhibitor drug? enfuvirtide
Integrase inhibitors end in what? -gravir
What is an NNRTI based regimen for new HIV pt? tenofovir + emtricitabine+ efavirenz
What is a PI based regimen for new HIV pt? tenofovir + emtricitabine + ritonavir-boosted atazanivir
Candidiasis non-esophageal involvement treatment? clotrimazole troches or nystatin suspension
Candidiasis esophageal involvement treatment? fluconazole 200mg po daily
PCP treatment? Bactrim, Dapsone, or atovaquone
What CYP does Bactrim inhibit which increases warfarin INR? 2C9
Patients with G6PD deficiency contraindicated with Bactrim and Dapsone because? hemolysis
Histoplasmosis treatment? Liposomal amphotericin B IV, then itraconazole po
Progressive Multifocal Leukoencephalopathy (PML) treatment? cidofovir + ART for HIV
Toxoplasmosis treatment? Bactrim, Dapsone, or atovaquone
Cryptosporidiosis treatment in immunocompetent pt? nitazoxanide
Cryptosporidiosis treatment in immunocompromised pt? HAART
Cryptococcosis treatment? Liposomal amphotericin B IV, then fluconazole po
MAC prophylaxis treatment? Azithromycin 1200mg po once weekly
MAC active treatment? Azithromycin + ethambutol
CMV treatment?

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