ANTIVIRAL AGENTS And Anti-retroviral Agent Flashcards
Viruses are the smallest living microorganism measuring ____-___nm (30 x 10-9M)in size and cannot reproduce outside their host cells which are usually larger including ______ and _____ cells.
20 – 30
bacteria and human
A _______ is the free-living virus particle outside the host cells.
virion
A virion is the free-living virus particle (inside or outside?) the host cells.
Outside
Virion consists of nuclear material (RNA or DNA) enclosed in a _____ coat known as _____ which may also be surrounded by an external ________ envelope.
protein; capsid
lipoprotein
The capsid together with the RNA/DNA => ___________
nucleocapsid
The capsid is made up of (symmetrical or asymmetrical?) repeating structural units called ___________ .
symmetrical
capsomeres
Some viruses also contain enzymes that initiate their replication in the host cell.
T/F
T
DNA viruses )-
___________ (warts)
________(Shingles, cold sores, glandular fever)
_________ virus (mononucleosis or kissing disease)
_______ virus (chicken pox)
_________(smallpox)
Hepatitis B virus
_________(sore throat, conjunctivitis)
__________(retinitis).
Papillomavirus
Herpesviruses
Epstein-Barr
Varicella zoster
Poxviruses
Adenovirus
cytomegalovirus
DNA viruses (PHEVPHAC)-
Papillomavirus (______)
Herpesviruses (_______,_______ , glandular fever)
Epstein-Barr virus (________ or ____ disease)
Varicella zoster virus (_______)
Poxviruses (smallpox)
Hepatitis B virus
Adenovirus (______ ,_______)
cytomegalovirus (_______).
warts
Shingles, cold sores
mononucleosis; kissing
chicken pox
sore throat, conjunctivitis
retinitis
RNA viruses (RHOEPARPARC)-
_________ (HIV/AIDS, T- cell leukamia)
Hepatitis C virus
_______(influenza A, B and C)
_______(myocarditis)
_________(measles, mumps, respiratory tract infections)
Arboviruses (Yellow fever)
________(rabies)
_________(poliomyelitis)
_______ (meningitis, lassa fever)
_______(German measles) and Coronaviruses (RTI).
Retroviruses; Orthomyxovirus
enterovirus; Paramyxovirus
Rhabdoviruses; Picornaviruses
Arenavirus; Rubella virus
HPV is a (DNA or RNA?) virus which affects human _____ and the _______ that line the body (throat, mouth, feet, fingers, nails, anus and cervix).
DNA
skin; moist membranes
HPV
There are over _____ types, of which ____ can affect the genital area.
Transmission: _____________ with infected person.
Symptoms: Asymptomatic or ________
100; 40
skin to skin sexual contact
appearance of warts.
HPV
Prevention:_______,_______, condoms, reduction of _______
Treatment: _____,________ ,________.
Vaccination, abstinence
sexual partners
cryotherapy, electrodessication, laser surgery
Mention 2 Effective drugs for papilloma virus infection
No effective drugs.
Viral REPLICATION
_______->_______->TRANSLATION- >_______ ->__________
ENTRY
TRANSCRIPTION; ASSEMBLY
BUDDING/RELEASE
Viral Replication : DNA Viruses
Viral DNA enters the host cell ______,
where transcription into ______ occurs catalyzed by the (host or viral?) cell _________.
nucleus; mRNA
host; RNA polymerase
Viral replication: DNA viruses
Translation of the ____ into _____- specific ______ then takes place.
Some of these proteins are enzymes (DNA polymerase) that _____________, as well as proteins comprising the _____ and ______
mRNA; virus; proteins
synthesize more viral DNA
viral coat and envelope.
Viral replication: DNA viruses
After assembly of coat proteins around the viral DNA, complete virions are released by ______ or after _________
budding
host cell lysis.
Viral replication: RNA viruses
Enzymes (____dependent ____ polymerase) within the (virion or host ?) synthesize its _____ from the ____ RNA
template, or sometimes the viral RNA serves as its own mRNA.
RNA; RNA
Virion; mRNA; viral
Viral replication: RNA viruses
mRNA, is translated by the (host or virion?) cell into various enzymes, including ____ polymerase (which directs the synthesis of more viral RNA), and also into structural proteins of the virion.
