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HIV drugs

CCR5 antagonist (MOA), Maraviroc, CCR5 antagonist prevent the co-receptor to bind with HIV to help facilitate the fusion of HIV RNA.
Maraviroc (Rights) ADR CCR5 antagonist, Rash, SJS, GI, Hepatotoxicity, URTI, Drug interactions as CYP 3a4 inhibitor
Fusion inhibitor (enfuvirtide) SC BID (painful),
enfuvirtide ADR injection site painful rxn 98%, hypersensitivity rxn, increase in bacterial pneumoniae, nodule formation at the injection site
NRTI meds (know class ADR: Lactic acidosis, hepatic steatosis & lipodystrophY) ZELTA (Zidovudine, Tenofovir, Abacavir, Lamivudine, Emtricitabine)
NRTI MOA prevent conversion of RNA to DNA (reverse transcriptase)
Abacavir ADR NRTI: life threatening hypersensitivity (FARMS N/V)
Tenofovir ADR GI intolerance, renal impairment
Zidovudine ADR HA, bone marrow suppresion
Lamivudine and Emtricitabine minimal toxicity
Integrase inhibitor (MOA) it will prevent the integration of viral DNA into cellular DNA. raltegravir, elvitegravir, stribild
Integrase inhibitor ADR of Raltegravir CHIMP N/D (CPK elevation, Nausea, diarrhea, pyrexia, headache, myocardial infraction)
Integrase inhibitor Stribild, Elvitegravir (cobicistat) one tablet a day with food, don't use if CrCl < 70 or with other ART, Cobcistat is booster.
Stribild N/D, renal impairment, decrease bone mineral density
Prevention: what can you do? Sexual Practice CDC's ABC. Latex condom and water-based lubricant. Early ART, do TRUVADA for prophylaxis. Male circumcision Dental dams
Prevention: what can you do? parenteral testing/treatment for accidental needlestick. universal precautions. screening of donated blood/organs etc. clean needle programs.
Perinatal: what can you do? perinatal treat during pregnancy (don't use efavirenz). RNA count less than 1000. Elective C-section. avoid breastfeeding if safe alternative exists.
Efavirenz Strength NNRTI. well tolerated, low pill burden, PI option reserved for future use
Efavirenz Weakness CNS symptoms, possible teratogenicty,DI, rash, hepatotoxicity, resistance single mutation
PCP prophylaxis Primary Bactrim 1 ds, if sulfa allergy then dapsone. Start if CD4 < 200, stop if CD4 > 200 for > 3 months.
PCP prophylaxis secondary same as primary, only this time don't stop treatment if CD4 >200
Toxoplasma gondii start bactrim ds qd if CD4 < 100 stop when CD4 > 200 for 3 months
MAC (mycobaterium avium complex) start azithromycin 1200 mg po qwk if CD4 < 50 Stop when CD4 > 100 for 3 months
DI ART CASHEW-G (contraceptive, antimicrobial (rifampin), antifungal, anticonvulsant, statins, herbals, ED, Gastric acid suppressant)
Four vaccine u need to avoid Varicella, Zostavax, MMR, live attenuated influenza vaccine
Four vaccine u need to get Pneumovax (at any CD4 above 200), inactive influenza (annually), Hep b (anti-HBc negative), Hep A (at risk plus negative anti-HAV)
Created by: Illusion