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Spring Pharmacology > HIV > Flashcards

HIV Flashcards

1
Q

What kind of virus is HIV?

A

Retrovirus and lentivirus

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2
Q

What enzyme allows RNA to be converted into DNA?

A

Reverse transcriptase

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3
Q

What enzyme allows HIV viral maturation?

A

Protease

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4
Q

What enzyme allows viral genes to enter nucleus and host DNA?

A

Integrase

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5
Q

When should antiretroviral therapy (ART) be started?

A

All HIV (+) patients

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6
Q

Should ART be used in pregnancy? Why of why not?

A

Yes. prevents transmission and provides clinical benefit to mother

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7
Q

In what condition should ART initiation be delayed?

A

cryptococcal meningitis

-can increase mortality if started to early, refer to specialist

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8
Q

Preferred Regimen to treat AIDS

A

NNRTI-base
-efavirenz/tenofovir/emtricitabine
Protease Inhibitor- based
-Darunavir or Ataxanavir + tenofovir/emtricitabine
INST- based
-Raltegravir + tenofovir/emtricitabine

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9
Q

Post exposure HIV prophylaxis should include

A

3 anti-HIV drugs, 4 week minimum

-Dual NRTI+ protease inhib or INSTI

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10
Q

Pre-exposure prophylaxis should include

A

tenovir/emtrictabine daily

-ie to prevent transmission from mother to baby

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11
Q

Dose a NRTI

A

Truvada

one tablet daily

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12
Q

Dose a NNRTIs

A

Atripla

one tablet daily

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13
Q

Dose a protease inhibitor

A

Prezista 800mg

one table daily, long with Truvada

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14
Q

Dose a fusion inhibitor

A

Enfuvirtide(Fuseon) 90mg

Inject subq twice a day

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15
Q

Dose an integrase strand transfer inhibitor

A

Isentress 400mg

1 tablet twice a day, with Truvada

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16
Q

Dose a CCR5 inhibitor

A

Selzentry 300mg

1 tablet twice a day

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17
Q

How are NRTIs excreted from the body

A

renally

30-49 adjust dose, <30 not recommended

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18
Q 
General class effect ADR seen in NRTI:
what drugs in this class is this generally not seen
A

Lactic Acidosis, Hepatomegaly

-not generally seen with abacavir, emtricitabine, lamivudine, tenofovir

19
Q

Who does no one continue to prescribe the NRTIs didanosine and stavudine?

A

Peripheral Neuropathy

20
Q

How are NNRTIs metabolized?

A

CYP3A

can act as an inhibitor or inducer

21
Q

MOA NRTI

A

integrate into structure, changing RNA/DNA, leading to host cell death

22
Q

MOA NNRTI

A

block activity of reverse transcriptase

23
Q

Name 2 NRTIs

A

Emtricitabine (Emitra)

Tenofovir (Viread)

24
Q

Name 2 NNRTIs

A 
Efavirenz (Sustiva)
Delaviridine (Rescriptor)
Etravirine (Intelence)
Nevirapine (Viramune)
Rilpivirine (Endurant)
25
Q

ADRs of efavirenz

A

dizzy, depression, insomnia, HA, rash, increase total cholesterol, triglycerides, HDL, GI symptoms

26
Q

Name 3 protease inhibitors

A

atazanavir (reyataz)
darunavir (prezista)
ritonavir (norvir)

27
Q

What drug class reduces viral shedding?

A

protease inhibitors

28
Q

How are protease inhibitors metabolized?

A

CYP3A4

29
Q

What drug interaction could affect effectiveness of a protease inhibitor?

A

stomach pH drugs
H2blocker, PPI

also keep in mind CYP3A4 metabolism

30
Q

Atazanavir can be used _______ an H2 blocker or________ after a PPI

A

with or 10 hours after H2blocker

12hrs after PPI

31
Q

What drug group can lead to new onset diabetes or worsen a diabetics control?

A

Protease Inhibitors

-monitor blood sugar

32
Q

What drug is used to increase maximum concentration of concomitant protease inhibitor

A

Ritonavir

33
Q

What ADR would you be concerned for with atazanavir?

A

nephrolithiasis

34
Q

What ADR would be watch for usin Darunavir?

A

pancreatitis, sulfonamide cross-reactions

35
Q

Name a fusion inhibitor

A

enfuvirtide (fuseon)

36
Q

Name the only HIV drug given by injection

A

enfuvirtide (fuseon)

37
Q

Which HIV drug would be a pneumonia risk

A

Fuseon

38
Q

Name an integrase strand inhibitor

A

Elvitegravir which is integrated into

Raltelgravir (Isentress)

39
Q

what is cobicistat

A

CYP3A inhibitor that allos elvitegravir to obtain therapeutic levels

40
Q

ADRs of Isentress

A

Skin & Hypersensitivity- SJS

Myopathy

41
Q

ADR concern for patient on statins and integrase strand inhibitor

A

rhabdomyolysis

42
Q

Name a CCR5 Inhibitor

A

Maraviroc (Selzentry)

43
Q

How are ccr5 inhibitors metabolized

A

CYP3A

44
Q

ADRs of Selzentry

A

Hepatotoxicity w/allergic features
Myocardial ischemia/infarction
postural hypotension

Spring Pharmacology (9 decks)

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