Host ; RNA
Viral replication: RNA viruses
The viral structural proteins are arranged around the newly formed viral RNA to form new virions which escape by ______ or ______ .
budding or cell lysis
The nucleus is usually not involved in RNA viral replication except for ___________.
orthomyxoviruses
Viral replication
Retroviruses: contain _____——- enzyme (virus ____-dependent ____ polymerase), which makes a ____ copy of the viral RNA.
This new copy is integrated into the genome of the host cell by ____ enzyme to form a ____virus which is transcribed into both ___________ and ________.
The latter is translated into (active or inactive?) proteins which are broken down by the _______ enzymes into structural proteins followed by assembly.
reverse transcriptase
RNA; DNA; DNA
integrase; provirus
new viral RNA & mRNA; inactive
protease
The ability of several viruses to remain dormant and be replicated together with, the host genome is responsible for the _________________ , such as those caused by __________ (cold sores) or the _______ (chickenpox) virus, which recur when _________ is reactivated when the immune system is compromised.
periodic nature of some viral diseases
herpes labialis
varicella zoster ; replication
Some RNA retroviruses can transform normal cells into malignant cells
T/F
T
Eg T-cell leukamia
herpes labialis
Aka
??
Cold sores
Host defenses against viruses
1)______ skin: can not be penetrated by most viruses unlike sites of ______ and _____
Intact
wounds and insect bites.
Host defenses against viruses
Innate and adaptive immune response:
____-lymphocytes killed viral infected cells which it recognises by the complex (formed from ______ and ______ ) presented on the surface of the infected cells.
T; viral peptide and major histocompatibility complex
Host defenses against viruses
Natural killer cells: kill viruses (which escape the initial _______-lymphocytes effect) using _________ strategy
cytotoxic T-
mother Turkey
Host defenses against viruses
Gene silencing: An attempt by the _____ to use the ______’s translational/transcriptional machinery causes the _______ for the _______ to be ________, probably by ___________, thereby interrupting with viral replication.
virus; host; gene coding
viral RNA; switched off
DNA phosphorylation
Antiviral drugs are used for treating viral infections. Unlike most antifungals and antibacterial, they ________________ rather than ___________.
inhibit the development or reproduction of viruses
destroying them
Antiviral drugs are the same as viricides
T/F
F
Antiviral drugs are different from viricides
viricides are chemicals that ____________
They are not ___________.
destroy virus particles
medication!
viricides
Examples: ______, sodium _______, ___________ chloride, essential oils (e.g. ________ oil).
Lysol
hypochlorite; benzalkonium
eucalyptus
Classification of non-retroviral Antiviral drugs
1)Viral ________ Inhibitors
2) Viral ________ Inhibitors
3) Viral __________ Inhibitors
4) _____________ inhibitors
DNA Polymerase
neuraminidase
coat disassembly
NSE protease
Viral DNA polymerase inhibitors
Examples : aci_____, famci______, ganci_____, penci____ valaci_____, valganci_____, ____ ,_______,_______,______
clovir x 6
foscarnet, idoxuridine, ribavirin, and cidofovir
Viral DNA polymerase inhibitors
Uses for the treatment of _____ infections.
In addition, cidofovir, valaciclovir, ganciclovir and valganciclovir are also used for the treatment of ______ infections
Ribavirin is used for the treatment of ______,______, and ______
herpes
cytomegalovirus
respiratory syncitial infections, lassa fever and hepatitis c
Viral DNA polymerase inhibitors is used for ______ and _______ infections
And ribavirin_____,______, and _______
CMV
HERPES
respiratory syncitial infections, lassa fever and hepatitis c
Ribavarin is used to treat _______,______,______
respiratory syncitial infections, lassa fever and hepatitis c
Viral DNA polymerase inhibitors
Mechanism of action- they inhibit the viral DNA polymerase in different ways.
Aciclovir, valaciclovir and penciclovir are __________ that are first converted to the ________ by viral ________ more rapidly by the (viral or host?) enzyme but this can also be done by the (viral or host?) enzyme.
guanosine analogue; monophosphate
thymidine kinase
Viral; host
Viral DNA polymerase inhibitors
Mechanism of action-
After Aciclovir, valaciclovir and penciclovir are converted to the mono phosphates , They are then converted by the (viral or host?) kinases to their _____ which _____________________ for ________________ by the enzyme viral DNA polymerase.
