Therapeutics ID Nelson Flashcard

Lamivudine: ADR

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

 

Emtricitabine: ADR

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

 

 

Tenofovir: ADR

NRTI

 

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

 

Abacavir: ADR

NRTI

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

 

 

Zidovudine: ADR

NRTI

 

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

 

Didanosine: ADR

NRTI

 

  • Pancreatitis
  • Peripheral neuropathy
  • Renal dosing

 

Stavudine: ADR

NRTI

 

  • Peripheral neuropathy
  • Pancreatitis
  • Lipodystrophy

 

NRTI Mitochondrial Toxicity

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

Efavirenz: ADR

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

;

Nevirapine: ADR

NNRTI

;

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

 

 

Etravirine: ADR

NNRTI

 

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

 

 

Delavirdine: ADR

NNRTI

  • Rash
  • CYP450 drug interactions
  • Teratogenic
  • Transaminitis

 

Atazanavir: ADR

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

 

Darunavir: ADR

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

 

Fosamprenavir: ADR

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

 

Lopinavir/Ritonavir: ADR

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

 

Saquinavir: ADR

 

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

 

Ritonavir: ADR

 

Protease Inhibitor

 

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

 

 

Nelfinavir: ADR

 

Protease Inhibitor

 

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

 

Indinavir: ADR

 

Protease Inhibitor

 

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

 

Tipranavir: ADR

 

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

 

Enfuvirtide: ADR

Fusion Inhibitor

 

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

 

Maraviroc: ADR

Entry Inhibitor

 

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

 

Raltegravir: ADR

Integrase Strand Transfer Inhibitor

 

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

 

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