reasons when not to use certain combos
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| what should not be used during 1st trimester of pregnancy | efavirenze
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| what should be used with caution in patients with unstable psychiatric disease | efavirenz
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| what should not be used in pts with moderate to sever hepatic impairment | nevirapine
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| what should not be used when CD4 counts are above 250 in women and 400 in men | nevirapine
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| what should not be used when a patient requires more than 20 mg of omeprazole or any other PPI | atazanavir and delavirdine (CI WITH even 20 mg of omep) atazanavir can be given with 20 mg omeprazole if 12 hours apart
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| what should not be used when the patient has an underlying renal insufficiency problem | tenofovir emtricitabine combination (truvada) this is first line normally so this is a good reason to go to alternative. Cl less than 50 no atripla cl less than 30 no truvada
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| what should not be used with a positive HLA-B*5701 test | abacavir, ziagen, epzicom, trizivir
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| what should not be used with a history of pancreatitis or peripheral neuropathy | combination didanosine & lamivudine or didanosine and emtricitabine. didanosine is a big offender of pancreatitis ( along with stavudine but is not in a preferred or alternative reg to care about)
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| which combination should you use caution in the presence of pretreatment anemia and or neutropenia | zidovudine & lamivudine comb brand name combivir. these two drugs are also found in trizivir
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