-
Lamivudine
- NRTI (preferred)
- minimal toxicity
- hyperpigmentation/skin discolorization
- aginst HBV
- M184 give resistance (but add this or emtricitabine in regimen!)
- don't give w/ emtricitabine
-
Etricitabine
- NRTI (preferred)
- minimal toxicity
- skin discoloration, hyperpigmentation
- nausea
- against HBV (Truvada for HIV/HBV co-infect)
- M184V gives resistance
- don't give w/ lamivudine
-
Tenofovir
- Asthenia,
- N/V/D; HA (these gone in a week)
- flatulence
- Nephrotoxicity (avoid renal insufficiency, but dialysis okay)
- active agains HBV (w/ emtricitabine)
- Potential for osteopenia
- “Ten kids fell and broke their bones”
- superior than zidovudine, and abacavir (when VL>100,000)
- w/ atazanavir, must give w/ ritonavir
-
Avacavir
NRTI (2nd line)
- HLA-B*5701 test-> avoid if (+)
- Hypersensitivity (fever, rash, malaise, fatiques, respiratory, GI symptoms; greater risk for 1st 6wks)
- MI risk
- dose adjust if hepatic impairment
- inferior to TDF when VL>100,000
- "ChewBACCA is so HYPERSENSITIVE
- about his appearance, he still had a HEART ATTACK after looking in the
- mirror for the 100,000th time"
-
Zidovudine
NRTI (3rd line)
- Mitochondrial toxicity
- - Lipoatrophy & lactic acidosis w/ hepatic steatosis
- Bone marrow suppression (anemia)
- Hyperlipidemia (cholesterol increase)
- GI intolerance
- Insulin resistance**
- HA/ insomnia, asthenia
- BID- adherence issue
- not with ribivirin (hep C drug)
-
Efavirenz
NNRTI (preferred- efficacy superior, less toxic than nevirapine)
- Take in empty stomach!
- Hyperlilidemia
- Pregnancy: D
- k103N mutation
- CNS effects (dreams,dizziness,
- somnolence,insomnia, etc)- take @ night!
- Lipohypertrophy
- Cyp3A4 inx(sub, inhibitor, inducer)
- False (+) drug (benzo, cannabinoid)
- My FAVorite artist is CHER
- C-CNS; H-Hyperlipidemia & lipohypertrophy ;E-elevated transaminases;R-rash
-
Etravirine
NNRTI (alternative-when efavirenz can't be used)
- ONLY PI wl : darunavir/ritonavir or Lopinavir/ritonavir.
- CAN'T USE w/ only 2 NRTIs!!!
- (add PI or other agent i.e. raltegravir)
- not 2 NNRTIs!!
- well tolerated
- Rash
- Elevated transaminases
- CYP inducer and substrate
- take w/ FOOD
- "ETR- extra agent; tolerable; rash"
-
Rilpivirine
NNRTI (alternative when can't use efavirenz)
- Very well- tolerated
- Rare: rash, HA, insomnia, dpressive
- Elevated transaminases
- Take with FOOD!
- cyp 3 A substrate only
- absorption depends on food and pH
- Cant use w/ PPI & H2 blockers!
RAT: rilpivirine, acid, tolerable
|
|