Anti-retrovirals Flashcards
Which RX has an AE that causes nephrotoxicity and bone mineral density changes?
Tenofovir
Which anti-retroviral can cause PR or QTc prolongation? What is generally recommended prior and after starting this RX?
Saquinavir
EKG
Which RX binds to gp41 on virus and prevents fusion w/ host cell membrane?
Enfuvirtide
When should NRTI treatment be suspended?
When you see rising aminotransferase levels, hepatomegaly, or unknown cause of metabolic acidosis
Which RX is used to boost bioavailiability and pharmacokinetics of protease inhibitors?
Ritonavir
Tenofovir is distinct because it has a _______ in the parent molecule?
Phosphate
Which RX has an AE that causes:
- Inj. site reactions
- Hypersensitivity
- Increase % of bacterial pneumonia
Enfuvirtide
Which RXs are non-nucleoside reverse transcriptase inhibitors (NNRTIs)?
- End w/ “virine” (3)
- End w/ “virenz” (1)
- End w/ “virapine” (1)
Which class has a black box warning of lactic acidosis syndrome?
NRTIs
Which RXs are binding/fusion inhibitors?
- Maraviroc
- Enfuvirtide
- Ibalizumab
Which anti-retroviral can cause kidney stones?
Indinavir
Protease inhibitor short-term AE?
- GI problems
- Hyperbilirubinemia (atazanavir + indanavir)
- Bleeding risk
- Hepatoxicity
Protease inhibitor long-term AE?
- Hyperlipidemia
- Lipodystrophy
- Insulin resistance
- Hypertension
- Diabetes?
Which class has AE of lipatrophy?
NRTIs
Enfuvirtide AE?
- Inj. site reactions (forms nodules + thick+
- Hypersensitivity
- Increase % of bacterial pneumonia
Emtricitabine unique AE?
Pigmentation of soles/palms
Enfuvirtide MOA?
Binds to gp41 on virus and prevents fusion w/ host cell membrane
Which RXs are protease inhibitors for HIV?
End w/ “navir”
EX: Atazanavir
Which RXs are integrase inhibitors?
End w/ “gravir”
EX: Raltegravir
Abacavir AE?
Cardiovascular toxicity
NNRTIs AE?
- Stevens-Johnson syndrome
- Hepatoxicity (more severe in nevirapine)
- Elevated liver enzymes (more severe in nevirapine)
Which RX is an CCR5 inhibitor?
Maraviroc
Which RX are sulfonamides and pts w/ sulfonamides should be treated w/ caution using this RX?
Darunavir
Tipranavir
Fosamprenavir
Fosamprenavir AE?
Rash + oral paresthesias
Maraviroc MOA?
CCR5 inhibitor; binds to CCR5 co-receptor on host cell and prevents HIV from binding
Which class has AE of mitochondrial toxicity?
NRTIs
Which RX has a chance of cardiovascular toxicity?
Abacavir
Which RX has a black box warning of fatal hepatitis and intracranial hemorrhage?
Tipranavir
Which class of anti-retrovirals has some sulfonamides in them?
Protease inhibitors specifically:
Darunavir
Tipranavir
Fosamprenavir
Maraviroc AE?
- General stuff (rash, cough)
- Upper respiratory infections
- Hepatotoxicity
What is the black box warning of Tipranavir?
Fatal hepatitis and intracranial hemorrhage
Which RXs are nucleoside reverse transcriptase inhibitors (NRTIs)?
- End w/ “vudine”
- Tenofavir (disoproxil/alafenamide)
- Emtricitabine
- Abacavir
Which anti-retroviral should not be used in the first trimester of pregnancy?
Efavirenz
Indinavir AE?
Kidney stones
NRTI MOA?
Has to be tri-phosphorylated by host
- Thymidine kinase
- Thymidylate kinase (Rate-limiting)
- Pyrimidine ND kinase
Binds/inhibits reverse transcriptase enzyme
Which RX causes a rash + oral paresthesias?
Fosamprenavir
Saquinavir AE?
PR and QTc prolongation
Tenofovir AE?
- Nephrotoxicity
2. Bone mineral density changes
Which RX has AE of pigmentation of soles/palms?
Emtricitabine
NRTIs AE?
- Mitochondrial toxicity
- Peripheral neuropathy
- Pancreatitis
- Lipoatrophy
- Black box = lactic acidosis syndrome
We know that Maraviroc is a CCR5 receptor antagonist, what unique MOA does this RX have?
Active against viruses that have become resistant to antiretroviral agents of other classes
HLA-B*5701 genotype is associated w/ what RX?
Abacavir
K103N mutation is associated w/ what RX?
NNRTIs