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Pharmacology > HIV > Flashcards

HIV Flashcards

1
Q

What does NRTIs stand for?

A

Nucleoside Reverse Transcriptase Inhibitors

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2
Q

components of basic ART

A

2 NRTIs + integrase inhibitor

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3
Q

NRTIs MOA

A

prohibits transfer of ssRNA to dsDNA

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4
Q

NRTIs examples

A
  1. Truvada (tenofovir DF + emtricitabine)
  2. Descovy (tenofovir AF + emtricitabine) - fewer kidney and bone issues than Truvada
  3. Epzicom (abacivir + lamivudine) - better for kidney disease
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5
Q

NRTIs SE

A
  1. osteoporosis

2. kidney disease

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6
Q

special consideration with Epzicom and ziagen

A

need to do HLA-B701 assay test before starting therapy b/c risk of hypersensitivity reaction

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7
Q

What does NNRTIs stand for?

A

Non-nucleoside Reverse Transcriptase Inhibitors

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8
Q

NNRTIs examples

A
  1. Atripla

2. Complera

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9
Q

NNRTIs usage

A 
no used as much now b/c lot of resistance! 
MC class for transmitted resistance
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10
Q

NNRTIs MOA

A

prevent RNA –> DNA

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11
Q

NNRTIs SE

A
  1. depression
  2. abnormal dreams
  3. insomnia
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12
Q

integrase inhibitors example

A

Biktarvy (combo of Descovy + integrase inhibitor)
Dolutegravir (DTG)
Bictegravir (BIC)

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13
Q

integrase inhibitors MOA

A

block HIV from being integrated into cell DNA

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14
Q

benefits of integrase inhibitors

A

least resistance, very well tolerated

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15
Q

integrase inhibitors SE

A

neuropsychiatric problems (rare)

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16
Q

protease inhibitor historical significance

A
  1. first drug that was shown to prolong life in HIV patients

2. class of drug that showed need for 3 different drugs for HIV

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17
Q

protease inhibitor example

A

Indinavir

18
Q

protease inhibitor MOA

A

blocks HIV copies from being cut into right size proteins so new virus is not infective

19
Q

protease inhibitor SE

A
  1. increase in lipids
  2. lipodystrophy
  3. GI s/e
  4. lots of drug interactions
  5. increased cardiovascular disease risk
20
Q

Entry inhibitors MOA

A

block HIV fusion to CD4 cells

21
Q

PrEP example

A

Truvada (TDF + emtricitabine)

Descovy

22
Q

PrEP MOA

A

prevents replication of virus and prevents infection

23
Q

PrEP Indications

A
  1. MSM
  2. HIV + partner
  3. commercial sex workers
  4. IV drug users
24
Q

PrEP dosage

A

once daily drug, given in 3 month supply

25
Q

what needs to be check before giving PrEP?

A

kidney function!

also viral load, viral Ab/Ag

26
Q

when to stop PrEP

A
  1. HIV +
  2. any issues w/ kidney function
  3. becomes pregnant
  4. non-compliant
27
Q

what should you check during every f/u if taking PrEP

A
  1. HIV test
  2. pregnancy test
  3. STI
  4. renal function
28
Q

PEP example

A

Tenofovir + emtricitabine + raltegravir (I.I)

29
Q

when to test for HIV with PEP

A

at baseline, 6 and 12 weeks, 6 months

30
Q

special considerations with HIV patients

A

age quicker - will see disease in 30-50 y/o that may not have developed until 50-70s
- sooner screening, monitor lipids, blood sugar, renal disease, bone loss

31
Q

strongest predictor of disease progression

A

CD4

32
Q

goal of treatment

A

decrease viral replication - undetectable viral load

raise CD4 count >200

33
Q

what do you use to evaluate response to treatment

A

HIV RNA (viral load)

34
Q

time frame to treat HIV before it goes into reservoirs

A

4 weeks

35
Q

truvada and descovy dose adjust for who?

A

renal patients w/ low creatinine clearance

36
Q

lab abnormality with NNRTIs

A

elevated LFTs b/c cytochrome P450 system

37
Q

special considerations with protease inhibitors

A

all require use of pharmacokinetic booster so that lower doses can be used (norvir, cobistat)

38
Q

special considerations with integrase inhibitors

A

avoid Ca, Fe, minerals - separate by 2 hours prior or 6 hours after

39
Q

rapid start regimen

A

Tivicay + Descovy

40
Q

important factor in HIV treatment

A

adherence - missing 3-4 doses can cause loss of class of drugs - needs to be 95%

41
Q

lab to check before starting HIV treatment

A

creatinine clearance

42
Q

considerations before prescribing PrEP

A
  1. age
  2. plans for pregnancy
  3. osteopenia/osteoporosis

Pharmacology (27 decks)

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