This leads to chain _________ and _________ of viral DNA replication.
Host; triphosphates
compete with host natural guanosine triphosphate
incorporation into viral DNA chain
termination and suppression
Ribavirin is a synthetic (nucleoside or non-nucleoside ?) analogue that is thought to act by altering the ______________ or by interfering with the _________
nucleoside
viral nucleotide pool
synthesis of viral mRNA.
Foscarnet is a (nucleoside or non nucleoside?) analogue of ______ which inhibit viral DNA polymerase by binding to the _________ binding site.
Non-nucleoside; pyrophosphate
pyrophosphate
Inhibitors of viral neuraminidase
Examples: oselta ______, zana_______, lanina_____ & pera_____.
n protein
mivir x4
Inhibitors of viral neuraminidase
Uses: are for treament of _____ and ________ infections and they are only effective in the ______ stage of the infections.
influenza A and influenza B viral
early
Inhibitors of viral neuraminidase
Mechanism of action: the neuraminidase inhibitors prevent the ____________________________________ by inhibiting the viral neuraminidase which is an protein enzyme on the surface of the virion that is responsible for __________________________
escape of the newly replicated viruses
severing the bond between the viral coat and the host sialic acid (neuraminic acid).
Neuraminidase is responsible for ______________ between the _________ and ____________
severing the bond
viral coat and the host sialic acid
sialic acid
Aka
??
neuraminic acid
Inhibitors of viral neuraminidase
Side effects: GIT symptoms such as nausea, vomiting, _______ and diarrhoea.
dyspepsia
Inhibitors of viral coat disassembly
Examples: Amantadine & rimantadine Uses: only for the treatment of influenza A
•
viral infection. No action on influenza B virus.
•
Mechanism of action: (i) Amantadine acts by blocking the M2 ion channel which is another protein through which an influx of H+ occurs
Inhibitors of viral coat disassembly
Examples: Aman______ & riman______
tadine
tadine
Inhibitors of viral coat disassembly
Uses: only for the treatment of __________ infection. No action on _________
influenza A viral
influenza B virus.
Inhibitors of viral coat disassembly
Mechanism of action: (i) Amantadine acts by blocking the ___________ which is another protein through which an influx of _____ occurs to _____ the viral particle in the host cell cytoplasm thereby —————— so that the viral RNA genome can be released into __________ for ________
M2 ion channel
H+; acidify
enhancing its dissassembly
the host cell for replication.
Inhibitors of viral coat disassembly
Side effects: most common:> dizziness, _________ and _______
slurred speech and insomnia.
NS3 protease inhibitors
Examples: Asuna______, boce________, grazo_____, parita______, sime_____ and tela_______
previr
previr
previr
previr
previr
previr
PaST BaGrA
NS3 protease inhibitors
Uses:to treat _______
Hepatitis C
NS3 protease inhibitors
Mechanism of action: Inhibits viral NSE protease enzyme which converts _____________ to ________________
large inactive protein/polypetide (formed after translation from mRNA)
smaller active functional and structural protein.
________ and _______ can be used to treat hepatitis C
Viral DNA polymerase inhibitors (ribavirin)
NS3 protease inhibitor(asunaprevir)
Antiretroviral agents: drugs for the treatment of infection caused by ________.
retroviruses
A retrovirus is an RNA virus which possesses _________ enzyme with which it produces _____ copy of its _____ genome.
reverse transcriptase
DNA
RNA
A retrovirus
Examples:______________ (HIV),___________ and _____________ (HTLV-1
Human immune deficiency virus
Simian immunodeficiency virus (SIV)
Human T-cell lymphotropic virus type 1
Structure of HIV-1
HIV-1:
(Small or large?) in size (~___ nm).
Consists of 2 single stranded RNA (___ genes) tightly bound to the viral enzymes (______,_____,_______, and ________) and surrounded by a protein coat (capsid).
