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HIV/AB/Vaccines
| Question | Answer |
|---|---|
| What is the screening test for HIV called? | ELISA (Enzyme-linked Immunosorbent Assay) |
| What is the diagnosis test for HIV called? | Western Blot test |
| What are the blood tests done for HIV (3)? | CD4 T-cell Count Viral Load Count Resistance testing |
| What is the normal count of CD4 T-cells in the body? | 500-1500 cells |
| New guidelines recommend starting treatment if CD4 count is below ____? | CD4 T-cell is <500 |
| Treatment for PCP is done if CD4 count is _____. Treatment? | CD4 T-cell is <200 Px: Bactrim or Dapsone or Mepron (Atovaqone) Tx: (Clindamycin + Primaquine + Prednisone) x 21 Days |
| Treatment for Toxoplasmosis is done if CD4 count is ____. Treatment? | CD4 T-cell is <100 Tx: Bactrim or Dapsone or Mepron (Atovaqone) |
| Treatment for MAC is done if CD4 count is ____. Treatment? | CD4 T-cell is <50 Tx: Azithro or Clarithro |
| Types of Resistance testing for HIV (2)? | Genotypic testing - looks at the HIV present in the person's blood and examines it to see what mutations exist. Phenotypic testing - takes the virus and exposes it to different concentrations of HIV meds to determine which ones are effective. |
| What is Genotypic testing? | Test looks at the HIV present in the person's blood and examines it to see what mutations exist. |
| What is Phenotypic testing? | Test takes the virus and exposes it to different concentrations of HIV meds to determine which ones are effective. |
| What are the steps of the HIV life cycle? | 1. Binding 2. Reverse Transcription 3. Integration 4. Transcription 5. Translation 6. Viral Assembly and Maturation |
| What are the drugs that work on the first step of HIV cycle? | Binding (Entry Inhibitors) Enfuvirtide (Fuzeon) Maraviroc (Selezentry) |
| What is Fuzeon? Where does it work? SE? | Enfuvirtide (Fuzeon) works on GP41 and GP120 (viral cell) Dose: 90mg SC BID (upper arm, thigh, abd) SE: may cause respiratory infection |
| What is Selezentry? Where does it work? | Maraviroc works on CCR5 (human cell) Dose: 300mg BID (Inhibitors: 150 BID; Inducers: 600 BID) |
| What is Agenerase? Forms? Contraindications? | Amprinavir (APV) (Agenerase) is a Protease Inhibitor. Forms: gel caps and PO soln taken BID Contraindicated: Sulfa allergy |
| What is Crixivan? Dosing? SE? | Indinavir (IDV) (Crixivan) comes in capsules and is given on EMPTY STOMACH, drink lots of water >1.5L; with liver disease, give 600mg Q8H. SE: Protease inhibitor side effects Nephrolithiasis |
| What is Kaletra? Forms? Storage? | Lopinavir/Ritonavir (RTV) (Kaletra) comes in tabs and PO solution (Fridge; RT: 60 days) |
| What is Viracept? SE? | Nefinavir (NPV) (Viracept) SE: very bad diarrhea |
| What is Norvir? Forms? | Ritonavir (RTV) (Norvir) comes in PO solution and capsules (Fridge, RT: 30 days) |
| What is Invirase? Forms? Must not use with what other Protease Inhibitor? | Saquinavir (SQV) (Invirase) comes in hard gel capsules and tabs given BID. Antagonistic with Indinavir (Crixivan) |
| What is Tiprinavir? Forms and storage? SE? | Aptivus (TPV) (Tiprinavir) comes in soft gell caps (Fridge, RT: 60 days) given BID. SE: Sulfa allergy Hepatotoxicity Intra-cranial bleeding |
