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316 Pharmacology > Final: HIV/AIDS > Flashcards

Final: HIV/AIDS Flashcards

1
Q

Viruses cause disease to

A

Animals, plants, and bacteria

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2
Q

Do viruses have cellular machinery?

A

NO, they need another living organism to reproduce

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3
Q

Life cycle of basic virus: Absorption

A

Virus particle attaches itself to a host cell

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4
Q

Life cycle of basic virus: entry

A

particle injects its DNA (or RNA) into the host cell

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5
Q

Life cycle of basic virus: replication

A

Cellular enzymes start making new virus particles

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6
Q

Life cycle of basic virus: assembly

A

Particles of the virus created by the cell come together to form new viruses

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7
Q

Life cycle of basic virus: Release

A

Newly formed viruses kill the cell so that they may break free and search for a new host cell

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8
Q

The genome of retroviruses consists of

A

RNA, not DNA

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9
Q

Reverse transcriptase

A

Polyamerase that uses RNA as its template, that making genetic information flow in the refer direction (RNA to DNA)

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10
Q

Can the human body rid HIB completely?

A

NO!

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11
Q

HIV 1 comprises four distinct groups

A

M, N, O, P

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12
Q

is there a cure for HIV?

A

No, there is not effective cure for HIV, but it can be controlled

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13
Q

How to know if one has HIV

A

GET TESTED@

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14
Q

AIDS stands for

A

Acquired immunodeficiency syndrome

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15
Q

AIDS is

A

Aquired

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16
Q

What stage is aids of HIV infection

A

Final stage

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17
Q

Does everyone who has HIV has aids>

A

No, not everyone who has HIV has aids

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18
Q

Aids is the stage go infection that occurs when

A

Immune system is vulnerable to opportunistic infections

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19
Q

Cell count of CD4 for AIDS

A

< 200 cells/ mm^3

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20
Q

How many people are living with HIV in 2018

A

35 million!

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21
Q

HIV promotes immunodeficiency by attacking

A

CD4 lymphocytes

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22
Q

1st HIV

A

1981

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23
Q

is HIV1 and HIV2 the same?

A

Differ genetically and in antigenicity, but cause similar disease syndrome

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24
Q

Do the same drugs effect HIV1 and HIV2?

A

No, not all drugs effective against HIV1 are effective against HIV2

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25
Q

Disease mechanism of HIV/AIDS

A

Primary event: entrance of HIV into the body’s CD4 cells (aka t-helper cells, t4 cells)

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26
Q

Once inside the T4 cell, the HIV…

A

Replicates and signals other cells that produce antibodies, which are essential for immune system function

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27
Q

Eventually, the HIV destroys T4 cells, it

A

Damages their ability to signal for antibody production, thus, deactivates the immune system

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28
Q

HIV life cycle

A
  • Fusion
  • Reverse transcriptase
  • Integrase
  • Protease
  • New HIV viruses
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29
Q

three links in the chain of infection must be present for the transmission of HIV

A
  • An HIV source.
  • A sufficient dose (viral load) of the virus
  • Access to the loodstream of another person
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30
Q

Transmission routes for HIV

A
  • Sex
  • Injection
  • Vertical transmission (mother to baby in utero)
  • Breastfeeding
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31
Q

Symptoms of HIV and Aids vary, depending on

A

The phase of infection

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32
Q

Primary infection (acute HIV) S/S

A

Muscle aches, fever, headache, join pain, rash, sore throat, swollen lymph glands

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33
Q

Clinical latent infection (chronic HIV) S/S

A

No specific symptoms; some have persistent swelling of LNs, it can last around 10 years if not receiving antiretroviral therapy

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34
Q

Early symptomatic HIV infection S/S

A

Fatigue, Fever, Swollen lymph glands, diarrhea, weight loss, oral yeast infection (thrust), shingles (herpes zoster)

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35
Q

By the time AIDS develops, the immune system is severely damaged, making the person susceptible to

A

Opportunistic infections; diseases that wouldn’t trouble a person with a healthy immune system

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36
Q

Signs and symptoms of the progression fo aids

A

soaking night sweats; recurring fever; chronic diarrhea; persistent white spots or unusual lesions on tongue/ mouth; persistent, unexplained fatigue, weight loss, skin rashes or lumps.

37
Q

What is the primary cause of AIDS related deaths

A

Opportunistic infection

38
Q

Triphase clinical course

A
  • Initial infection (acute retroviral syndrome)
  • Latency (may last up to 10 years)
  • Late phase (CD4 T-cells drop to critical low)
39
Q

A patient is diagnosed with AIDS IF

A

CD4 T-cell counts it <200

HIV+ patient has AIDS-defining illness

40
Q

Treatment of HIV

A

3 or 4 drugs combined in a regiment known as HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

41
Q

Goals of HIV treatment

A
  • suppression of viral load
  • restoration/preservation of immune function
  • improve quality of life
  • reduce HIV – related morbidity & mortality
  • does NOT cure HIV infection
42
Q

HAART must be a

A

Lifelong treament!

43
Q

HIV prevention

A

Pre-exposure prophylaxis

Post-exposure prophylaxis

44
Q

Pre-exposure prophylaxis

A

CDC provides information for the use of daily oral antiretroviral preexposure prophylaxis to reduce the risk of acquiring HIV infection in adults.

45
Q

Post-exposure prophylaxis must be started within

A

72 hours after recent possible exposer

46
Q

If prescriber PEP, take

A

Once or twice daily for 28 days

47
Q

Is PEP 100%?

