55: Antiretroviral Drugs

Question 1

indicates acute HIV infection

Answer 1

p24 antigen

later stages see anti-HIV antibody gp120

Question 2

adverse effects common to NRTIs

Answer 2

lactic acidosis
fatty liver disease
lipdystrophy

Question 3

MOA NRTIs

Answer 3

mimic nucleotides to inhibit nt binding to the catalytic site and cause chain termination when incorporated into the DNA

*require cellular kinases to convert to a triphosphate form

Question 4

guanosine analogue NRTI

Answer 4

abacavir

Question 5

cytosine analogue NRTI

Answer 5

lamivudine

safe for preggers and neonates

Question 6

fluorinated analogue of lamivudine NRTI

Answer 6

emtricitabine

longer half life than lamivudine but now contraindicated for young children and preggers or pt with renal and hepatic failute

Question 7

nucleotide analogue of adneosine NRTI

Answer 7

tenofovir

Question 8

deoythymidine analogue NRTI

Answer 8

zidovudine

Question 9

which group of drugs is not active against HIV-2?

Answer 9

NNRTIs

Question 10

MOA NNRTIs

Answer 10

bind to a site on reverse transcriptase distinct from the active site

do not require phosphorylation for activation

Question 11

adverse effects common to NNRTIs

Answer 11

drug-drug interactions due to effects on cytochrome p450 enzymes

also rash, steven johnson syndrome and hepatotoxicity

Question 12

the two NNRTI drugs =

Answer 12

nevirapine

efavirenz

Question 13

MOA protease inhibitor s

Answer 13

mimic peptide targets for the protease and block maturation of virion particles after budding

Question 14

adverse effects common to protease inhibitors

Answer 14

*drug-drug alterations due to alteration of cytochrome p450 enzymes

Question 15

three protease inhibitor drugs =

Answer 15

atazanavir
ritonavir
darunavir

Question 16

MOA maraviroc

Answer 16

binds to CCR5 preventing gp120 binding, fusion and entry

Question 17

what must be done before maraviroc use?

Answer 17

screening for topism (only work with CCR5 tropic virus ppl)

Question 18

fusion inhibitor

Answer 18

enfuvirtide

Question 19

only parenterally delivered antiretroviral agent

Answer 19

enfuvirtide

Question 20

intergrase inhibitors (3)

Answer 20

raltegravir
elvitegravir
dolutegravir

Question 21

pyrimidones analogue integrase inhibitor

Answer 21

raltegravir

Question 22

HIV integrase strand transfer inhibitor

Answer 22

elvitegravir

dolutegravir

Question 23

antiretroviral therapy is recommended for ______ HIV infected individuals

Answer 23

all - to reduce risk of disease progression and prevent transmission

strength and evidence for recommendation vary by CD4 cell count – best evidence for less than 350

Question 24

standard of care =

Answer 24

combinations of at least three ARV drugs usually from at least two different classes

Question 25

preferred combination ARV therapies for initial therapy

Answer 25

1 PI (ritonavir boosted) and 2 NRTIs

or 1 integrase inhibitor and 2 NRTIs