Small
120; 9
Reverse transcriptase , integrase, protease, & ribonuclease
Structure of HIV-1
HIV-1:
Capsid made of repeated units (______) and surrounded by _____ of viral proteins which in turn is surrounded by a ________ envelope
capsomere; matrix
lipoproprotein
Structure of HIV-1
HIV-1:
a lipoproprotein envelope made of mainly _____ & protein from _______ and also few copies of viral protein [gp _____ (___) + gp ____ (___)].
lipid bilayer; human host
120; cap
41; stem
Structure of HIV-1
HIV-1:
The stem are of ____ molecules
3
In HIV
gp 120 is the ________
gp 41 is the ______
cap
Stem
Life cycle of HIV
Step 1: Binding-
the virus binds to molecules on the surface of the _____ cell: first a ____ receptor and then either a ______ or ______ coreceptor.
CD4
CD4
CCR5 or CXCR4
Life cycle of HIV
Step 1: Binding-
the virus binds to molecules on the surface of the ______ cell: first a ____ receptor and then either a ______ or _____ coreceptor.
CD4
CD4
CCR5 or CXCR4
Life cycle of HIV
Step 2: Fusion-
HIV _________ fuses with the
CD4 ___________ which allows HIV to enter the CD4 cell and releases HIV RNA & HIV enzymes into the cell.
Viral envelope
cell membrane
Life cycle of HIV
Step 3: Reverse transcription-
HIV releases and uses __________ to convert its genetic material—HIV _____—into HIV _____ which allows HIV to enter the CD4 ___________
reverse transcriptase
RNA; DNA
cell nucleus
Life cycle of HIV
Step 4: Integration-
Once inside the host CD4 cell nucleus, HIV releases ______ enzyme. HIV uses HIV this enzyme to _____________________________________ to form a ______
integrase
insert its viral DNA into the DNA of the host cell
Provirus
Life cycle of HIV
Step 5: Replication-
After integration. The _______ DNA is transcribed into _____________________. The latter is translated into ———
provirus
both new viral genome RNA as well as mRNA
inactive proteins.
Life cycle of HIV
Step 7: Assembly-
new HIV RNA and HIV proteins made by the host CD4 cell move to the _____ of the cell and assemble into (mature or immature?) (infectious or noninfectious?) new virions.
surface
Immature
noninfectious
Life cycle of HIV
Step 8: Budding-
immature virions ((can or can’t?) infect another CD4 cell) pushes themselves out of the host CD4 cell.
Once outside the CD4 cell, the new HIV releases HIV ______ enzyme which break up the (short or long?) (active or inactive?) protein chains to form (smaller or larger?) HIV active proteins that combine to form (mature or immature?) , (non-infectious or infectious ?) HIV.
Can’t ; protease
Long; inactive
Smaller
Mature ; infectious
Classification of Antiretroviral agents
1.___________ inhibitors (NRTIs)
2. ___________ inhibitors
3. ___________ inhibitors
4. _________ inhibitors
5. ________/______ inhibitors
6. ________ inhibitors
7. ________ inhibitors
Nucleoside/nucleotide reverse transcriptase
Non-nucleoside reverse transcriptase
Protease
Fusion; Entry/CCR5
Integrase; Maturation
(1)Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Examples: ______ (ABC), _______ (TDF) [nucleotide], ______ (DDC), _________ (FTC), _________, ________ (3TC), ______ (D4T) & ___________ (AZT).
abacavir; tenofovir; didanosine
emtricitabine; zalcitabine
lamivudine; stavudine
zidovudine
(1)Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Mechanism of action:
initial _________ of the NRTI’S by the ____ cell enzymes (kinase) to their ___________ derivatives.
These then compete with their corresponding _________ and act as __________ to the viral reverse transcriptase enzyme in the synthesis of the proviral DNA.
The incorporation of the ________ into the growing viral DNA chain eventually results in chain _________.
phosphorylation; host
5’ triphosphate; host cellular triphosphates
false substrate ; 5’-triphospate
termination
(1)Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Mechanism of action:
The mammalian ________ –DNA polymerase is (susceptible or resistant?) to the effect of the NRTI’s.
However the ______-DNA polymerase in their host cell _______ is fairly (sensitive or resistant ?) and this may account for the ____________
alpha
relatively resistant
gamma; mitochondria; sensitive
unwanted effects of the NRTI’s.
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Uses: mainly for _____ with other ARVs.
But Lamivudine, adefovir and tenofovir are also used for ___________
HIV
hepatitis B.
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Uses: ________,________, and _______ are also used for hepatitis B.
Lamivudine ,adefovir and tenofovir
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Adverse effects:
Class adverse effects: ______ which involves the building up of _____ in the blood due to _________ which results in production of ______ as a bye product of energy formation.
