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DEN 7108 Micro and Immuno Concepts Part II > Exam 3 Anti-retroviral therapy > Flashcards

Exam 3 Anti-retroviral therapy Flashcards

(64 cards)

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1
Q

What are some therapeutic implications of HAART?

A
  • Inhibit RTase (cytoplasmic)
  • Inhibit integrase (nuclear)
  • Inhibit protease (cytoplasmic)
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2
Q

Anti-retroviral therapy drugs approved by FDA (5)

A
  • Reverse transcriptase inhibitors (RTI)
  • Protease inhibitors
  • Fusion and entry inhibitors
  • Integrase inhibitors
  • Pharmacokinetic enhancers
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3
Q

What is a NRTI?

A

Nucleoside reverse transcriptase inhibitor

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4
Q

NRTI’s are _____ analogs

A

Nucleoside

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5
Q

First generation NRTI’s are not ____ specific

A

Viral DNA polymerase (RT)

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6
Q

First NRTI’s introduced

A
  • Azidothymidine (AZT)
  • Zidovudine (ZDV)
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7
Q

Functions of NRTI’s

A
  • chain terminators
  • block RTase
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8
Q

What are NNRTI’s?

A

Non-nucleoside reverse transcriptase inhibitors

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9
Q

What do NNRTI’s do?

A
  • Allosteric “non-competitive” inhibition
  • Bind to binding site, not enzyme active site
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10
Q

NNRTI’s are synergistic with ____

A

NRTI’s

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11
Q

Characteristics of protease inhibitors

A
  • Synthetic peptide
  • Non-hydrolysable
  • stable
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12
Q

What is the function of protease inhibitors?

A

Block HIV protease (polyprotein cleavage)

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13
Q

What does integrase inhibitor do?

A

Inhibits irreversible strand transfer step of DNA integration

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14
Q

Raltegravir is an example of:

A

Integrase inhibitor

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15
Q

Integrase inhibitors are metabolized by:

A

Cellular glucuronidation

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16
Q

Dolutegravir is an example of:

A

Integrase inhibitor

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17
Q

____ (integrase inhibitor) was approved in August 2013. It has a prolonged intracellular half life

A

Dolutegravir

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18
Q

Elvitegravir (EVG) is an example of:

A

Integrase inhibitor

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19
Q

Elvitegravir is also called:

A

Vitekta

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20
Q

____ (integrase inhibitor) was approved in September 24, 2014

A

Elvitegravir

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21
Q

______ is the newest integrase inhibitor (Jan 22, 2021)

A

Cabotegravir

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22
Q

Examples of pharmacokinetic enhancers

A
  • Cobicistat (COBI); Tyboost
  • P450 CYP3A4 enzyme inhibitor
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23
Q

A new attachment inhibitor called _____ binds to ____

A

Fostemsavir; gp120

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24
Q

Enfuviritide is an example of:

A

Fusion inhibitor

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25
Enfuviritide binds to ____
gp41
26
Maraviroc is a _____ inhibitor which acts as a _____
Entry; CCR5 receptor agonist
27
Which drug has a black box warning?
Maraviroc (hepatotoxicity)
28
What does it mean if a drug has a black box warning?
Can kill a patient
29
Ibalizumab is a ____ inhibitor that binds to ____
Entry; CD4
30
____ is for restricted use only with multidrug-resistant HIV-1
Ibalizumab
31
____ is always used in combination
Cobicistat (Tyboost)
32
HAART stands for:
Highly active anti-retroviral therapy
33
HAART consists of:
Combinations of antiretroviral drugs that block different stages of viral replication
34
What are the US FDA approved HAART combination products?
- Stribild - Triumeq - Evotaz - Prezcobix - Genvoya
35
Stribild (HAART) consists of what antivirals?
- Elvitegravir (II) - Cobicistat (PE)
36
Evotaz (HAART) consists of what antivirals?
- Atazanavir - Cobicistat
37
Prezcobix (HAART) consists of what antivirals?
- Darunavir - Cobicistat
38
Genvoya (HAART) consists of what antivirals?
- Elvitegravir (II) - Cobicistat (PE)
39
Stribild was introduced in what year?
2012
40
In what year was Evotaz, Prezcobix, and Genvoya introduced?
2015
41
What are the DHSS recommendations for current standard of care?
- All HIV+ patients with an AIDS-defining illness or CD4 count of < 350/microliter - All pregnant HIV+ patients regardless of CD4 count - HIV post-exposure prophylaxis (PEP)
42
If one has CD4+ 350-500/microliter, what is the indication for HAART therapy?
Strong/moderate recommendation
43
If one has CD4+ >500/microliter, what is the indication for HAART therapy?
Recommended/optional
44
If one has HBV or HCV co-infection, what is the indication for HAART therapy?
Recommended
45
If one has HIV-associated nephropathy, what is the indication for HAART therapy?
Recommended
46
If one has acute HIV infection, what is the indication for HAART therapy?
Optional
47
Those who undergo HAART therapy have increased _____ and decreased _____
CD4 count; risk of opportunistic infection of death
48
Vertical transmission of HIV can occur through what ways?
- Ante-partum - During delivery - During breastfeeding
49
Risk of perinatal transmission is significantly reduced with:
Effective antiretroviral (ART/HAART) therapy
50
____ is needed to reduce perinatal transmission for all pregnant women with HIV infection, regardless of ____
3 part regimen; Viral load or CD4 cell count
51
HAART therapy and pregnancy: include ____ in ARV regimen, and for newborns Rx is _____
Zidovudine (AZT); AZT first six weeks of life
52
HIV post-exposure prophylaxis
- 2 drug PEP (NNRTI + NRTI) for 4 weeks - 3+ drug PEP for 4 weeks
53
What is PrEP?
Pre-exposure prophylaxis
54
Success of PrEP in ____ recently reported
MSM
55
HAART therapy may induce:
Immune restoration disease (IRD)
56
What is immune restoration disease?
Diseases properly recognized --> larger immune response after immune system restored
57
In immune reconstitution syndrome, flares of _____ are particularly common
Mycobacterial disease
58
Co-infection of HIV and TB causes:
- 800x greater risk for developing active TB - increases transmission of TB - Increases overall % with latent TB
59
Side effects of NRTI's
- Pancreatitis - Neuropathy - GI - Marrow suppression
60
Side effects of NNRTI's
- Rash - Hypersensitivity reactions
61
Side effects of protease inhibitors (PI's)
- glucose intolerance - hyperlipidemia - lipodystrophy - breast hypertrophy - GI - paresthesia - Rashes
62
Side effects of fusion inhibitors
- hypersensitivity - increased risk of bacterial pneumonia
63
Lipodystrophy caused by protease inhibitors can cause:
- fat buildup - fat loss - increased fat levels in the blood - increase in blood sugar
64
On 1/21/21, the US FDA approved ______ as a complete regimen for the treatment of HIV-1 infection in adults. This is the first FDA-approved ____ complete regimen for HIV-infected adults that is administered ____
Cabenuva; injectable; once a month

DEN 7108 Micro and Immuno Concepts Part II (27 decks)

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