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Case 7: Efavirenz-Associated Central Nervous System Adverse Effects

You answered:

D 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.

This answer is incorrect. There is no convincing evidence that patients with a history of recreational drug use have increased rates of psychosis or any other neuropsychiatric adverse effects with use of efavirenz.

Choose another answer:

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

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