Lactic acidosis ; lactic acid
mitochondria toxicity; lactic acid
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Adverse effects:
______ adverse effects
_______ adverse effects
Class
Specific
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Adverse effects:
Specific adverse effects:
Zidovudine ( ________ )
Stavudine (_________ and ________ )
Abacavir (———- reaction)
tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF).
anaemia
peripheral neuropathy & lipodystrophy
allergic
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
Adverse effects:
Specific adverse effects:
________ (anaemia)
_________ (peripheral neuropathy & lipodystrophy)
________ (allergic reaction)
tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF).
Zidovudine
Stavudine
Abacavir
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF)
Specific adverse effects:
(TAF or TDF?) has better effects on bones and kidney and is preferable in patients with underlying bone or kidney disease than (TAF or TDF?) . However the latter also have better _________ effects .
TAF; TDF
lipid lowering
Why is TDF better than TAF in lowering lipids levels
This is because TDF produce higher level of tenofovir which lowers lipid.
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Examples
1st generation: _______,________,_______
2nd generation: ———,——-,———-
efavirenz (EFV), nevirapine (NVP) & delavirdine
daravirine, etravirine and rilpivirine
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Uses: for _____ in combination with other ARVs.
________ (resistant case in tmt exp pt only), ______ (tmt naïve pt)
HIV
Etravirine
Rilpivirine
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Mechanism of action: NNRTIs bind to the ————— near its ______ site and _____ it.
reverse transcriptase enzyme
catalytic; denature
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Class adverse effects: ______
Specific adverse effects:
Efavirenz: _____ toxicity
Nevirapine: ______toxicity
Etravirine: _____ reaction
Delavirdine: ______ reaction, fever, _____ vision,stuffy nose.
rash
CNS
hepa
allergic ; allergic; blurred
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Class adverse effects: rash
Specific adverse effects:
__________: CNS toxicity
___________: hepatoxicity
__________: allergic reaction
__________: allergic reaction, fever, blurred vision, stuffy nose.
Efavirenz
Nevirapine
Etravirine
Delavirdine
HIV PROTEASE INHIBITORS
Ends with??
Navir
HIV PROTEASE INHIBITORS
Mechanism of action:- protease inhibitors bind to the site where _____ normally occur.
This prevent the viral specific protease from ____________________________ into various viral structural and functional proteins
cleavage
breaking down the inert polyproteins at the appropriate cleavage positions
HIV PROTEASE INHIBITORS
Uses: for ______ infection in combination with other antiretroviral drugs of different classes
HIV
HIV PROTEASE INHIBITORS
Class adverse effects:
__________, ____________ , myalgia, lipodystrophy, hyperglycemia.
paraesthesia
rhabdomyolysis
HIV PROTEASE INHIBITORS
Specificic adverse effects:
Atazanavir causes ___________________ but has less effects on _________ and __________
raised bilirubin levels
lipodystrophy and hyperglycemia.
Inhibitors of HIV fusion
Example: __________,_________
enfuvirtide, ibalizumab
Inhibitors of HIV fusion
Mechanism of action:
Enfuvirtide: binds to ______ to inhibit fusion of HIV with host cells CD4 molecules. It is usually given by ________ injection.
Ibalizumab: binds to _________ and prevent fusion with HIV
GP41 ; subcutaneous
CD4 molecules
Inhibitors of HIV fusion
Uses: used in treatment of HIV in combination with other ARV drugs when ———————————- or ___________________________
resistance becomes a problem or when there is intolerance to other antiretroviral drugs.
Inhibitors of HIV fusion
Side effects:
Enfuvirtide:______ symptoms and __________ reactions.
flu-like
hypersensitivity
HIV Integrase Strand Transfer inhibitors (ISTIs)
Examples:
•
– 1st generation: ralte________ and elvite_____.
•
– 2nd generation: dolute_______ and bicte______
gravir; gravir
gravir; gravir
we aRE BaD
HIV Integrase Strand Transfer inhibitors (ISTIs) cont’d
Side effects of raltegravir:
– Common: headache, nausea, diarrhoea, weakness,insomnia.