| What is Lexiva? Forms? Monitor? | Fosamprenavir (FPV) (Lexiva) comes in tabs and PO solution (EMPTY STOMACH) given BID. Monitor: Bleeding Sulfa allergy D/C if rash occurs |
| What is Reyataz? What group does it belong to? | Atazanavir (ATZ) (Reyataz) comes in capsules kept at RT Dose: 400mg QD with food SE: cardiac abnormalities, monitor for bleeding |
| What is Prezista? Dose? Points to remember? | Darunavir (Prezista) comes in 300mg tabs (RT) given BID. Points: Sulfa allergy Increases Pravastatin levels 5x; use Fluvastatin instead |
| Where does Protease Inhibitors work? | Step 6: Viral Assembly and Maturation |
| What Protease Inhibitors are contraindicated in Sulfa Allergy (4)? | ***DAFT Darunavir (Prezista) Amprenavir (Agenerase) Fosamprenavir (Lexiva) Tiprinavir (Aptivus) |
| What forms does Agenerase come in? | Amprenavir (Agenerase) comes in gel capsules and solution (not interchangeable) |
| Agenerase dosing? | Amprenavir (Agenerase) >50kg: 1200 mg caps BID : 1400 mg solution BID <50kg: 200mg/kg BID |
| What are the SE for Protease Inhibitors? | GI intolerance Lipodystrophy Hyperglycemia Hyperlipidemia Weight Gain |
| Crixivan dosing? Dosing if patient has liver disease? Renal patient? | Dosing: 800mg Q8H Liver Px: 600mg Q8H Take on EMPTY STOMACH!! AVOID IN RENAL PATIENTS!!! |
| SE for Crixivan? | GI intolerance Hyperlipidemia Hyperglycemia Lipodystrophy NEPHROLITHIASIS |
| Px counseling when taking Crixivan? | Take on empty stomach. Drink >1.5L of water Call MD if blood in urine or flank pain. Very sensitive to moisture!!!! |
| How do you store Kaletra? | Lopinavir/Ritonavir Tabs: Room temperature Solution: Fridge : 60 days if RT |
| Dosing for Kaletra? With or without food? | Tabs: 200mg/50mg : 2 tabs BID Soln: 80mg/20mg mL : 10mL QD with FOOD |
| What is the SE for Nelfinavir? Forms? Dosing? | Viracept, VERY BAD DIARRHEA Forms: tabs & PO powder Dosing: 750mg TID |
| What is EMS found in Viracept? | Ethyl methanesulfonate that has shown to be teratogenic, mutagenic & carcinogenic. |
| What forms does Norvir come in? Dosing? | Forms: caps and solution Dosing: 600mg (6 caps) BID TITRATE!!!!! |
| Storage for Norvir? | Caps: Fridge : 30 days if RT Soln: Room temperature |
| What form does Invirase come in? Dosing? | Hard gel capsule Dose: 1000mg + 100mg Ritonavir BID |
| Can you use Rifampin with Ritonavir + Saquinavir? No, use is contrainidicated due to risk of HEPATOTOXICITY. | |
| Invirase is contraindicated in what allergy? | Lactose allergy |
| Dosing for Aptivus? Storage? | Dose: 500mg (2 soft gel caps) + 200mg Ritonavir BID Storage: Fridge before opening : RT for 60 days |
| SE for Aptivus? | FATAL HEPATOTOXICITY Intra-cranial bleeding (black box) |
| Lexiva comes in what forms? Dosing? | Tabs: 700mg Susp: 50mg/mL (2-18 YO) Dose: 1.4mg BID or 1.4mg + 200mg Ritonavir QD |
| Reyataz dosing? Storage? | 400mg QD with FOOD!!! Storage: Keep at ROOM TEMP |
| Precautions when using Reyataz? | Cardiac abnormalities Bleeding |
| Reyataz drug interactions (4)? | Atazanavir is a substrate & inh. Crixivan, when combined can increase bilirubin. Viread, can decrease Reyataz and Reyataz can increase Viread. Clarithromycin levels are increased by Reyataz. |
