Antiretrovirals

Question 1

Drug combinations

Answer 1

Avoid irrational combos
Avoid overlapping toxicity
Avoid DI
Consider ease of adherence and PT comorbidities

Question 2

Nucleoside/tide reverse transcriptase inhibitors (NRTI)

Answer 2

Didanosine, Abacavir, Zidovudine, Lamivudine, Tenofovir
Mitochondrial toxicity, lactic acidosis
Zidovudine: insulin resistance, dyslipidemia

Question 3

Non-Nucleoside Reverse Transcriptase (NNRTI)

Answer 3

Efavirenz, Delavirdine
All substrates for CYP3A4
Inducer: Nevirapine
Inhibitor: Delavirdine
Mixed: Efavirenz, Etravirdine
AE: skin rash
Efavirenz: teratogenic

Question 4

Protease inhibitor

Answer 4

Fosamprenavir, Idinavir, Lopinavir, Ritonavir
Prevents metamorphosis of HIV into mature form
Ritonavir (3A4 inhibitor enhances effect)
AE: hyperglycemia, lipodystrophy (buffalo hump)

Question 5

Fusion inhibitor

Answer 5

Enfuvirtide

AE: site rxn (erythema, nodules, cysts)

Question 6

Binding inhibitor

Answer 6

Maraviroc
Binds to host cell CCR5 receptor to block binding of viral gp120
tropism testing must be performed to ensure virus uses CCR5 receptor

Question 7

Raltegravir

Answer 7

Integrate strand transferase inhibitors

Inhibits replication of HIV 1 and 2

Question 8

Cobicistat

Answer 8

CYP3A4 inhibitor not active against HIV used to boost levels of other drugs

Question 9

HIV infected women

Answer 9

Zidovudine
Generally used IV during labor and delivery to prevent transmission to the fetus and given orally for 6 weeks to the newborn