[9] MIDTERMS | IMMUNOLOGIC AGENTS Flashcards
HIV AND AIDS-RELATED DRUGS
PATHOLOGY: Three Modes of Transmission of HIV Infection
PATHOLOGY: Three Modes of Transmission of HIV Infection
1. Injection on infected blood
2. Sexual contact
3. Maternal-fetal transmission
HIV AND AIDS-RELATED DRUGS
ANTIRETROVIRAL THERAPY
Aims to: (3)
ANTIRETROVIRAL THERAPY
Aims to:
* Reduce the detectable viral load of HIV RNA as low as possible
* Maintain this level of suppression for as long as possible
* Prevent opportunisitic infections
HIV AND AIDS-RELATED DRUGS
HAART (Highly Active Antiretroviral Therapy)
Goals:
* Decreasing Virus Level to an undetectable levels
* Preserving and increasing the number of CD4 + T cells
* Preventing resistance
* Having client in good clinical condition
* Preventing secondary infections and cancers
HIV AND AIDS-RELATED DRUGS
NUCLEOSIDE or NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)
* NRTIs force the HIV virus to use faulty versions of building blocks so infected cells can’t make more HIV.
* Abacavir, or ABC (Ziagen)
* Didanosine, or ddl (Videx)
* Emtricitabine, or FTC (Emtriva)
* Lamivudine, or 3TC (Epivir)
* Stavudine, or d4T (Zerit)
* Tenofovir alafenamide, or TAF (Vemlidy)
* Tenofovir disoproxil fumarate, or TDF (Viread)
* Zidovudine or ZDV (Retrovir)
HIV AND AIDS-RELATED DRUGS
NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)
* These are also called “non-nukes.” NNRTIs bind to a specific protein so the HIV virus can’t make copies of itself.
* Cabotegravir/rilpivirine (Cabenuva)
* Delavirdine or DLV (Rescripor)
* Doravirine, or DOR (Pifeltro)
* Efavirenz or EFV (Sustiva)
* Etravirine or ETR (Intelence)
* Nevirapine or NVP (Viramune)
* Rilpivirine or RPV (Edurant)
HIV AND AIDS-RELATED DRUGS
PROTEASE INHIBITORS (PIs)
* These drugs block a protein that infected cells need to put together new HIV virus particles.
* Atazanavir or ATV (Reyataz)
* Darunavir or DRV (Prezista)
* Fosamprenavir or FPV (Lexiva)
* Indinavir or IDV (Crixivan)
* Lopinavir + ritonavir, or LPV/r (Kaletra)
* Nelfinavir or NFV (Viracept)
* Ritonavir or RTV (Norvir)
* Saquinavir or SQV (Invirase, Fortovase)
* Tipranavir or TPV (Aptivus)
HIV AND AIDS-RELATED DRUGS
INTEGRASE INHIBITORS
* These stop HIV from making copies of itself by blocking a key protein that allows the virus to put its DNA into the healthy cell’s DNA. They’re also called integrase strand transfer inhibitors (INSTIs).
* Bictegravir or BIC (combined with other drugs as Biktarvy)
* Cabotegravir and rilpivirine (Cabenuva)
* Cabotegravir (Vocabria)
* Dolutegravir or DTG (Tivicay)
* Elvitegravir or EVG (Vitekta)
* Raltegravir or RAL (Isentress)
HIV AND AIDS-RELATED DRUGS
FUSION INHIBITORS
* Unlike NRTIs, NNRTIs, PIs, and INSTIs, which work on infected cells, these drugs block HIV from getting inside healthy cells.
* Enfuvirtide, or ENF or T-20 (Fuzeon)
HIV AND AIDS-RELATED DRUGS
gp120 ATTACHMENT INHIBITOR
* This is a new class of drug with just one medication, fostemsavir (Rukobia).
* It is for adults who have tried multiple HIV medications and whose HIV has been resistant to other therapies.
* It targets the glycoprotein 120 on the surface of the virus, stopping it from being able to attach itself to the CD4 T-cells of your body’s immune system.
HIV AND AIDS-RELATED DRUGS
CCR5 ANTAGONIST
* Maraviroc, or MVC (Selzentry), also stops HIV before it gets inside a healthy cell, but in a different way than fusion inhibitors.
* It blocks a specific kind of “hook” on the outside of certain cells so the virus can’t plug in.
HIV AND AIDS-RELATED DRUGS
POST-ATTACHMENT INHIBITOR or MONOCLONAL ANTIBODY
* This is a new class of antiviral medication specifically for adults living with HIV who have tried multiple HIV medications and whose HIV has been resistant to other therapies.
* Ibalizumab-uiyk (Trogarzo) blocks your body’s HIV infected cells from spreading the virus into those which are uninfected. It is given by IV.
HIV AND AIDS-RELATED DRUGS
PHARMACOLOGIC ENHANCERS or DRUG BOOSTERS
* Ritonavir (RTV), taken in a low dose, increases blood levels of lopinavir (LPV) and the drug LPV/r (Kaletra).
* Cobicistat (Tybost) does the same thing in combination with atazanavir, darunavir, elvitegravir.
* Atazanavir + cobicistat, or ATV/c (Evotaz)
* Darunavir + cobicistat, or DRV/c (Prezcobix)
* Elvitegravir + TDF + FTC + cobicistat, or EVG/c/TDF/FTC (Stribild)
* Elvitegravir + TAF + FTC + cobicistat, or EVG/c/TAF/FTC (Genvoya)
* Because these “drug boosters” can increase the levels of other drugs and cause potential harm, you should always tell your doctor about the medicines you are taking.
HIV AND AIDS-RELATED DRUGS
- FIXED DOSE COMBINATIONS
- Some drug manufacturers put together specific medicines into a single pill so they’re easier to take, including:
- Integrase strand transfer inhibitor (INSTI)-based:
- Bictegravir + tenofovir alafenamide + emtricitabine, or BIC/TAF/FTC (Biktarvy)
HIV AND AIDS-RELATED DRUGS
PrEP MEDICATION
* PrEP stands for pre-exposure prophylaxis. That means you take these medications before (“pre-“) HIV gets into your system (exposure) to help protect against infection (prophylaxis).
* These medications work quite well, but they aren’t foolproof – you need to take them every day for best effect, and even then, they don’t work 100% of the time.
* That’s why it’s best to take other steps to protect yourself when you can. For example, consider using a condom for extra protection if you have sex with people who might have HIV.
* PrEP medications for HIV include Truvada and Descovy.
* PrEP can help protect both you and your baby if you plan to get pregnant from a partner with HIV. It helps block the virus during pregnancy and while breastfeeding.
HIV AND AIDS-RELATED DRUGS
PEP
* PEP, or post-exposure prophylaxis, is a short course of HIV medicines taken very soon after a possible exposure to HIV to prevent the virus from taking hold in your body.
* You must start it within 72 hours (3 days) after a possible exposure to HIV, or it won’t work. Every hour counts!
* PEP should be used only in emergency situations. It is not meant for regular use by people who may be exposed to HIV frequently.
* If you are prescribed PEP, you will need to take the HIV medicines every day for 28 days.