| Prezista dosing? Storage? | Dose: 600mg BID + 100mg Ritonavir BID Storage: Room temp |
| Can you use Prezista with Pravachol? | No, because Pravachol levels will be increased 5x. Use Fluvastatin. |
| Where does NRTI's work? Metabolized where? | Step 2: Reverse Transcription Renal |
| What is Ziagen? SE? | Abacavir (ABC) (Ziagen) is given 300mg BID SE: Hypersensitivity |
| What is Didanosine? How do you give it? SE? | Didanosine (Videx, Videx EC) must be given on EMPTY STOMACH or with Mg antacid. SE: Peripheral neuropathy, Pancreatitis, Eye defects |
| What is Lamivudine? Dose? Similar to what meds (2)? | Lamivudine (Epivir, Epivir HBV) (3TC) HIV dose: 150mg BID Hepatitis dose: 100mg QD x 1 year Similar: Tyzeka (Telbivudine), for Hepatitis Emtricitabine (Emtriva) |
| What is Zerit? Don't use with? Storage? | Stavudine (d4T) (Zerit) is antagonistic with Zidovudine. Storage: RT, Fridge after reconstitution and good for 30 days SE: Lipodystrophy (similar to Protease Inh) |
| What is Retrovir? What group does it belong? Form? | Zidovudine (AZT, ADV) (Retrovir) is the only one to come in IV form Forms: IV, caps, PO solution Headache/Nausea => #1 SE Bone marrow depression = neutropenia, anemia Myopathy Purple toenails |
| What is Emtriva? | Emtricitabine (FTC) (Emtriva) is chemically similar to Epivir (Lamivudine). |
| What is Combivir? Dosing? | Zidovudine 300mg + Lamivudine 150mg Dose: 1 PO BID |
| What is Trizivir? | Zidovudine 300mg + Lamivudine 150mg + Abacavir 300mg |
| What is Epizicom? | Abacavir 600mg + Lamivudine 300mg |
| What is Truvada? | Tenofovir 300mg + Emtricitabine 200mg |
| What is Atripla? Dose? | Efavirenz 200mg + Emtricitabine 200mg + Tenofovir 300mg Dose: 1 PO QHS |
| SE of NRTI's (2)? Metabolized where? | SE: Lactic Acidosis & Headache Metabolized: Renal With or without food EXCEPT FOR Didanosine which is ON EMPTY STOMACH |
| What do you give with Videx? | Didanosine is given with Mg antacid bec stomach needs to be alkaline. EMPTY STOMACH. |
| Videx storage? Dose for renal patient? | Room temperature Dose adjust in patients with CrCl <50mg/mL |
| What do you monitor Q3 months when using Protease Inhibitors (4)? | LFT's Glucose Cholesterol Look for fat redistribution |
| Didanosine SE (4)? | Pancreatitis Peripheral neuropathy Lactic acidosis Retinal pigmentation |
| Lamivudine dosing? | Epivir: 150mg BID Epivir HBV (Hep B): 100mg x 1 yr |
| Stavudine dosing? Storage? | <60kg: 15-30mg BID >60kg: 30-40mg BID Storage: Room Temp : Fridge after reconstitution, good for 30d |
| Stavudine SE (5)? | LIPODYSTROPHY GI intolerance Pancreatitis Peripheral neuropathy Lactic acidosis |
| Retrovir comes in what forms? | Caps, IV solution, PO solution. |
| Retrovir dosing? | 200mg (2 caps) TID with FOOD to decrease nausea 100mg TID with severe anemia or CrCl <25mL/min |
| Zidovudine SE (4)? | Myelosuppression (anemia & neutropenia) Purple toenails Headache Myopathy (>6mos of use) Lactic acidosis & hepatic steastosis (black box) |
| Patient counseling for Zidovudine? | Advise Px of S/Sx of Neutropenia: fever, chills, sore throat, unusual weakness/tiredness |
| Treatment for Anemia? | Erythropoietin (Procrit, Epogen) Darbepoietin (Aranesp) |
Created by:
oparaMK
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