Exam 3 HIV(each drug detail)

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Anonymous
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241059
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Exam 3 HIV(each drug detail)
Updated:
2013-10-17 00:02:21
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HIV drug AE Tx
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HIV individual drug details
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  1. Lamivudine
    • NRTI (preferred)
    • minimal toxicity 
    • hyperpigmentation/skin discolorization
    • aginst HBV
    • M184 give resistance (but add this or emtricitabine in regimen!)
    • don't give w/ emtricitabine
  2. Etricitabine
    • NRTI (preferred)
    • minimal toxicity
    • skin discoloration, hyperpigmentation
    • nausea
    • against HBV (Truvada for HIV/HBV co-infect)
    • M184V gives resistance
    • don't give w/ lamivudine
  3. Tenofovir
    • Asthenia,
    • N/V/D; HA (these gone in a week)
    • flatulence

    • Nephrotoxicity (avoid renal insufficiency, but dialysis okay)
    • active agains HBV (w/ emtricitabine)
    •  Potential for osteopenia
    •  “Ten kids fell and broke their bones”
    • superior than zidovudine, and abacavir (when VL>100,000)
    • w/ atazanavir, must give w/ ritonavir
  4. Avacavir
    NRTI (2nd line)

    • HLA-B*5701 test-> avoid if (+)
    • Hypersensitivity (fever, rash, malaise, fatiques, respiratory, GI symptoms; greater risk for 1st 6wks)
    • MI risk
    • dose adjust if hepatic impairment
    • inferior to TDF when VL>100,000 










    • "ChewBACCA is so HYPERSENSITIVE
    • about his appearance, he still had a HEART ATTACK after looking in the
    • mirror for the 100,000th time"
  5. Zidovudine
    NRTI (3rd line)

    • Mitochondrial toxicity 
    • - Lipoatrophy & lactic acidosis w/ hepatic steatosis
    • Bone marrow suppression  (anemia)
    • Hyperlipidemia (cholesterol increase)
    • GI intolerance 
    • Insulin resistance**
    • HA/ insomnia, asthenia
    • BID- adherence issue
    • not with ribivirin (hep C drug)
  6. Efavirenz
    NNRTI (preferred- efficacy superior, less toxic than nevirapine)

    • Take in empty stomach!
    • Hyperlilidemia
    • Pregnancy: D
    • k103N mutation
    • CNS effects (dreams,dizziness,
    • somnolence,insomnia, etc)- take @ night!
    • Lipohypertrophy
    • Cyp3A4 inx(sub, inhibitor, inducer)
    • False (+) drug (benzo, cannabinoid)

    • My FAVorite artist is CHER 
    • C-CNS; H-Hyperlipidemia & lipohypertrophy ;E-elevated transaminases;R-rash
  7. Etravirine
    NNRTI (alternative-when efavirenz can't be used)

    • ONLY PI wl : darunavir/ritonavir or Lopinavir/ritonavir.
    • CAN'T USE w/ only 2 NRTIs!!! 
    • (add PI or other agent i.e. raltegravir)
    • not 2 NNRTIs!!
    • well tolerated
    • Rash 
    • Elevated transaminases
    • CYP inducer and substrate
    • take w/ FOOD
    • "ETR- extra agent; tolerable; rash"
  8. Rilpivirine
    NNRTI (alternative when can't use efavirenz)


    • Very well- tolerated
    •  Rare: rash, HA, insomnia, dpressive
    • Elevated transaminases
    • Take with FOOD! 
    • cyp 3 A substrate only
    • absorption depends on food and pH
    • Cant use w/ PPI & H2 blockers!

    RAT: rilpivirine, acid, tolerable

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