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Flashcards in HIV DRUGS Deck (13)
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1
Q

What is an opportunistic infection?

When does it hit?

A

opportunistic infections are secondary infections

and often occur on STAGE 4

2
Q

HIV ORGAN SYSTEM INVOLVEMENT

A
3
Q

A 54 year old M patient is scheduled for surgery. You have noticed a history of AIDS. You noticed ground-glass opacities on his Xray what may this be and how will you treat it?

what may you order to confirm xray finding?

A

Pneumocystis jirovecci pneumonia

may order CT

Tx of choice: HIGH DOSE BACTRIM

SYSTEMIC STEROID FOR PERSISTENT HYPOXEMIA

4
Q

REVERSE TRANSCRIPTASE INHIBITOR

A
5
Q

Nucleoside/nucleotide (NRTI)

AND SIDEFFECTS

Abacavir

Didanosine

Emtricitabine

Lamvidune

Stavudine

Zidovudine

A

MOA: binds to evolving viral DNA and prevents completion of reverse transcription

Abacavir: distributive shock in patients expressing human leukocyte antigen, MYOCARDIAL INFARCTION

Didanosine: pancreatitis

Emtricitabine

Lamivudine

Stavudine: pancreatitis

Zidovudine: Bone marrow suppression

–>LACTIC ACIDOSIS WITH MITOCHONDRIAL DYSFUNCTION

6
Q

NON-NUCLEOTIDE (NNRTI)

and SE

A

MOA: binds to reverse transcriptase interfering with transcriptional activity

Delavirdine

Efavirenz: LFT, CNS [insomnia, unable to concentrate, nightmares, mania]

Etravirine

Nevirapine: LFT

Tenofovir: lactic acidosis

SE: LFTs,

7
Q

Protease Inhibitor

A

“VIR”

Parasthesias, Qtc prolongation, heart block, hyperbilirubinemia

–please Qt, heartblock hyper B–

8
Q

Entry Inhibitors

A

Fusion Inhibitor

Pneumonia

local injection site reaction

CCR 5 antagonist

hepatotoxicity

hypotension

Infection

9
Q

INTEGRASE INHIBITORS

A

RALTEGRAVIR

CPK ABNORMALITIES

POSSIBLE RHABDO

GRAB A CPK BASELINE

– muscular folks, long cases not uncommon for CPK to increase, if a patient already has an increase baseline its better to monitor –

10
Q

What do Protase Inhibitors inhibit?

What is the effect of NNRTIS?

how can this impact your pain management?

A

Protase Inhibitors: inhibit CYP3A4

RITONAVIR is a strong INHIBITOR

NNRTIs

INDUCES CYP3A4

except

DELAVIRDINE: INHIBITS 3A4

- depending on the medication the patient is on, patient migh require more pain medicine intra/post op –

11
Q

Drug Interactions

of PIs and NNRTIS with antiarrhythmics

A
12
Q

What do you do with the anti-retrovirals before or after the case?

WHY?

A

If possible continue if patient is able to take drugs orally.

PARTIAL CONTINUATION OF DRUGS SHOULD ABSOLUTELY PROHIBITED

ALL OR NOTHING

MAY INCREASE VIRAL RESISTANCE (LIFE LONG)

consult ID

13
Q

Your patient is NPO except meds. will you give your patient atazanavir or rilpivirine?

A

NO. Avoided in patients not eating

Avoid acid suppressant agents