Case 7: Efavirenz-Associated Central Nervous System Adverse Effects

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You answered:

	Plasma efavirenz drug level should be monitored on a monthly basis during the first 6 months of therapy.

This answer is incorrect. Although several studies have suggested that central nervous system adverse effects may correlate with higher efavirenz levels, routine monitoring of efavirenz levels is not currently recommended. Further, the association between psychiatric side effects and efavirenz levels has not been established.

Choose another answer:

	When efavirenz is taken with a meal, the levels are significantly lower than when taken on an empty stomach. Thus, the patient has probably developed abnormally high plasma efavirenz levels because he is taking efavirenz on an empty stomach.
	After initiating therapy with an efavirenz-containing regimen, the development of early central nervous system adverse effects, such as dizziness, mild cognitive difficulty, fatigue, and sleep disturbances, usually improve within 4 weeks.
	Patients with a history of recreational drug use should never be prescribed efavirenz because of the high likelihood of developing psychosis if they receive efavirenz.

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