Antiretrovirals Flashcards
The following ADRs fit which ARV class: Lipodystrophy, Hepatic Steatosis, Lactic Acidosis
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
The following ADRs fit which ARV class: Headache, Nausea, Diarrhea, Rash
Integrase Inhibitors
Which Integrase Inhibitor includes nephrotoxic ADRs
Vitekta (Elvitigravir) ** Found in Stribild, so not recommended for patients w CrCl <70mL
The following ADRs fit which ARV class: Injection site reaction, hypersensitivity reaction, increased risk of bacteria pneumonia
Fusion Inhibitors (FI): “Enfuviritide
The following ADRs fit which ARV class: Hyperlipidemia, Lipodystrophy, Hepatotoxicity, GI Intolerance, Increased bleeding risk for hemophiliacs
Protease Inhibitors
The following ADRs fit which ARV class: Hepatotoxicity, Rash (including Steven Johnsons Syndrome) and drug reactions
Non-nucleoside reverse transcriptase inhibitors
MOA for NRTI
Competitively inhibits HIV reverse transcriptase using nucleoside analogs. The analogs compete w the naturally occurring nucleosides, preventing their incorporation into viral DNA and ultimately terminating the transcription process. “Chain termination”
MOA for NNRTI
Target the viral RT enzyme directly, binding to the active enzymatic “pocket” / catalytic site, preventing any conversion of viral RNA to DNA
MOA for PI
Inhibitor binds to protease enzyme, preventing it from cleaving the large nonfunctional viral polyprotein precursors into their functional viral protein forms - ultimately preventing the virus from being able to fully assemble w infectious viral particles
MOA for II
Inhibits inTEGRAse (ralTEGRAvir), preventing viral DNA integration into host genome
MOA for FI/CCR5 Antagonists
Prevents viral fusion w target CD4 cell membrane
Enfuviritide (FI) : blocks entry via binding GP120 viral protein
Maraviroc: blocks entry via CCR5
NRTI Names: REVVZEZ
Retrovir Emtriva* (Emtricitabine) Viread* (Tenofovir) Videx Zerit Epivir Ziagen
PI Names: Navir! FAD
PINAVIR, SUCH A FAD
Fosamprenavir
Atazanavir* (Reyataz)
Darunavir* (Prezista)
NNRTI Names: VIRSE
NNRTI Mission Statement:
Viral Intelect Resquires Sustainable Edurcation
Viramune Intelence Rescriptor Edurant Sustiva* (Efavirenz)
Integrase Inhibitor/INSTI Names: RED
Raltegravir*
Elvitegravir* - (found in Stribild, caution for CrCl)
Dolutegravir
What class are these drugs in?
Fosamprenavir
Atazanavir* (Reyataz)
Darunavir* (Prezista)
Protease Inhibitors
What class are these drugs in? Viramune Intelence Rescriptor Edurant Sustiva* (Efavirenz)
NNRTI
What class are these drugs in?
Raltegravir*
Elvitegravir
Dolutegravir
Integrase Inhibitors / INSTI
What class are these drugs in? Retrovir Emtriva* Viread* (Tenofovir) Videx Zerit Epivir Ziagen
NRTI’s
What class are these drugs in?
Enfuvirtide
Maraviroc
Fusion Inhibitors
GP120/CCR5
1st line regimen for treatment-naive, initial HIV infection
“INSTI with 2 NRTI” (STRIBILD)
Elvitigravir + cobi boost with Tenofo/Emtribi
or
“Boosted PI with 2 NRTI”
Darunavir (or maybe Atazanavir) + Ritonavir with Tenofo/Emtribi
or
“NNRTI with 2 NRTI” (ATRIPLA)
Sustiva (Efavirenz) with Tenofo/Emtribi
Viread (tenofavir) + Emitriva (emitricitabine)
with either a Boosted PI
(Ritonavir + Darunavir or Atazanavir)
or NNRTI (Efavirenz) or INSTI (Raltegravir)
1st line regimen for treatment-naive, initial HIV infection in a pregnant woman
STRIBILD
If in first trimester or trying to get pregnant, no Efavirenz/Sustiva (NNRTI) - found in ATRIPLA
Stribild
** Not recommended for CrCl <70mL **
II/INSTI - based, 1 INSTI + Booster + 2NRTI
Elvitegravir (INSTI)
+
cobicistat (booster, P450, 3A4 inhibitor)
+
Viread (tenofovir) + Emtriva (emitricibine) (NRTI)
Atripla
Not recommended for 1st trimester pregnancy
NNRTI-based, 1 NNRTI + 2 NRTI
Sustiva (Efavirenz), NNRTI
+
Emtriva (NRTI) + Viread (NRTI)
Truvada
** Not recommended to use alone, must add INSTI, or boosted PI **
Emitricitabine + Tenofavir
Stribild
** Not recommended for CrCl <70mL **
INSTI - based, 1 INSTI + Booster + 2NRTI
Elvitegravir (INSTI)
+
cobicistat (booster, P450, 3A4 inhibitor)
+
Viread (tenofovir) + Emtriva (emitricibine) (NRTI)