A

No, it is effective in preventing HIV, but it is not 100%

48
Q

Exposures for which PEP is indicated

A

– Break in the skin by a sharp object that is contaminated with blood, visibly bloody fluid, or other potentially infectious material, or that has been in the source patient’s blood vessel

–Bite from a patient with visible bleeding in the mouth that causes bleeding in the exposed worker

–Splash of blood, visibly bloody fluid, or other potentially infectious material to a mucosal surface (mouth, nose, or eyes)

–A non-intact skin (e.g., dermatitis, chapped skin, abrasion, or open wound) exposure to blood, visibly bloody fluid, or other potentially infectious material

49
Q

Types of Antiretroviral treatment

A

Viral Entry Blockers
Enzyme Inhibitors
Viral Entry Blockers
Enzyme inhibitors

50
Q

types of viral entry blockers

A

Entry and fusion inhibitors

CCR5 antagonists

51
Q

types of enzyme inhibitors

A
  • -Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  • -Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  • -Integrase Inhibitors
  • -Protease Inhibitors
52
Q

Monotherapy with any antiretroviral can lead to resistance, which is why

A

they are often given in combination with other antiviral agents

53
Q

Types of viral entry blockers

A
  • Entry and Fusion Inhibitors

- CCR5 Antagonists

54
Q

Types of enzyme inhibitors

A
  • -Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  • -Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  • -Integrase Inhibitors
  • -Protease Inhibitors
55
Q

Entry and fusion inhibitors indications

A

Tx of advances HIV or resistance to other drugs

56
Q

Entry and Fusion Inhibitors MOA

A

Prevents fusion of HIV lipid membrane with CD4 TCELL

57
Q

Entry and Fusion Inhibitors

administration

A

SQ BID (very expensive, 20k/yr)

58
Q

Entry and Fusion Inhibitors

effects

A

injection site irritation, pneumonia (cough, SOA, fever), allergic rxn (chills, fever, hypotension, nausea, ↑ liver enzymes

59
Q

Enfuvirtide drug class

A

Entry and fusion inhibitor; viral entry blockers

60
Q

Maraviroc drug classification

A

CCR5 antagonist; viral entry blockers

61
Q

CCR5 Antagonist indication

A

treatment of HIV1 that binds with CCR5

62
Q

CCR5 Antagonist Moa

A

Blocks fusion by binding to CCR5 co-receptor

63
Q

CCR5 Antagonist administration

A

Oral, 150-600mg BID

64
Q

CCR5 Antagonist S/S

A
  • CNS (dizziness, sleep disorders, paresthesias)
  • MS pain
  • cough and URTIs
  • liver damage/ hepatoxicity
65
Q

Nucleoside reverse transcriptase end in

A

-Vudine

66
Q

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) Indication

A

treats s/s of HIV in combination with other drugs; prevents maternal HIV transfer to fetus

67
Q

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

MOA

A

using the viral reverse transcriptase, this medication incorporates itself into the DNA chain and blocks the addition of further nucleotides, thereby terminating viral replication

68
Q

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) administration

A

All are administered orally, Zidovundine is available as an IV injection

69
Q

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) S/S

A
  • Bone marrow suppression
  • GI (Nausea, vomit, pain)
  • CNS (dizziness, insomnia, HA)
  • Fever
  • Myalgia
70
Q

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) examples

A

efavirenz (Sustiva)

delavirdine (Rescriptor)

71
Q

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) indication

A

treat s/s of HIV in combination with other drugs

72
Q

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) MOA

A

binds to reverse transcriptase to stop HIV-1 replication by blocking the activity of RNA-dependent and DNA dependent polymerase.

73
Q

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) administration

A

Oral

74
Q

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) SE

A

Rash
GI (nausea, vomit, diarrhea)
Increase liver enzyme

75
Q

Raltegravir drug class

A

Inegase inhibitors

76
Q

Integase inhibitors indications

A

Treats HIV-1 that I resistant to other drugs

77
Q

Integase Inhibitors Administration

A

Oral

78
Q

Integase Inhibitors MOA

A

Stops HIV replication by preventing newly made HIV DNA from becoming integrating into Human DNA

79
Q

Integase Inhibitors SE

A

GI (N/v/d)

CNA (dizziness, HA)

80
Q

Protease inhibitor example

A

Sauinavir

Ritonavir

81
Q

Protease Inhibitors indiciation

A

Treats HIV1 AND 2 in combination with other drugs

82
Q

Protease Inhibitors administration

A

Oral with food

83
Q

Protease Inhibitors MOA

A

Prevents break up of large poly proteins, keeping new HIV virus immature (must be combine with NRTIs, then extremely effective)

84
Q

Protease Inhibitors SE

A

hyperglycemia
↑ risk of diabetes
fat redistribution
↑ cholesterol, ↑TGs (leading to atherosclerosis and CV disease)
↓ bone density (leading to osteoporosis)
liver toxicity
GI (n/v/d or constipation, heartburn, abd pain)

85
Q

Drugs that are approved by the FDA as the first successful, single two drug therapy option

A

Dolutegravir and Rilpivirine (Juluca)

86
Q

Drug that is a new single two drug, fixed dose treatment who are HIV +

A

dolutegravir and lamivudine (Dovato

87
Q

dolutegravir and rilpivirine (Juluca) indication

A
  • -For people who had already been receiving treatment
  • -Essentially a maintenance regimen for those who have achieved an undetectable viral load. (HIV-1 RNA < 50 copies/ ml and on a stable antiretroviral regimen for > 6 months with no history of treatment failure.)
88
Q

dolutegravir and lamivudine (Dovato) Administration

A

Tablet once a day

89
Q

dolutegravir and lamivudine (Dovato) SE

A

: HA, diarrhea, nausea, insomnia and fatigue

Risk of neural tube defects in babies born to women taking dolutegravir

316 Pharmacology (19 decks)

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