Case Studies about Anti-HIV Agents – Antiviral Drugs

by Pravin Shukle, MD

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    Let's go on to a question on HIV. A 44 year old female prostitute is HIV positive and is seen with abdominal pain and elevated amylase and lipase levels. She is diagnosed with pancreatitis. She's following a three drug HAART protocol with DDI, ritonavir and zidovudine. She was placed on terbentine for a foot fungal infection. Which of these drugs is most likely to have caused the pancreatitis? Is it A) Didanosine B) Ritonavir C) Zidovudine or D) Terbenifine Good show you picked the DDI. Now this is a very similar question that we actually saw on the USMLE and MCCQE exams every year. You just have to unfortunately have to memorize this to get this question right. DDI is well known to cause pancreatitis. Up to 30% of recipients will develop it. It is a feared and potentially fatal disease if you don't recognize it quickly. And you should be aware of this fact simply because of the high incidence of pancreatitis. And guaranteed we seem to see it on exams every year. And we do talk about it on the floors and on the wards. So it's a good thing to memorize. Let's go on to a question that I like to call HAARTburn. A 32 year old HIV patient presents with polyuria, polydypisa, dehydration and confusion. Now she has bloodwork done which shows an acidosis, hypokalemia and hyperchloremia. The patient is on HAART therapy with these three drugs. Which is the most likely culprit for this presentation. Is it A) The NRTI zidovudine. Is it B) The NNRTI nevirapine. Or is it C) The PI ritanovir. Good job it was zidovudine. Now the purpose of this question is to reinforce that NRTI's are associated with an increased risk of lactic acidosis. The NNRTI is well known to...

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    The lecture Case Studies about Anti-HIV Agents – Antiviral Drugs by Pravin Shukle, MD is from the course Antimicrobial Pharmacology.

    Author of lecture Case Studies about Anti-HIV Agents – Antiviral Drugs

     Pravin Shukle, MD

    Pravin Shukle, MD

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