Therapeutics ID Nelson – Flashcards

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question
Lamivudine: ADR
answer

NRTI

  • Minimal toxicity
  • Mild GI AEs, Headache
  • Renal dosing for renal insufficiency
  • Severe acute exacerbation of hepatitis may occur in HBV-coinfected patients who discontinue Lamivudine/Emtricitabine therapy

 

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Emtricitabine: ADR
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NRTI
  • Minimal toxicity
  • Mild GI AEs, Headache
  • Hyperpigmentation
  • Renal dosing for renal insufficiency
  • Severe acute exacerbation of hepatitis may occur in HBV-coinfected patients who discontinue Lamivudine/Emtricitabine therapy

 

 

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Tenofovir: ADR
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NRTI

 

  • Less GI intolerance
  • Asthenia
  • Acute Renal Failure, Fanconi Syndrome
  • Potential for decrease in bone mineral density
  • Osteomalacia
  • Renal dosing

 

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Abacavir: ADR
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NRTI

  • Hepatic dosing required
  • Renal adjustments necessary
  • Hypersensitivity reaction: potentially fatal

 

 

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Zidovudine: ADR
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NRTI

 

  • GI intolerance
  • Asthenia
  • Headache
  • Myalgias
  • Myelosuppression (Anemia, Neutropenia)
  • Lactic Acidosis (rare)
  • Renal dosing
  • Neuropathy

 

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Didanosine: ADR
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NRTI

 

  • Pancreatitis
  • Peripheral neuropathy
  • Renal dosing

 

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Stavudine: ADR
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NRTI

 

  • Peripheral neuropathy
  • Pancreatitis
  • Lipodystrophy

 

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NRTI Mitochondrial Toxicity
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  • Lactic acidosis
  • Lipodystrophy
  • Hepatomegaly with Steatosis
  • Peripheral neuropathy
  • Pancreatitis
  • Myopathy
  • Cardiomyopathy

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Efavirenz: ADR
answer

NNRTI

 

  • Hepatic metabolism
  • CYP3A4 drug interactions
  • Rash
  • Pregnancy Category D -- don't use within 1st trimester of pregnancy, women trying to conceive, and not using contraceptives
  • Neuropsychiatric effects

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Nevirapine: ADR
answer

NNRTI

;

  • Hepatic metabolism - autoinduction
  • Hepatotoxicity
  • CYP3A4 drug interactions
  • Rash (Stevens-Johnson Syndrome)
  • Don't use in women CD4 > 250, men CD4 > 400

 

 

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Etravirine: ADR
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NNRTI

 

  • Hepatic metabolism
  • CYP450 drug interactions
  • Rash
  • Hypersensitivity reactions
  • Nausea

 

 

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Delavirdine: ADR
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NNRTI

  • Rash
  • CYP450 drug interactions
  • Teratogenic
  • Transaminitis

 

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Atazanavir: ADR
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Protease Inhibitor

 

  • Hepatic metabolism
  • Notorious for CYP3A4 drug interactions
  • GI adverse effect
  • Indirect hyperbilirubinemia
  • Prolonged PR interval
  • Hyperglycemia
  • Fat maldistribution
  • Possible increase bleeding episodes in patients with hemophilia
  • Nephrolithiasis

 

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Darunavir: ADR
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Protease Inhibitor

 

  • Hepatotoxicity
  • Notorious for CYP3A4 drug interactions
  • Diarrhea, nausea
  • Rash: Stevens-Johnson syndrome
  • Headache
  • Hyperlipidemia
  • Hyperglycemia
  • Fat maldistribution
  • Possible increase bleeding episodes in patients with hemophilia

 

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Fosamprenavir: ADR
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Protease Inhibitor

 

  • Hepatic dosing
  • Elevated transaminases
  • Notorious for CYP3A4 drug interactions
  • GI adverse effect
  • Skin rash
  • N/V/D
  • Headache
  • Hyperlipidemia, possible increase risk for MI
  • Hyperglycemia
  • Fat maldistribution
  • Possible increase bleeding episodes in patients with hemophilia

 

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Lopinavir/Ritonavir: ADR
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Protease Inhibitor

 

  • Hepatic dosing
  • Notorious for CYP3A4 drug interactions
  • GI intolerance, N/V/D
  • Asthenia
  • PR interval prolongation, QT prolongation and torsades de pointes
  • Hyperglycemia
  • Fat maldistribution
  • Possible increase bleeding episodes in patients with hemophilia

 

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Saquinavir: ADR
answer

 

Protease Inhibitor

 

  • Hepatic dosing
  • Notorious for CYP3A4 drug interactions
  • Elevated liver transaminases
  • GI intolerance, N/V/D
  • Headache
  • Hyperlipidemia
  • Hyperglycemia
  • Fat maldistribution
  • Possible increase bleeding episodes in patients with hemophilia

 

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Ritonavir: ADR
answer

 

Protease Inhibitor

 

  • Hepatic dosing
  • Notorious for CYP3A4 drug interactions
  • GI intolerance
  • Circumoral and extremity paresthesias
  • Taste perversion
  • PR interval prolongation
  • Hypertriglyceridemia
  • Hyperuricemia

 

 

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Nelfinavir: ADR
answer

 

Protease Inhibitor

 

  • Hepatic dosing
  • Notorious for CYP3A4 drug interactions
  • GI intolerance - DIARRHEA
  • Hyperglycemia
  • Hyperlipidemia
  • Elevated transaminases
  • Possible increase bleeding episodes in patients with hemophilia

 

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Indinavir: ADR
answer

 

Protease Inhibitor

 

  • Mild-moderate hepatic failure
  • Cirrhosis
  • Notorious for CYP3A4 drug interactions
  • GI intolerance
  • "Crix Belly"
  • Nephrolithiasis
  • Crystalluria, hematuria, hydronephrosis, pyuria, urinary eosinophilia

 

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Tipranavir: ADR
answer

 

Protease Inhibitor

 

  • Hepatotoxicity
  • Notorious for CYP3A4 drug interactions
  • GI intolerance, N/V/D
  • Asthenia
  • Rash
  • Intracranial hemorrhage
  • Hyperlipidemia
  • Hyperglycemia
  • Fat maldistribution
  • Possible increase bleeding episodes in patients with hemophilia

 

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Enfuvirtide: ADR
answer

Fusion Inhibitor

 

  • Injection site reaction (pain, erythema, induration, nodules/cysts, pruritis, ecchymosis)
  • Increase bacterial pneumonia
  • Hypersensitivity reaction

 

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Maraviroc: ADR
answer

Entry Inhibitor

 

  • CYP450 drug interactions
  • Abdominal pain, cough, dizziness, musculoskeletal symptoms, pyrexia, rash, URI, hepatoxicity, orthostatic hypotension

 

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Raltegravir: ADR
answer

Integrase Strand Transfer Inhibitor

 

  • UGT1A1-mediated glucuronidation
  • Nausea, diarrhea, headache, pyrexia, CPK elevation

 

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