Question 1
A 30-year-old male patient with human immunodeficiency virus infection is being treated with a HAART (highly active antiretroviral therapy) regimen. Four weeks after initiating therapy, he comes to the emergency department complaining of fever, rash, and gastrointestinal upset. Which one of the following drugs is most likely the cause of his symptoms?
- Zidovudine.
- Nelfinavir.
- Abacavir.
- Efavirenz.
- Darunavir.
Explanation -
The abacavir hypersensitivity reaction is characterized by fever, rash, and gastrointestinal upset. The patient must stop therapy and not be rechallenged.
Question 2
Chills, fever, and muscle aches are common reactions to which one of the following antiviral drugs?
- Acyclovir.
- Ganciclovir.
- Oseltamivir.
- Interferon.
- Ribavirin
Explanation -
Interferon causes flu-like symptoms, including chills, fever, and myalgias, upon injection. Pretreatment with acetaminophen decreases the reaction. The other drugs do not cause this particular adverse effect.
Question 3
An HIV infected woman is diagnosed with cytomegalovirus (CMV) retinitis. She has been on a HAART (highly active antiretroviral therapy) regimen containing zidovudine. Which of the following anti-CMV drugs is likely to cause additive myelosuppression with zidovudine?
- Acyclovir.
- Ganciclovir.
- Amantadine.
- Foscarnet.
- Ribavirin.
Explanation -
Ganciclovir is myelosuppressive in and of itself and will add to the myelosuppression caused by zidovudine. The combination has an increased risk of neutropenia and anemia. Foscarnet has anti-CMV activity, but it does not cause myelosuppression. The other drugs are not effective against CMV.
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