Therapeutics - HIV 1
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What are the risk factors for HIV?
- Homosexual/bisexual men
- IV drug use/abuse
- sex partners in abuse groups
- heterosexual men and women
- Infants of above groups
What are the Symptoms of HIV?
- Weight loss
- Night sweats
- Sore throat
What labs indicate HIV?
- CBC - decrease in WBC; decrease in H/H; decrease in platelets (slight)
- T-cells subsets - prognostic valve (indirect)
- T-helper (CD4) count (<500)
- Skin-test anergy (can’t mount an immune response if they get a skin test of some sort)
- ELISA IgM or ELISA/Ag (Quick screening test)
- Western blot – if negative - perform HIV viral load
What drug is used to prevent HIV infection in high risk individuals?
How do you prevent an HIV infection after an errant needle stick?
- Decide whether to get treatment
- Wash wound
- Treatment (prophylaxis) - start ASAP (within 2 h)
- Lasts 6 months if ELSIAs are all negative
- ELISA - 0, 6 wks, 3 & 6 months
What are the Nucleoside reverse transcriptase inhibitors?
- Zidovudine - Retrovir
- Didanosine - Videx
- Lamivudine - Epivir
- Stavudine - Zerit
- Abacavir - Ziagen
- Abacavir+Lamivudine - Epzicom
- Emtricitabine+Tenofovir DF – Truvada
- Lamivudine+Zidovudine – Combivir
What is the brand name for Zidovudine?
What is the brand name for Lamivudine?
What is the brand name for Stavudine?
What is the brand name for Tenofovir?
What is the brand name for Abacavir?
What is the brand name for Didanosine?
What is the brand name for Emtricitabine?
What is the brand name for Abacavir+Lamivudine?
What is the brand name for Emtricitabine+Tenofovir DF?
What is the brand name for Lamivudine+Zidovudine?
Nuceoside reverse transcriptase inhibitors need what to happen before they are active?
Phosphorylation process (tri or di phosphorylation)
What is the MOA of Nucleoside Reverse Transcriptase inhibitors?
- Similar to Purines and Pyrimidines
- Integrated in replication chain
- Stop reverse transcriptase from replicating the DNA strand
- Prevent formation of new virions
What is the generic name for Retrovir?
What is the generic name for Epivir?
What is the generic name for Zerit?
What is the generic name for Ziagen?
What is the generic name for Viread?
What is the generic name for Videx?
What is the generic name for Emtriva?
What is the generic name for Epzicom?
What is the generic name for Truvada?
What is the generic name for Combivir?
How often is Abacavir (ABC) given?
BID or QD
What is Abacavir metabolized by?
- EtOH dehydrogenase
- EtOH leads to elevated ABC
What are the major risks of taking Abacavir?
- Cardiac events
- Potentially fatal hypersensitivity reactions (Fever/Rash/N/V, Anorexia, SOB, cough, sore throat)
How can you avoid Hypersensitivity reactions associated with Abacavir?
- Screen for HLA B*5701
- Homozygous + or Heterozygous + are likely to have a hypersensitivity rxn
- 100% positive predictive value for the rxn
What combination therapy should be avoided with Abacavir?
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