Brainscape's Knowledge GenomeTM

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


See full index

PHARMACOLOGY - Heme > HIV drugs > Flashcards

HIV drugs Flashcards

1
Q

What is the advantage to using drugs from different classes?

A
  • Synergy

* Decreased Resistance

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

What is the typical way that HAART therapy is prescribed, in terms of mechanism of action?

A

Give:

• 2 NRTI’s + (NNRTI or protease inhibitor or integrase inhibitor)

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

What should you do first if detect through western blot and elisa that a patient is relapsing despite HAART therapy?

A
  1. Ask if they are actually taking the therapy

2. Perform Resistance Testing

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

Before initiating therapy with miravoc what should you do?

A

• Make sure they are CCR5+, otherwise the drug is useless

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

NRTI’s and NNRTI’s act on what step in the HIV life cycle?

A

Reverse Transciption

• These are (Non) Nucleotide Reverse Transciption inhibitors

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

What drugs act as NRTI’s?
• are the competitive or non-competitive inhibitors?
• Do they work on HIV-1 and 2?

A 
ABACAVIR
LAMIVUDINE (3TC)
TENOFOVIR (TDF)
EMTRICIBINE 
ZIDOVUDINE (AZT)

Inhibition:
• Competitive

Tropism:
• Work on HIV 1 and 2

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

What drugs act as NNRTIs?
• are the competitive or non-competitive inhibitors?
• Do they work on HIV-1 and 2?

A

EFAVIRENZ
NEVIRAPINE
DELAVIRDINE

Inhibition:
• Non-competitive

Tropism:
• Work on HIV 1

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

What drugs act as protease inhibitors?
• are the competitive or non-competitive inhibitors?
• Do they work on HIV-1 and 2?

A

the -navirs

ATAZNAVIR
RITONAVIR

Inhibition:
• Competetive

Tropism:
• HIV 1 ONLY

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

What drugs act as Fusion inhibitors?
• are the competitive or non-competitive inhibitors?
• Do they work on HIV-1 and 2?

A

ENFUVIRTIDE - HIV-1 ONLY

MARAVOC - CCR5+ ONLY

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

What drugs act as integrase inhibitors?

A

RALTEGRAVIR

DOLUTEGRAVIR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q 
NRTIs 
• Administration 
• Metabolism 
• Standouts???
• Drugs?
A

Administration:
• Oral

Metabolism:
• No Significant CYP interactions

Standouts:
• Abacavir - is metabolized by ALCOHOL DEHYDROGENASE (don’t drink with it)

ABACAVIR
LAMIVUDINE (3TC)
TENOFOVIR (TDF)
EMTRICIBINE 
DIDANOSINE
STAVUDINE
ZIDOVUDINE (AZT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
NNRTIs 
• Administration 
• Metabolism 
• Standouts???
• Drugs?
A

Administration:
• Oral

Metabolism:
• Delavirdine - weakly CYPS
• Efavirenz, Nevirapine - INDUCE CYPS

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

Which NNRTIs might cause unwanted pregnancy?

• why?

A

Efavirenz, Nevirapine

• They INDUCE CYP3A4 and CYP2B6 which can lead to ORAL CONTRACEPTIVE FAILURE

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

What happens to drug metabolism when you give a patient Rifamin and Rifabutin, what would you have to do to counteract this?
• is it okay to give NNTRI’s with this?

A

Rifampin and Rifabutin
• Known PAN-INDUCERS of CYP

Efavirenz OKAY to give with these but you need to UP THE DOSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
What class of drugs should you NEVER give rifampin with? 
• Why?
A

PROTEASE INHIBITORS - the “-navirs”

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

What group of HIV drugs should come to mind when you think about CYP issues?

A

PROTEASE INHIBITORS - the “-navirs”

17
Q

Which of the protease inhibitors might you give if you’re trying to increase the concentration or prolong the effect of a drug in the bloodstream?

A

RITONAVIR

18
Q

Suppose you begin taking a drug X (a cyp metabolized drug) for migraines and begin taking rifampin, what would you expect to happen?
• What HIV Drug might have the opposite effect?

A
  • Headaches would come back, you would see a recurrence of symptoms due to induction of CYPs by rifampin
  • RITONAVIR (protease inhibitor)
19
Q

What the the ONLY HIV drug given subcutaneously?

A

ENFUVIRTIDE

20
Q

Fusion and Integrase inhibitors
• Name them
• Administration?