– Rare: _______ ,________,_______ , pyrexia, diaphoresis, rashes, _____ failure, nephrolithiasis, depression, _____ behaviours, anxiety and paranoia.
hepatitis, thrombocytopenia, rhabdomyolysis
renal; suicidal
HIV Integrase Strand Transfer inhibitors (ISTIs)
Mechanism of action:- they inhibit the __________ enzyme which is responsible for integration of the viral DNA with the infected cell DNA.
Uses: HIV/AIDS infection (with other ARVs)
viral integrase
Entry Inhibitors or CCR5 antagonists
Examples: mara____, apla______ and vicri______.
viroc
viroc
viroc
Entry Inhibitors or CCR5 antagonists
Mechanism of action-
maraviroc binds to ______ and blocks its association with the HIV gp _____ thereby preventing _____________
However some HIV can also enter the host cell through _________. Therefore hiv ___________ is essential for efficacy.
CCR5 ; 120; entry into the host cell.
CXCR4
tropism test
Maturation Inhibitors
Examples: __________ and __________
vivecon and bevirimat
Maturation Inhibitors
Mechanism of action-
they inhibit the conversion of ________ to _________ leading to formation of (infective or non infective ?) virions with ________
viral polyprotein
mature capsid
non infective
defective core.
Maturation Inhibitors Examples: vivecon and bevirimat
Uses: HIV/AIDS in combination with other ARV drugs
T/F
T
Pharmacotherapy of antiretroviral
Principles involved:
– start treatment as soon as __________
– use combination of at least _________ different antiretroviral drugs (______)
– monitoring of _________ and _________
– change treatment regimen if viral plasma concentration persists or increases.
HIV is diagnosed
three; HAART
plasma viral load and cd4+ cells count
At present, HIV infection has no cure.
T/F
T
However, the virus can be reduced to an ___________ level in the blood with ___________.
undetectable
HAART
ART FOR TREATMENT NAÏVE
PATIENTS (2014 GUIDELINES)
1. Tenofovir/emtricitabine + _______/______
- Tenofovir + emtricitabine + _______
- Tenofovir/emtricitabine + ______/______
- Tenofovir/emtricitabine + ________
- Tenofovir/emtricitabine +________/cobicistat
- Tenofovir/emtricitabine + _______
- Abacavir/lamivudine + dolutegravir in (HLA*B-5701 negative)
_____________ could be used to replace emtricitabine in all the regimen.
darunavir; ritonavir
efavirenz
atazanavir; ritonavir
raltegravir
Elvitegravir
dolutegravir
Lamivudine
Prevention of mother to child transmission of HIV (PMTCT)
Mother to child transmission happens when HIV, the virus that causes AIDS, is passed from a mother to her unborn baby during ________,_______, or ________.
pregnancy, labour, childbirth or during breastfeeding
Prevention of mother to child transmission of HIV (PMTCT)
The main aim in treating pregnant women with antiretroviral drugs is to ____________ and to ________________.
avoid damage to the fetus
prevent mother to child transmission of HIV
Scheduled caesarean delivery can not prevent MTCT of HIV.
T/F
F
Scheduled caesarean delivery could also prevent MTCT of HIV.
PMTCT
Breastfeeding mother
Mother: continue _____ being used from ________________________________ and thereafter.
Infant: ______ started within _____ of birth till ______ after ___________
HAART ; before conception throughout pregnancy, breastfeeding
nevirapine; 6-72hrs
one week; stoppage of breastfeeding.
PMTCT
Non-breastfeeding mother:
mother: same as above
Infant: ______ started within ______ after birth for _________
nevirapine
6-72hrs
6 weeks.
HIV post exposure prophylaxis
WHO recommendations are administration of
a)_______/_________+ _______/______for ____ days
OR
(b) ________ /________ + ______/ ————-for _____ days
_________ could replace emtricitabine in either case. And patient should avoid unprotected sex during this period.
TENOVOFIR; EMTRICITABINE
LOPINAVIR; RITONAVIR ; 28
TENOFOVIR ; EMTRICITABINE
ATAZANAVIR; RITONAVIR; 28
Lamivudine
TELl R or TEAm R
________ ARV has been controversially said to be teratogenic
efavirenz
No ARV has been clearly stated to be teratogenic
T/F
No ARV has been clearly stated to be teratogenic except efavirenz controversially.
efavirenz should be avoided in pregnant and child-bearing age women
T/F
T
