Anti-Retroviral Pharm

Question 1

What drugs are in the Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTIs) class?

Answer 1

Delavirdine, Efavirenz, Nevirapine, Etravirine, Rilpivirine

Question 2

What is the MOA of NNRTIs?

Answer 2

Bind HIV reverse transcriptase causing inhibition of RNA/DNA-dependent DNA polymerase

Question 3

How is resistance created to NNRTIs?

Answer 3

Point mutations that alter NNRTI binding

Question 4

What is the main SE of Delavirdine?

Answer 4

Skin rash

Question 5

What are the SE’s of Efavirenz?

Answer 5

CNS issues
Skin rash
Hypercholesterolemia

Question 6

What are the SE’s of Nevirapine?

Answer 6

Rash

Liver toxicity

Question 7

What are the SE’s of Etravirine*?

Answer 7

Rash
Nausea
Diarrhea

Question 8

What are the SE’s of Rilpivirine*?

Answer 8

Rash
Depression
HA
Insomnia
Increased aminotransferases

Question 9

Which NNRTI can be used to prevent transmission from mother to newborn?

Answer 9

Nevirapine

Question 10

Which NNRTI can be used after the first 8 weeks of gestation?

Answer 10

Efavirenz

Question 11

Which NNRTI can be used during all of pregnancy?

Answer 11

Rilpivirine

Question 12

What is the suffix of the drugs in the Protease Inhibitor (PI) class?

Answer 12

-navir

Question 13

What is the MOA of the PIs?

Answer 13

Block HIV proteases –> prevention of maturation of proteins that make up virion core

Question 14

Which PIs can be used during pregnancy?

Answer 14

Atazanavir/Darunavir (if boosted)

Lopinavir

Question 15

What are the SE’s of Atazanavir?

Answer 15

Diarrhea, nausea, skin rash, jaundice

Question 16

What are the SE’s of Darunavir?

Answer 16

Rash, sulfa hypersensativity

Question 17

What are the SE’s of Fosamprenavir?

Answer 17

HA, nausea, diarrhea, depression, sulfa hypersensitivity

Question 18

What are the SE’s of Indinavir?

Answer 18

Hyperbilirubinemia (jaundice), nephrolithiasis

Question 19

What must the pt do to avoid stone formation when taking Indinavir?

Answer 19

Drink lots of water

Question 20

How is Darunavir given?

Answer 20

Co-administered with Ritonavir or Cobicistat

Question 21

What are the SE’s of Lopinavir?

Answer 21

None

Question 22

What are the SE’s of Nelfinavir, Ritonavir, and Saquinavir?

Answer 22

GI issues

Question 23

What are the SE’s of Tipranavir?

Answer 23

GI issues, maculopapular rash, sulfa hypersensitivity

Question 24

Which PIs should not be given to pts with sulfa allergies?

Answer 24

Darunavir, Fosamprenavir, Tipranavir

Question 25

Which PI is used mainly as a booster because it is a potent CYP450 inhibitor?

Answer 25

Ritonavir

Question 26

Which PI is used for Tx of Tx-experienced pts who have resistant HIV strains?

Answer 26

Tipranavir

Question 27

Which drug is in the Fusion Inhibitor class?

Answer 27

Enfuvirtide

Question 28

What is the MOA of Enfuvirtide?

Answer 28

Binds gp41 preventing fusion of viral envelope to host cell membrane

Question 29

How is resistance created to Enfuvirtide?

Answer 29

Mutations in gp41

Question 30

When is Enfuvirtide used?

Answer 30

As salvage Tx

Question 31

How is Enfuvirtide administered?

Answer 31

SubQ injection 2x daily

Question 32

What drug is in the Entry Inhibitor class?

Answer 32

Maraviroc

Question 33

What is the MOA of Maraviroc?

Answer 33

Binds CCR5 preventing viral entry into the host cell

Question 34

How is resistance created to Maraviroc?

Answer 34

Mutations in V3 loop of gp120

Question 35

What are the SE's of Maraviroc?

Answer 35

Possible hepatotoxicity

Question 36

What is the suffix for the drugs in the Integrase Strand Transfer Inhibitor (INSTI) class?

Answer 36

-tegravir

Question 37

What is the MOA of INSTIs?

Answer 37

Inhibit integration of reverse-transcriptase HIV DNA into host DNA

Question 38

Which INSTI has some SE and what is the SE?

Answer 38

Dolutegravir; | Hypersensitivity rxn

Question 39

Which INSTI can be used during pregnancy?

Answer 39

Raltegravir

Question 40

Which INSTI is used for Tx of Tx-naive pts with HIV?

Answer 40

Dolutegravir

Question 41

Which INSTI requires a booster with Cobicistat?

Answer 41

Elvitegravir