HIV/Antiviral Drugs Flashcards
which NRTIs are the most inhibitory of mDNA poly y
didanoaine> stavudine> zidovudine
NRTI with neuropathy
didanosine and stavudine
NRTI with lactic acidosis and hepatic steatosis
stavudine, didanosine, zidovudine
NRTI with lipoatrophy, lipodystrophy
all of them
NRTI with pancreatitis
stavudine
tenofovir AE
dont give to pts with what
alternative
nephrotoxicity
don’t give to pts with renal insufficiency
give abacavir
NRTI with hypersensitivity and HLA associated
abacavir and HLA B 5701
NRTI combos to avoid
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
which NNRTI should be avoided in pregnancy
efavirenz
which NNRTI is acceptable in pregnancy
nevirapine
-single dose to pregvent maternal fetal transmission
more toxic in 1st 3 months
what is the NNRTI to use if resistant to efavirenz and nevirapine
etravirine
MOA of NNRTI
bind and distort RT enzyme so RT cannot make viral DNA
hypersensitivity to NNRTIs
all NNRTIs associated with rash and hypersensitivity including stevens jonshon syndrome (worse with nevirapine)
what is life threatening effect with NNRTI and which one most toxic
hepatoxicity, risk higher in pts with higher CD4 count at time of starting NEVIRAPINE
don’t continue NNRTI medications in the setting of ___ mutation
K103N
atazanavir and ritonavir
- aide effect
- contraindication
- used for what special case
protease inhibitors that cause hyperbilirubienmia
PPI contraindicated
used for strains that are MDR
lopinavir and ritonavir
AE
GI intolerance
diabetes/insulin resisantce
possible increased risk of MI
darunavir and ritonavir AE
rash, liver tox
tipranavir nad ritonavir AE
black box
- fatal hepatitis
- intracranial hemorrhage
Protease inhibitor MOA
mimic bond between F-P and 167-168, target for HIV aspartyl protease (HAP)
bioavailabilty of PI and how to fix
low, extensive first pass metab
ritonavir inhibits CYP450 so increases effect of other PIs
ritonavir only used for this purpose
which PIs have sulfonamide hypersensitivyity
darunavir, fosamprenavir, tipranavir
DF tolerance Sucks (sulfan)
what proteins are effected from PIs that cause redisbritution of fat
CRAB P1
LRP
