RNA to DNA, causing Purine Analogues: TDF: Renal and bone adverse effects. Fanconi nonfunctional DNA. Abacavir (ABC) syndrome. Favorable Lipids. Tenofovir (TDF or TAF) Didanosine: Pancreatitis; peripheral Didanosine neuropathy, lipoatrophy, lactic acidosis Non-Nucleoside Also inhibit reverse Efavirenz (EFV) Efavirenz: Neuropsychiatric effects, rash in Analogue Reverse transcriptase, but do so Rilpivirine 15% of pts Transcriptase by binding directly to Nevirapine Rilpivirine: Cannot take with PPIs Inhibitors reverse transcriptase Etravirine Nevirapine: Hypersensitivity; hepatotoxicity (NNRTIs) Etravirine: Rash Protease Inhibitors Prevents protease from Atazanavir: Hyperbilirubinemia; Darunavir (PI) cleaving HIV proteins and nephrolithiasis Atazanavir enzymes into forms that Indinavir: Lipoaccumulation Ritonavir can infect other cells. Fosamprenavir Saquinavir: Lipoaccumulation Indinavir Lopinavir All PIs may cause the metabolic syndrome Nelfinavir Saquinavir Tipranavir Integrase Inhibitors Block HIV integrase, Raltegravir Dolutegravir: Caution when used with which encorporates HIV Elvitegravir (EVG) metformin; May elevate serum creatinine; DNA into host DNA Dolutegravir (DTG) New data suggests may increase risk of neural tubes defects if taken during pregnancy. Booster Agents Inhibit CYP 3A4, Ritonavir (also a PI itself) Cobicistat: May increase serum creatinine increasing concentrations Cobicistat of other HIV drugs Drug-Drug interactions may occur, notably (notably PIs) with commonly prescribed medications such as statins, NOACs, and steroids (inhaled and systemic) Note: Entry Inhibitors that block attachment of HIV to host cells, including Enfuvirtide and Maraviroc, have a limited role in therapy and are now rarely used because of method of delivery (injection) and side effects.
RNA to DNA, causing nonfunctional DNA. Purine Analogues: Abacavir (ABC) Tenofovir (TDF or TAF) Didanosine TDF: Renal and bone adverse effects. Fanconi syndrome. Favorable Lipids. Didanosine: Pancreatitis; peripheral neuropathy, lipoatrophy, lactic acidosis Non-Nucleoside Analogue Reverse Transcriptase Inhibitors (NNRTIs) Also inhibit reverse transcriptase, but do so by binding directly to reverse transcriptase Efavirenz (EFV) Rilpivirine Nevirapine Etravirine Efavirenz: Neuropsychiatric effects, rash in 15% of pts Rilpivirine: Cannot take with PPIs Nevirapine: Hypersensitivity; hepatotoxicity Etravirine: Rash Protease Inhibitors (PI) Prevents protease from cleaving HIV proteins and enzymes into forms that can infect other cells. Darunavir Atazanavir Ritonavir Fosamprenavir Indinavir Lopinavir Nelfinavir Saquinavir Tipranavir Atazanavir: Hyperbilirubinemia; nephrolithiasis Indinavir: Lipoaccumulation Saquinavir: Lipoaccumulation All PIs may cause the metabolic syndrome Integrase Inhibitors Block HIV integrase, which encorporates HIV DNA into host DNA Raltegravir Elvitegravir (EVG) Dolutegravir (DTG) Dolutegravir: Caution when used with metformin; May elevate serum creatinine; New data suggests may increase risk of neural tubes defects if taken during pregnancy. Booster Agents Inhibit CYP 3A4, increasing concentrations of other HIV drugs (notably PIs) Ritonavir (also a PI itself) Cobicistat Cobicistat: May increase serum creatinine Drug-Drug interactions may occur, notably with commonly prescribed medications such as statins, NOACs, and steroids (inhaled and systemic) Note: Entry Inhibitors that block attachment of HIV to host cells, including Enfuvirtide and Maraviroc, have a limited role in therapy and are now rarely used because of method of delivery (injection) and side effects.
Silver-Medicine-Rotation-Guide_Final.docx