Save
Busy. Please wait.
Log in with Clever
or
show password
Forgot Password?
Don't have an account?  Sign up 
Sign up using Clever
or
Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account. Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't Know
Remaining cards (0)
Know
0:00
edit
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

ARV ADEs

and Mgmt Recommendations

Adverse EffectAssociated ARVsManagement
Bone marrow suppression ZDV Switch to another NRTI if possible. D/C concomitant bone marrow suppressant if possible. For neutropenia - Consider treatment with filgrastim. For anemia - Consider treatment with erythropoietin therapy.
CV effects (including MI and CVA) MI and CVA - PIs // MI only - ABC and ddI Prevent or manage other CV risk factors; modify lifestyle risk factors
CNS effects EFV Symptoms usually diminish or disappear within 2-4 weeks.
GI intolerance All PIs, ZDV, ddI Sx may spontaneously resolve or become tolerable over time. If not, consider: For N/V - antiemetic prior to dosing. For D - bulk-forming agents (e.g. psyllium products), antimotility agents (e.g., loperamide), Ca tablets, pancreatic enzymes
HS w/hepatic failure NVP D/C ARVs. r/o other causes of hepatitis. Hepatic injury may progress despite treatment discontinuation. Careful monitoring, don't rechallenge. Use other NNRTIs w/caution
Hepatotoxicity All NNRTIs (w/in first 12 wks); all PIs (after weeks to months); most NRTIs (w/in months to years); maraviroc Rule out other causes of hepatotoxicity (EtOH, viral hepatitis, chronic HBV w/3TC, FTC, or TDF initiation or withdrawal; HBV resistance, etc.) // D/C all ARVs, construct a new regimen w/o the potential offending agent when serum transaminases are normal
Hyperlipidemia All PIs (except unboosted ATV); d4T; EFV > NVP Lifestyle modifications, pharmacologic management (HIVMA/ACTG guidelines)
Hypersensitivity Rxn (HSR) ABC d/c ABC and switch to another NRTI; r/o other causes of symptoms
Insulin resistance/ DM Thymidine analogs (ZDV, d4T); some PIs linked to insulin resistance and DM (but unclear if a class effect) Consider using NNRTI if feasible; diet, exercise, pharmacologic mgmt
Lactic acidosis/ hepatic steatosis +/- pancreatitis (severe mitochondrial toxicities) NRTIs, esp. d4T, ddI, ZDV For severe lactic acidosis, d/c all ARVs. Use NRTIs w/less propensity for mitochondrial tox (ABC, TDF, 3TC, FTC). Close monitoring of serum lactate after restarting NRTIs
Lipodystrophy Lipoatrophy - NRTIs (d4T > ZDV > TDF, ABC, 3CT, FTC), esp. when combined with EFV. Lipohypertrophy - PI- or NNRTI-based regimens and w/thymidine analogs (e.g., d4T, ZDV) Lipoatrophy - switch from thymidine analogs to TDF or ABC, which may slow or halt progression and not fully reverse // Lipohypertrophy - Improvement in visceral fat seen in pts on LPV/r switched to ATV/r
Nephrolithiasis/ urolithiasis/ crystalluria IDV, ATV, FPV Increase hydration, control pain, if possible switch to alternative agent
Nephrotoxicity IDV, TDF Stop offending agent, generally reversible; Supportive care, electrolyte replacement as indicated
Neuromuscular weakness syndrome (ascending) d4T is ARV most frequently implicated d/c ARVs. Recovery often takes months and ranges from complete recovery to substantial residual effects. DO NOT RECHALLENGE
Osteonecrosis Older PIs, but unclear whether caused by ARVs or by HIV Decr weight bearing, remove/reduce risk factors
Osteopenia r ostenecrosis TDF or d4T; similar rate of bone loss with EPV or LPV/r based regimens over 96 wk period Switch to other ARVs and stop other contributing drugs. Follow Natl Osteoporosis Fouondation Guidelines and/or IDSA Guidelines. Bisphosphate (alendronate qweek)
Pancreatitis ddI alone; ddI + d4T, hydroxyurea, ribavirin, or TDF. Rare reports with LPV/r D/C offending agents. Manage symptoms of pancreatitis
Peripheral neuropathy ddI, d4T D/C offending agents. Substitute alternate ART w/o potential for neuropathy. Pharmacologic mgmt - gabapentin, TCAs, lamotrigine, carbamazepine, topiramate, tramadol, narcotics
SJ syndrome/ Toxic Epidermal Necrosis NVP > DLV, EFR, ETR. Also reported with APV, FPV, ABC, DRV, ZDV, ddI, IDV, LPV/r, ATV d/c all ARVs and any other possible agents
Bleeding events TPV/r - reports of ICH // PIs - incr bleeding in hemophiliac patients D/C TPV/r and manage ICH w/supportive care // Hemophiliac patients may require increased use of factor VIII products
Created by: battlangl99
Popular Pharmacology sets

 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
Retries:
restart all cards