Anti-retrovirals Flashcards

1
Q

Which RX has an AE that causes nephrotoxicity and bone mineral density changes?

A

Tenofovir

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2
Q

Which anti-retroviral can cause PR or QTc prolongation? What is generally recommended prior and after starting this RX?

A

Saquinavir

EKG

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3
Q

Which RX binds to gp41 on virus and prevents fusion w/ host cell membrane?

A

Enfuvirtide

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4
Q

When should NRTI treatment be suspended?

A

When you see rising aminotransferase levels, hepatomegaly, or unknown cause of metabolic acidosis

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5
Q

Which RX is used to boost bioavailiability and pharmacokinetics of protease inhibitors?

A

Ritonavir

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6
Q

Tenofovir is distinct because it has a _______ in the parent molecule?

A

Phosphate

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7
Q

Which RX has an AE that causes:

  1. Inj. site reactions
  2. Hypersensitivity
  3. Increase % of bacterial pneumonia
A

Enfuvirtide

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8
Q

Which RXs are non-nucleoside reverse transcriptase inhibitors (NNRTIs)?

A
  1. End w/ “virine” (3)
  2. End w/ “virenz” (1)
  3. End w/ “virapine” (1)
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9
Q

Which class has a black box warning of lactic acidosis syndrome?

A

NRTIs

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10
Q

Which RXs are binding/fusion inhibitors?

A
  1. Maraviroc
  2. Enfuvirtide
  3. Ibalizumab
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11
Q

Which anti-retroviral can cause kidney stones?

A

Indinavir

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12
Q

Protease inhibitor short-term AE?

A
  1. GI problems
  2. Hyperbilirubinemia (atazanavir + indanavir)
  3. Bleeding risk
  4. Hepatoxicity
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13
Q

Protease inhibitor long-term AE?

A
  1. Hyperlipidemia
  2. Lipodystrophy
  3. Insulin resistance
  4. Hypertension
  5. Diabetes?
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14
Q

Which class has AE of lipatrophy?

A

NRTIs

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15
Q

Enfuvirtide AE?

A
  1. Inj. site reactions (forms nodules + thick+
  2. Hypersensitivity
  3. Increase % of bacterial pneumonia
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16
Q

Emtricitabine unique AE?

A

Pigmentation of soles/palms

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17
Q

Enfuvirtide MOA?

A

Binds to gp41 on virus and prevents fusion w/ host cell membrane

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18
Q

Which RXs are protease inhibitors for HIV?

A

End w/ “navir”

EX: Atazanavir

19
Q

Which RXs are integrase inhibitors?

A

End w/ “gravir”

EX: Raltegravir

20
Q

Abacavir AE?

A

Cardiovascular toxicity

21
Q

NNRTIs AE?

A
  1. Stevens-Johnson syndrome
  2. Hepatoxicity (more severe in nevirapine)
  3. Elevated liver enzymes (more severe in nevirapine)
22
Q

Which RX is an CCR5 inhibitor?

A

Maraviroc

23
Q

Which RX are sulfonamides and pts w/ sulfonamides should be treated w/ caution using this RX?

A

Darunavir
Tipranavir
Fosamprenavir

24
Q

Fosamprenavir AE?

A

Rash + oral paresthesias

25
Q

Maraviroc MOA?

A

CCR5 inhibitor; binds to CCR5 co-receptor on host cell and prevents HIV from binding

26
Q

Which class has AE of mitochondrial toxicity?

A

NRTIs

27
Q

Which RX has a chance of cardiovascular toxicity?

A

Abacavir

28
Q

Which RX has a black box warning of fatal hepatitis and intracranial hemorrhage?

A

Tipranavir

29
Q

Which class of anti-retrovirals has some sulfonamides in them?

A

Protease inhibitors specifically:

Darunavir
Tipranavir
Fosamprenavir

30
Q

Maraviroc AE?

A
  1. General stuff (rash, cough)
  2. Upper respiratory infections
  3. Hepatotoxicity
31
Q

What is the black box warning of Tipranavir?

A

Fatal hepatitis and intracranial hemorrhage

32
Q

Which RXs are nucleoside reverse transcriptase inhibitors (NRTIs)?

A
  1. End w/ “vudine”
  2. Tenofavir (disoproxil/alafenamide)
  3. Emtricitabine
  4. Abacavir
33
Q

Which anti-retroviral should not be used in the first trimester of pregnancy?

A

Efavirenz

34
Q

Indinavir AE?

A

Kidney stones

35
Q

NRTI MOA?

A

Has to be tri-phosphorylated by host

  1. Thymidine kinase
  2. Thymidylate kinase (Rate-limiting)
  3. Pyrimidine ND kinase

Binds/inhibits reverse transcriptase enzyme

36
Q

Which RX causes a rash + oral paresthesias?

A

Fosamprenavir

37
Q

Saquinavir AE?

A

PR and QTc prolongation

38
Q

Tenofovir AE?

A
  1. Nephrotoxicity

2. Bone mineral density changes

39
Q

Which RX has AE of pigmentation of soles/palms?

A

Emtricitabine

40
Q

NRTIs AE?

A
  1. Mitochondrial toxicity
  2. Peripheral neuropathy
  3. Pancreatitis
  4. Lipoatrophy
  5. Black box = lactic acidosis syndrome
41
Q

We know that Maraviroc is a CCR5 receptor antagonist, what unique MOA does this RX have?

A

Active against viruses that have become resistant to antiretroviral agents of other classes

42
Q

HLA-B*5701 genotype is associated w/ what RX?

A

Abacavir

43
Q

K103N mutation is associated w/ what RX?

A

NNRTIs