anti HIV

Question 1

Need tropism assay

Answer 1

Maraviroc

Question 2

NRTI with hypersensitivity

Answer 2

Abacavir: due to genetic disposition

Question 3

NRTI with highest side effect of lactic acidosis and hepatic steatosis due to mitochondrial toxicity? Lowest?

Answer 3

highest: stavudine
lowest: lamivudine, emtricitabine

Question 4

Two NRTIs that are antagonistic of each other

Answer 4

stavudine, zidovudine

lamivudine, emtricitabine

Question 5

main toxicity of NNRTI

Answer 5

rash on trunk and extremities

Question 6

What can tenofovir be combined with to create increased effects against HIV? What is the significance?

Answer 6

Combined with emtricitabine (Truvada)

Used as initial HIV therapy, extending time to virologic failure and first adverse event.

**1st effective antiretroviral chemoprophylaxis before exposure (infection prevention!)

Question 7

major toxicity of Nevirapine

Answer 7

hepatoptoxicity: increased liver enzymes

severe and life-threatening

Question 8

2 major toxicities of efavirenz

Answer 8

neuropsychiatric

teratogenic (Category D)

Question 9

HIV-1 specific

Answer 9

raltegravir

NNRTIs

maraviroc

Question 10

What inhibits the UGT? What anti-HIV does this affect?

Answer 10

atazanavir inhibits

raltegravir is metabolized by UGT

Question 11

What is the most effective ART available?

Answer 11

protease inhibitors

Question 12

What two PIs are used in conjunction to increase effects up to 100x?

Answer 12

Ritonavir increases Lopinavir’s effects 100x

Question 13

Do NRTIs have to be phosphorylated?

Answer 13

yes, by cellular kinases

Question 14

Do NNRTIs have to be phosphorylated?

Answer 14

no!

Question 15

First line of NRTI in HAART

Answer 15

tenofovir+emtricitabine OR zidovudine+lamivudine

**emtri/lam can be used in place of each other

Question 16

anti-HIV BM suppressor

Answer 16

zidovudine

Question 17

anti-HIV: peripheral neuropathy

Answer 17

didanosine, stavudine

Question 18

anti- HIV: pancreatitis

Answer 18

didanosine (dose limiting), stavudine, lamivudine (kids), ritonavir

Question 19

anti-HIV: nephrotoxicity

Answer 19

indinavir

Question 20

anti-HIV: hepatotoxicity

Answer 20

NNRTIs, NRTIs, PIs

*life-threatening in nevirapine

Question 21

anti-HIV: rash

Answer 21

abacavir, NNRTIs

Question 22

anti-HIV: diarrhea

Answer 22

didanosine, nelfinavir, ritonavir, lopinavir/ritonavir

Question 23

anti-HIV: ocular effects

Answer 23

didanosine

Question 24

What is needed for ARV regimen?

Answer 24

3 drugs from at least 2 classes

Question 25

What is different about NRTIs from their analogs that makes them effective?

Answer 25

3’ hydroxyl end is replaced by azido, hydrogen, etc. which terminates the synthesis of the chain

Question 26

What type of anti-HIV are used as secondary therapy when resistance occurs?

Answer 26

intgrase inhibitors (raltegravir)

Question 27

What is used in conjuction with HAART to increase effectiveness?

Answer 27

Fusion inhibitors (enfuvirtide, maraviroc)

Question 28

What type of cells do NRTIs have the greatest effect on?

Answer 28

Those that have not yet been infected, but are susceptible

Question 29

What anti-herpesvirus drug interacts with didanosine? What is the end effect?

Answer 29

Ganciclovir increases didanosine plasma concentration x2

Question 30

First line of NNRTI in HAART

Answer 30

efavirenz

*avoid in prego

Question 31

First line of PI in HAART

Answer 31

atazanavir + ritonavir, fosamprenavir + ritonavir (BID), OR lopinavir/ritonavir (BID)

Question 32

What are NNRTIs excreted as?

Answer 32

glucuronide conjugates

Question 33

What drug can cause anemia? How can it be alleviated?

Answer 33

Zidovudine can cause anemia in children. Offset by EPO administration