HIV Flashcards
What are the non-nucleotide reverse transcriptase inhibitors?
Efavirenz
Rilpivirine
What are the common toxicities of all of the protease inhibitors?
Altered body fat distribution “buffalo hump and truncal obesity”
Insulin resistance/hyperglycemia
High cholesterol (but not ok to combine with statins)
Bleeding in pts with hemophilia
What is the one drug that is an integrase inhibitor?
Dolutegravir (Tivicay)
*****NOT A PROTEASE INHIBITOR despite it’ ending in -avir
What do you need to do before you give your patient maraviroc (Selzentry)?
You need to test to see which type of receptor the patient has.
You’re either CXCR4 or CCR5 or a combo of both. Maraviroc only works on CCR5.
Won’t work on R4 or mixed infections
What is the MOA of the NNRTI’s?
Bind directly to viral reverse transcriptase, which is ESSENTIAL for the conversion of RNA to DNA
What is the MOA of dolutegravir?
Prevents the viral DNA from incorporating into the host DNA
What nucleotide is zidovudine an analogue of?
Thymidine
What do you need to screen for before starting abacavir?
HLA-B-5701 due to extreme hypersensitivity
Ok so i know i can’t give ritonavir with saquinavir, but what else should i not give Ritonavir with and why?
Do not give with metronidazole, disulfiram, or cephalosporins
Ritonavir contains ethanol 🍺🍻🥂🍾🍸
Which HIV drugs are Nucleoside reverse transcriptase inhibitors?
Zidovudine-thymidine
Emtricitabine-cytosine
Tenofovir-adenosine
Lamivudine-cytosine
Abacavir-guanosine
If you take your patient off of abacavir, can you ever start them back on it?
No may be fatal
What are the two NRTI’s that can be used to treat Hep B as well as HIV?
Tenofovir
Lamivudine
What is the MOA of enfuvirtide (Fuzeon)?
Binds to gp41 subunit of the viral envelope and prevents the conformational change required for membrane fusion and subsequent viral entry into cells
What is the MOA of protease inhibitors?
They all work “post-integration” by binding to proteases and inhibiting their function, which is to cut up huge chunks of protein into smaller, functional proteins
Why does ritonavir “boost” the other protease inhibitors?
It inhibits CYP3A4, so it increases the bioavailability of the other ones since they are metabolized by CYP3A4
(Except fot saquinavir…it will make the QT issues even worse for that person)
Would we ever give rilpivirine to a non-pregnant person
No, use efavirenz for every non pregnant patient
Which NRTI’s should not be used together since they both are analogues of the same nucleoside?
Emtricitabine
Lamivudine
What are the protease inhibitors?
Darunavir
Atazanavir
Ritonavir
Saquinavir
Lopinavir
Indinavir
Tipranavir
What are the fusion inhibitors?
Enfuviritde (Fuzeon)
Maraviroc (selzentry)
Which one of the protease inhibitors is used to give a boost to the other protease inhibitors?
Ritonavir
Except don’t give it with Saquinivir due to QT prolongation issues
Every single NRTI has two rare but serious side effects. What are they?
Lactic acidosis
Hepatotoxicity
(Especially if they are obese, have liver disease, or take them for a long time)
Which NNRTI are you going to give to your HIV+ pregnant patient?
Rilpivirine
Which two NRTIs have flatulence as their main side effect?
Tenofovir
Emtricitabine
Your aids patient starts developing lactic acidosis, which can be deadly. Which drug do you think is causing it?
The NRTI they are on.
NRTIs: Zidovudine, Emtricitabine, tenofovir, lamivudine, abacavir
Which one of the NNRTIs are you going to give to 99% of your Aids patients? When wouldn’t you give it?
Efavirenz
Do NOT use in pregnancy
Which of the protease inhibitors have sulfa components and may cause hypersensitivity?
Darunavir
Tipranavir
(Don’t Take……DT)
What nuclsoede is lamivudine an analogue of?
Cytosine
What is the MOA of maraviroc (Selzentry)?
Inhibits the fusion of the virus by binding to the CCR5 receptor of the CD4 T-cell
