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IOS 11 Exam 3
Drug Interactions with HIV/AIDS meds
| Question | Answer |
|---|---|
| Efavarinz + Lopinavir DI | Efavarinz is an inducer and lopinavir inhibitor but Efavarinz wins must give with Ritonavir 3 tablets BID - PK interaction |
| Tenofovir + Azantavir DI | Must give with ritonavir BID -We do not know the MOA- PK |
| Fos-Ampranavir + Lopinavir | Cannot give this compination- PK |
| Tirpranavir +saquanivir or amprinavir or lopinavir | Cannot give these combinations -PK |
| Zidovudine + stavudine DI | Cannot give these since they are both thymidine analogs- PD |
| Didanosine +tenofovir | Cannot give since they are both Adenosine analogs- PD and there is a PK-didansine is increased so must decrease dose to 250mg>60kg or 200mg if <60Kg |
| Atazanavir + rifampin | Atazanavir is chewed by 3A4 do not give suggest Efavarinz-Interaction PK |
| Efavarinz + rifampin | Decrease in Efavarinz 25% suggest increasing to 800mg in >65Kg person-Interaction PK |
| Rifabutin + Efavirinz | Must increase rifabutin to 450mg QD-Interaction PK |
| Rifabutin + Ritonavir | Decrease Rifabutin 150mg 2-3 times week-Interaction PK |
| Bactrium + Ribavirin + zidovudine | All cause Bone marrow suppression-Interaction PD |
| Atazanavir + PPI | Avoid use due to decrease in atazanavir-Boosting does not help-Interaction PK |
| Atazanavir +H2 | Ok if Boost with ritonavir or seperate by 10 hrs then 2 hrs-Interaction PK |
| Indinivir + PPI | Ok just boost with ritonavir-Interaction PK |
| Lopinavir/rit +simvastatin or lovastatin | Contraindicated due to increased statin- PK |
| Ritonavir + sidenafil | Must decrease duration-25mg Q48 hours-Interaction PK |
| Ritonavir + Vardenafil | 2.5 mg Q72 hrs-Interaction PK |
| Ritonavir +Tadenafil | 10mg Q72 hrs-Interaction PK |
| Atazanavir +Oral Contraceptives | Increases OC AUC- PK- But others are reduced rule- 2nd method should be used-Interaction PK |
| Lopinavir/ritonavir + Phenytoin | Both are decreased-Interaction PK-Monitor levels |
| St.Johns Wort + Protease inhibitors | Contrindicated-PK |
| Secondary Adrenal Suppression | PI's cause increase in exogenous hormone absorption as well as utilization. D/C and give oral glucocorticoid |
| Efavarinz is contraindicated | In Pregnancy |
| Pharmacodynamic-Additive | "Activity" of the 2 drugs is equal to the sum of their indepent activities |
| Pharmacodynamic-Antagonistic | "Activity" of the 2 drugs is less that the sum of their independant activities |
| Pharmacodynamic- Synergistic | "Activity" of 2 drugs is greater than the sum of their individual activities |
| Pharmacokinetic interactions | Result in a change in serum drug levels: ADME |
| Metabolism types | Substrates, Inhibitors, inducers |
| Substrates | Undergo metabolism or transport |
| Inhibitors | Decrease the ability of isozymes to metabolize substrates |
| Inducer | Increase the amount or ability of the isozyme to metabolize substrates-may also be a substrate(auto-induction) |
Created by:
liza001
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