HIV/Antiviral Drugs

Question 1

which NRTIs are the most inhibitory of mDNA poly y

Answer 1

didanoaine> stavudine> zidovudine

Question 2

NRTI with neuropathy

Answer 2

didanosine and stavudine

Question 3

NRTI with lactic acidosis and hepatic steatosis

Answer 3

stavudine, didanosine, zidovudine

Question 4

NRTI with lipoatrophy, lipodystrophy

Answer 4

all of them

Question 5

NRTI with pancreatitis

Answer 5

stavudine

Question 6

tenofovir AE
dont give to pts with what
alternative

Answer 6

nephrotoxicity
don’t give to pts with renal insufficiency
give abacavir

Question 7

NRTI with hypersensitivity and HLA associated

Answer 7

abacavir and HLA B 5701

Question 8

NRTI combos to avoid

Answer 8

Zido and stav- antagonism

lami and emtri- nearly identical drug

stavb and didan- mitochondrial toxicity, neurop, lipodys

didan and tenof- blundted CD4 t cell response

triple nucleoside analog combo

Question 9

which NNRTI should be avoided in pregnancy

Answer 9

efavirenz

Question 10

which NNRTI is acceptable in pregnancy

Answer 10

nevirapine
-single dose to pregvent maternal fetal transmission
more toxic in 1st 3 months

Question 11

what is the NNRTI to use if resistant to efavirenz and nevirapine

Answer 11

etravirine

Question 12

MOA of NNRTI

Answer 12

bind and distort RT enzyme so RT cannot make viral DNA

Question 13

hypersensitivity to NNRTIs

Answer 13

all NNRTIs associated with rash and hypersensitivity including stevens jonshon syndrome (worse with nevirapine)

Question 14

what is life threatening effect with NNRTI and which one most toxic

Answer 14

hepatoxicity, risk higher in pts with higher CD4 count at time of starting NEVIRAPINE

Question 15

don’t continue NNRTI medications in the setting of ___ mutation

Answer 15

K103N

Question 16

atazanavir and ritonavir

• aide effect
• contraindication
• used for what special case

Answer 16

protease inhibitors that cause hyperbilirubienmia

PPI contraindicated

used for strains that are MDR

Question 17

lopinavir and ritonavir

AE

Answer 17

GI intolerance
diabetes/insulin resisantce
possible increased risk of MI

Question 18

darunavir and ritonavir AE

Answer 18

rash, liver tox

Question 19

tipranavir nad ritonavir AE

Answer 19

black box

• fatal hepatitis
• intracranial hemorrhage

Question 20

Protease inhibitor MOA

Answer 20

mimic bond between F-P and 167-168, target for HIV aspartyl protease (HAP)

Question 21

bioavailabilty of PI and how to fix

Answer 21

low, extensive first pass metab
ritonavir inhibits CYP450 so increases effect of other PIs
ritonavir only used for this purpose

Question 22

which PIs have sulfonamide hypersensitivyity

Answer 22

darunavir, fosamprenavir, tipranavir

DF tolerance Sucks (sulfan)

Question 23

what proteins are effected from PIs that cause redisbritution of fat

Answer 23

CRAB P1

LRP