A

MARAVIROC
ENFUVIRTIDE

RALTEGRAVIR (integrase inhibitor)

21
Q

What is the point of giving Cobicistat?

A

• Orally active CYP3A4 inhibitor that can be given to increase the serum concentration of drugs like Ataznavire (a weak CYP inducer)

22
Q

Besides Rifampin what other antimicrobials tend to have major effects on when given with HIV drugs, specifically RITONAVIR?
• What other HIV drugs is this drug contrainidcated with?

A

• Voriconazole - inhibits CYP2C9 (a little) and CYP3A4 (a lot)

  • *ALL Protease Inhibitors Contraindicated
  • *NNRTIs contratindicated
23
Q

Activity of Rifampin vs. Rifabutin

A

RIfampin is a much intense inducer of CYP

24
Q

What Black Box Warnings are associated with all of the NNRTIs?
• which has the most black box warnings?
• What raises your risk for experiencing these effects?

A

BBWs:
• Hepatic Disease
• Lactic Acidosis
• Neuropathy

ZIDOVUDINE - has the most, also causes Anemia, myopathy, and neutrapenia

RISK FACTORS:
• Being Obese
• Being a woman

25
Q

What Drugs would you want to avoid if you are a drinker with HIV?

A
  • Abacavir - metabolized by Alcohol Dehydrogenase

* Didanosine and Stavudine - may cause Pancreatitis

26
Q

A person experiences Vivid dreams and CNS symptoms during the first 2 weeks of HIV therapy?
• What drug are they likely taking?
• This drug is a member of what class?

A

• Efavirenz - NNRTI

27
Q

What symptoms are common to all of the NNRTIs?
• Which are contraindicated in pregancy?
• Name them

A

Common:
• Rash and Hepatotoxicity

Pregnancy:
• Efavirenz and Delavirdine

NNRTIs
EFAVIRENZ
NEVIRAPINE
DELAVIRDINE

28
Q

What are som effects caused by ALL of the Protease Inhibitors?
• Name them

A

PIs cause Cushings-like effects:
Lipodystrophy - BUFFALO NECK
Hyperglycemia - Glut 4 issues, think DIABETES
Severe Rash

Others: Dyslipidemia, GI intolerance

29
Q

What HIV drug is likely to cause insomnia?

• what about Upper respiratory Tract infections?

A

Insomina:
• Raltegravir

URTI:
• Maraviroc

30
Q

What drugs are given as HIV post-exposure prophylaxis?

A

Tenofovir
Emitricitabine
Raltegravir

31
Q

If somebody gets CMV while on HAART therapy, what drugs will they probably get?
• Method of administration?

A

Oral:
Valganciclovir (also used in prophylaxis)
Ganciclovir (also used in prophylaxis)

IV:
Foscarnet
Cidofovire

32
Q

Fluconazole is the drug of choice for fungal infection prophylaxsis in HIV pts.

A

Fluconazole is the drug of choice for fungal infection prophylaxsis in HIV pts.

33
Q

Why would you see an HIV patient get genital ulcerations while getting treated for CMV?

A

Foscarnet - drug is very insoluble and will become concentrated in the urine if you don’t stay hydrated

Can also cause nephrotoxicity via electrolyte imbalances

34
Q

What drug is often given to treat an EBV infection in an someone with an HIV infection?
• How does resistance against this drug arise?
• Application?

A

Vidarabine OCULAR OINTMENT

  • works by inhibiting EBV DNA pols. and mutation in the DNA pols. causes loss of drug activity
35
Q

How does resistance against Vidarabine differ from resistance against Valgancilovir?

A

Vidarabine - enzyme that it works on is mutated

Gancilovir - enzyme that phosphorylates it in herpes viruses is mutated

36
Q

What Drug is often given to combat KSHV?

A

Cidofovir - nucleotide analogue that must be phosphorylated

37
Q 
Of the following drugs, determine which ones could pose a higher risk of drug-drug interactions: 
• Dabigatran
• Enoxaparin
• Fondaparinux
• Apixaban 
• Bivalirudin
• Rivaroxaban
• Warfarin
A 
CYP/P-gp issues: 
• Dabigatran
• Apixaban
• Rivaroxaban
• Warfarin

No Issues:
• Enoxaparin
• Fondaparinux
• Bivalirudin

PHARMACOLOGY - Heme (4 decks)

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