Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MID II > HIV antiretroviral therapy > Flashcards

HIV antiretroviral therapy Flashcards

1
Q

What is HAART?

A

Highly Active AntiRetroviral Therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 6 classes of antiretrovirals?

A
  • Nucleos(t)ide reverse transcriptase inhibitors (NRTIs)
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • Protease Inhibitors (PIs)
  • Fusion inhibitor
  • CCR5 antagonist
  • Integrase inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Whats the difference between Nucleoside and Nucleotide

A

Nucleoside = needs to be phosphorylated
Nucleotide = already diphosphorylated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the process of HIV infectino of CD4 cell?

A

HIV binds the CD4 receptor –> glycoprotein capsid is released during fusion –> RNA is reverse transcribed to DNA –> DNA is integrated from cytoplasm into host nucleus (this is why it has latency, bc it integrates in the the host genome of CD4+ cell) –> at time of reactivation, uses normal host machinery to make RNA –> new RNA is integrated into virion making viral particles (catalyzed by the enzyme protease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which steps can antiretrivirals inhibit?

A

Binding to the CD4 receptor

Synthesis of viral DNA via Reverse Transcriptase

Integration into host chromosomal DNA

Assembly of virus and budding from the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do NRTI’s work?

A

Compete with host nucleotides- competitive inhibitor, chain terminators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the NTRIs?

A

Nucleoside: block replication with “ZEAL”
Zidovudine = AZT
Emtricitabine
Abacavir
Lamivudine

Nucelotide:
Tenofovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the side effects of nucleoside RTI’s?

A

Lactic acidosis, neuropathy

Abacavir = hypersensivity syndrome

Anemia = AZT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the side effects of nucleotide RTIs?

A

Nephrotoxicity

Fanconi’s syndrome = kidney

Bone mineralization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What’s the mechanism of action of NNRTIs?

A

Inhibit RT through binding the enzyme near the active site & locking it in an inactive conformation

Active against HIV-1 only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the NNRTIs?

A

ENE

Efiravenz (1G)

Nevirapine (1G)

Etravirine (2G)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the side effects of NNRTIs?

A

1st gen = susceptible to resistance, neuro, teratogen “Efavirenz effs with your dreams and yo baby”

All have rash, liver, DDI (CYP3A4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do proteas inhibitors work?

A

Bind active iste of protease, prevent cleaving of precursor proteins for important enzymes (gag and gag-pol)

Leads to production of virions that are incomplete and noninfectious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the PI’s

A

“messes with your LARD”

Lopinavir

Atazanavir

Ritonavir

Darunavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the side effects of PIs?

A

GI, dyslipidemia, atherosclerosis, DDI (CYP3A4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is ritonavir always included when administering other protease inhibitors?

A

Inhibits CYP3A4, making it a great “booster” to increase conc of other drugs

17
Q

Which drugs have higher barriers to resistance? Lower barrier?

A

Protease inhibitors - you need accumulation of several mutations

NNRIs: one mutation can lead to resistance

18
Q

How do fusion inhibitors work?

Which drug is it?

What is the side effect?

A

Prevents entry by binding to the glycoprotein on the viral envelope - binds gp41 envelope glycoprotein

Enfuvirtide
“Enfelope” binding

Injectible only

Injection site effects

Very potent/ salvage therapy for those who have multidrug resistance HIV

19
Q

What is the CCR5 antagonist?

What is its mechanism?

A

Maraviroc
“Rocblocks CCR5”

Prevents entry by binding to the chemokine coreceptor on the host CD4+ cell

Active against CCR5 tropic virus only

20
Q

How do integrase inhibitors work?

A

Inhibit DNA integration into genome

21
Q

What are the 2 integrase inhibitors?

A

Raltegravir

Elvitegravir (combo with cobicistat-booster, tenofovir-NRTI, and emtricatabine- NRTI)

”-gravir” are integrase inhibitors

22
Q

What are the side effects of integrase inhibitors?

A

Low barrier to resistance, cross resistance in the class, take it 2x/day, headache, rash

23
Q

What are the 2 boosters?

A

Ritonavir: early protease inhibitor, used to boost other PIs. can cause GI discomfort and dyslipidemia

Cobicistat: not an antiretroviral agent, coformulated with integrase inhibitor elvitegravir; can cause renal dysfunciton

Both are potent inhibitors of CYP3A4

24
Q

Which drugs treat both HIV and Hep B?

A

Lamivudine

Emtrictabine

25
Q

What is the backbone for HAART?

A

tenofovir

Emtricitabine

26
Q

What are the three first line antiretroviral therapy options?

A

2NRTI + one of the following:

1NNRTI

1PI/r

1 INSTI

27
Q

What are the goals of ART?

A

Decrease viral load

Rise CD4+ count

Decrease in HIV associated morbidity and mortality

28
Q

What is the risk of percutaneous exposure for HIV?

A

0.3%

MID II (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions