Anti-retrovirals Flashcards by Josh Datnow

Q

In the treatment of HIV

a. indinavir prevents the synthesis of HIV DNA

A

A. False. Indinavir is a protease inhibitor

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Q

In the treatment of HIV

b. zidovudine is a protease inhibitor

A

B. False, zidovudine is nucleoside reverse transcriptase inhibitor

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Q

In the treatment of HIV

c. lopinavir causes hyperlipidaemia as an adverse effect

A

C. True, PI cause insulin resistance, hyperglycaemia, diarrhea, dyslipidemia, lipodystrophy, atherosclerosis, hepatitis, osteoporosis, osteonecrosis as AEs

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Q

In the treatment of HIV

d. zidovudine is more likely to cause anaemia than lamivudine

A

D. True. Zidovudine is the big one.

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Q

In the treatment of HIV

e. didanosine is used to treat stavudine-induced lactic acidosis

A

E. False, didanosine and stavudine greatly increase the risk of lactic acidosis

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Q

In the management of HIV

a. tenofovir is a HIV nucleotide reverse transcriptase enzyme inhibitor (NRTI)

A

A. True

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Q

In the management of HIV

b. ritonavir causes inhibition of CYP3A4

A

B. True. Ritonavir is a potent inhibitor of CYP3A4

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Q

In the management of HIV

c. lopinavir inhibits the action of HIV protease

A

C. True

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Q

In the management of HIV

d. nevirapine inhibits DNA gyrase

A

D. False, nevirapine is a NNRTI and inhibits reverse transcriptase. Fluoroquinolones inhibit DNA gyrase

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Q

In the management of HIV

e. rifampicin increases the plasma levels of lopinavir

A

E. False, lopinavir is metabolised by CYP3A4 enzymes, which are induced by rifampicin

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Q

Lopinavir + ritonavir combination

a. inhibits HIV reverse transcriptase

A

A. False, PI inhibit HIV protease

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Q

Lopinavir + ritonavir combination

b. induces cytochrome P450 enzymes

A

B. False. The role of ritonavir in this combination is to act as a pharmacokinetic, enhancer, inhibiting CYP3A4 hence inhibit the metabolism of lopinavir

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Q

Lopinavir + ritonavir combination

c. causes insulin resistance as an adverse effect

A

C. True, PIs cause insulin resistance

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Q

Lopinavir + ritonavir combination

d. is a protease inhibitor

A

D. True

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Q

Lopinavir + ritonavir combination

e. causes lipodystrophy

A

E. True, Pis cause lipodystrophy

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Q

In the treatment of HIV

a. nevirapine is a direct inhibitor of reverse transcriptase

A

A. False, NNRTIs are indirect inhibitors of reverse transcriptase (allosteric inhibition)

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Q

In the treatment of HIV

b. lamivudine causes peripheral neuropathy as an adverse effect

A

B. True, NRTIs cause peripheral neuropathy as an adverse effect

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Q

In the treatment of HIV

c. efavirenz requires phosphorylation to its active form

A

C. False, NNRTIs don’t require phosphorylation

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Q

In the treatment of HIV

d. tenofivir is contraindicated in severe renal failure

A

D. True, tenofovir (TDF) causes nephrotoxicity

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Q

In the treatment of HIV

e. zidovudine is a cytosine analogue

A

E. False, thymidine analogue

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Q

In the treatment of HIV:

a. nevirapine is hepatotoxic

A

a. True. NNRTIs are hepatoxic

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Q

In the treatment of HIV:

b. efavirenz causes sleep disturbances

A

b. True

Q

In the treatment of HIV:

c. nevirapine increases the risk of Stevens Johnson syndrome

A

c. True

Q

In the treatment of HIV:

d. efavirenz is a nucleoside reverse transcriptase inhibitor

A

d. False, NNRTI

In the treatment of HIV: | e. nevirapine is used in combination with lamivudine as part of triple therapy

e. True, in neonates give Zidovudine (AZT) + Lamivudine (3TC) + Nevirapine (NVP)

Lamivudine | a. is a non-nucleoside reverse transcriptase inhibitor

a. False. NRTI

Lamivudine | b. causes peripheral neuropathy as an adverse effect

b. True, NRTIs causes peripheral neuropathy

Lamivudine | c. is more toxic to the mitochondrion than zidovudine

c. False, zidovudine, didansoine and stavudine are the most toxic towards mitochondria. Mitochondrial toxicity is characterised by: peripheral neuropathy, pancreatitis, lipodystrophy syndrome, hepatic steatosis and myopathy

Lamivudine | d. is used in combination with emtricitabine

d. False, either Emtricitabine (FTC) or Lamivudine (3TC)

Lamivudine | e. has activity against Hepatitis B

e. True

Non-nucleoside reverse transcriptase inhibitors (NNRTI) | a. efivarenz is hepatotoxic

a. True

Non-nucleoside reverse transcriptase inhibitors (NNRTI) | b. efivarenz is safe to use in patients with schizophrenia

b. False, cause neurocognitive impairment

Non-nucleoside reverse transcriptase inhibitors (NNRTI) | c. nevirapine causes Stevens Johnson syndrome

c. True

Non-nucleoside reverse transcriptase inhibitors (NNRTI) | d. efivarenz induces cytochrome P450 enzymes

d. False, metabolised by CYP450 enzymes.

Non-nucleoside reverse transcriptase inhibitors (NNRTI) | e. efivarenz and nevirapine are combined as part of triple therapy in HIV

e. False, triple therapy includes 2 NRTIs + NNRTI/ Integrase inhibitor.

Tenofovir | a. is contraindicated in patients with advance kidney disease

a. True, nephrotoxic

Tenofovir | b. is used in combination with lamivudine as part of triple therapy in HIV

b. True

Tenofovir | c. compared to zidovudine, has a higher risk for causing lactic acidosis

c. False, both cause

Tenofovir | d. is a protease reverse transcriptase inhibitor

d. False, NRTI

Tenofovir | e. is a nucleotide anologue of adenosine

e. True

tenofovir is an HIV protease inhibitor

False, NRTI

lamivudine causes peripheral neuropathy as an adverse effect

True

zidovudine inhibits reverse transcriptase

True

nevirapine causes hepatotoxicity as an adverse effect

True

lopinavir decreases blood glucose levels

False | Increases

Antiretroviral agents | a. zidovudine inhibits reverse transcriptase

a. true, NRTI

Antiretroviral agents | b. nevirapine prevents the synthesis of viral DNA

b. true, NNRTI

Antiretroviral agents | c. efavirenz is contraindicated during pregnancy

c. False, indicated, dolutegravir is risky

3. In the management of HIV | a. tenofovir is a HIV nucleotide reverse transcriptase enzyme inhibitor (NRTI)

a. True

In the management of HIV | b. ritonavir causes inhibition of CYP3A4

b. True

In the management of HIV | c. lopinavir inhibits the action of HIV protease

c. True

In the management of HIV | d. nevirapine inhibits DNA gyrase

d. False, NNRTI

In the management of HIV | e rifampicin increases the plasma levels of lopinavir

e. False, induces p450 enzymes