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ANTIVIRALS

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nibbs06's version from 2018-11-19 03:46

Exam to know

Question Answer
NRTI (6)Mitochondrial Toxicity + Insulin Resistance + Lactose Intolerance + Dyslipidemia + Hypersensitivity + Rash ("MILD HR")
PI (3)Redistribution & Accumulation of Body Fat (“Buffalo hump”) + Increased Liver Enzymes + Dyslipidemia (BED)
INSTI(2)Nervous System + Neuropsychiatric Effects
NNTRI (3)Hepatitis + Increased Liver Enzymes + Rash (H.E.R)
ID Drug Name from Class - NRTI (2)-dINE or -vir (Abacavir & Tenofovir)
ID Drug Name from Class - PI-NAVir
ID Drug Name from Class - INSTI-TEGRAVIR
ID Drug Name from Class - NNRTI-VIR-
ABACAVIR (CLASS, ADR & CONTRAINDICATIONS)NRTI, Hypersensitivity Rxn (HLA) + Rash + Possible Increase in MI, Avoid Alcohol
Cough & HLA-Hypersensitivity(1)(NRTI) AbacaVIR
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Allergic response protocol

Question Answer
Cross Reactivity occurs incross reactivity occurs in Type 1 (maaaaybe Type 4, but depends)
Protocol for Type 1protocol for type 1 Desensitize
Mediators for Type 1Mediators are histamine & IgE
Mediators for Type 2Mediators areIgG & IgM
Mediators for Type 3Mediators are IgG & IgM
Mediators for Type 4Mediators are T-Cells
Thrombocytopenia Purpuria, Hemolytic Anemia & AgranulocytosisClinical Sx of Type 2(cytotoxic/delayed)
Lupus-Like run, Serum sickness-like syndrome, vasculitis, Uticaria & AngioedemaClinical Sx of Type 3 Immune Complex/Delayed
Eczema, Drug-Rash, Contact Dermatitis are clinical sx ofClinical sx of Type 4 Delayed/T Cell mediated
Clinical symptoms are dose-dependent fordose dependent sx for Type 2 cytolytic
Response from Morphine/Codeine reactionAnaphylactoid response (vancomycin & caspofungin also)
Protocol for type 2change drug class and group
Protocol for type 3Change drug class/group
Protocol for type 4Desensitize FIRST then rechallenge
Protocol for anaphylactoid responseRechallenge only + pre-medicate
How to determine if Anaphylaxis or Anaphylactoid?give chemically related compound. If reaction occurs, then it's type 1. If it doesn't, then it's type 2
Mediators for Anaphylactoid responseIgG & also basophils/histamine
Type 3 acts onkidney & tissue since they deposit their complexes there
Protocol for type AReduce Dose OR withhold (since it is an exaggeration of an INTENDED response)
Protocol for type BAvoid AND Withhold (since bizarre ADR is a TOXIC/unpredictable/unanticipated)
What class would we put a beta-lactam or sulfonamide that exhibits a Type 1 or Type 4 Hypersensitivity? What should we do? Type B. Type 1, desensitize. Type 2, desensitize first and then rechallenge.
Protocol for Type CAvoid AND Withhold (Since it is DOSE & TIME related)
Protocol for Type DWithdraw*(Can be irreversible since it is time related)
Protocol for Type EWithdraw (i.e, when someone stops taking drug)
Between type A, B, C, D, E, F. Which one is Dose-Dependent?Type A
Depletion of Neurotransmitters is an example of what type of drug reaction classification? What's the protocol?Type D (Delayed). Withdraw
Suppression of HPA Axis via corticosteroid use is an example of what type of drug reaction classification? What's the protocol?Type C (Chronic). Avoid & Withhold
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More detailed drug names (reverse it)

Question Answer
Hyperlipidemia & Increased Liver Enzymes (PI)DaruNAVIR
Hypertriglyceridemia + Increased Liver Enzymes (PI) (2)FosampreNAVIR + LopiNAVIR/RitoNAVIR
Increased Liver Enzymes + Hypercholesterolemia + Hypertriglyceridemia (PI)TipraNAVIR
Rash + Increased Liver Enzymes (NNRTI) (3)DelaVIRdine + EfaVIRenz + NeVIRapine
Increased Liver Enzymes (NNRTI)RilpiVIRine
Increased Liver Enzymes (INSTI) (2)DoluTEGRAVIR + RalTEGRAVIR
Increased Liver Enzymes (CCR5 Inhibitors)Maraviroc
Lipodystrophy + Hyperlipidemia + Insulin Resistance (2)(NRTI) ZidovuDINE + StavuDINE
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