PIs. Ahhh the ever-so-important private investigators.
Err...I mean protease inhibitors.
You may recall that we've already discussed protease inhibitors in our post on Hepatitis C.
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Howdy all. This is just a quick note to let you know that I wrote a short piece for Pharmacy Times.
You can check it out here:
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I have a confession to make...
I didn't "get" acid-base disorders until well after pharmacy school. They were something I was willing to skate through. To take an "L" on the exam if I had to.
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Non-Nucleoside Reverse Transcriptase Inhibitors, or NNRTIs (pronounced like NRTIs, but with a stutter), are the next class of HIV drugs we will be covering.
What makes a NON-nucleoside as opposed to a regular old fashioned nucleoside reverse transcriptase inhibitor?
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Oncology pharmacy is hard.
Like, really hard.
You get a 3 - 5 week module during school. Maybe you have an APPE rotation. But there's just too much. Too many types of cancers. Too much history that explains how we got to where we are.
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Editor's Note: It is with great pleasure that I introduce Nina Vadiei, PharmD. Nina is a totally bad ass PGY2 Psych Pharmacy Resident who has written the excellent post you're about to read. She's sort of like a wizard when it comes to all things 'psych,' and we really appreciate her dropping knowledge bombs here for you all.
Pro Tip: There is a whole bunch of awesome dosing charts at the end of this post.
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Drug
sofosbuvir / velpatasvir [Epclusa]
Indication
Epclusa is used for treatment of chronic hepatitis C (HCV). It can be used in patients both with and without cirrhosis. If the patient does have cirrhosis (moderate to severe), Epclusa should be given with ribavirin.
Eplcusa can be given all by its lonesome self if there is no cirrhosis or if cirrhosis is in earlier stages.
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Hypertension has been called the “silent killer.” It’s basically asymptomatic unless your blood pressure is high enough to classify as a "hypertensive urgency/emergency." Only then do you really notice anything. You'll get headaches, dizziness, blurry vision, shortness of breath...that sort of thing.
Otherwise, a hypertensive patient feels normal. But behind the scenes, bad stuff is going down in the body.
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Nucleoside Reverse Transcriptase Inhibitors make up what's called the "backbone" of every traditional HAART regimen. It is also an awfully long phrase to type, so I will refer to them only as "NRTIs" from here on out.
But before I go on, there's another distinction I have to make. There are actually both nucleoside and nucelotide reverse transcriptase inhibitors. We lump them into the same "NRTI" bucket because they work in exactly the same way. But they are technically different from each other.
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Editor's Note: She's baaaaaaacccckkk... Stephanie Kujawski, PharmD, BCPS is back with the next installment in her epic series: Pharmacokinetics Dosing Wars. Up for today, we have Episode II: Attack of the Vancomycin. It seems that our hero, Han Solo, has contracted a nasty MRSA infection (which apparently you can do while being frozen in carbonite).
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When I was finishing up pharmacy school (2013), the landscape of Hep-C therapy was drastically changing. Two new drugs, boceprevir and telaprevir, were fresh on the market and were "game changers" according to any and everyone. In fact--I presented these new protease inhibitors (in all their majesty) during my residency interviews.
Now it's 2016 and they're both gone.
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Editor's note: To date, our most reader requested topic has been HIV. We've written a guest post at MedEd101 to cover the most NAPLEX-worthy testing points. But we thought we'd dig in a little further here. Over the next few weeks, we're posting a series called HIV Boot Camp. We'll shore up your HIV fundamentals. Then we'll breakdown each drug class piece by piece to highlight what you need to know. For convenience, we'll link each part of the series here. Part I
Part II: Treatment Goals and Considerations
Alright. Last time we looked at the background and pathophysiology of HIV. We looked at a small glimpse of what a patient might experience in the early days of an HIV infection. As practitioners, we have to ask ourselves "Now what?" Is it time to just give the patient an Atripla and go on about our day?
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