HIV Meds

Question 1

what does HAART stand for

Answer 1

Highly active antiretroviral therapy

Question 2

6 steps to HIV replication

Answer 2

entry (binding and fusion)
reverse transcription
integration
replication (transcription and translation)
assembly
budding and maturation

Question 3

CCR5 antagonist

Answer 3

Maraviroc

Question 4

what do you have to use for pt prior to initiating a CCR5 antagonist

Answer 4

tropism assay

Question 5

fusion inhibitors

Answer 5

Enfuvirtide (T-20)

Question 6

MOA fusion inhibitors

Answer 6

bind to envelope glycoprotein 41 to prevent viral fusion to CD4 T cell

Question 7

attachment inhibitors

Answer 7

Fostemsavir

Question 8

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

Answer 8

Abacavir
Emtricitabine
Lamivudine
Stavudine
Tenofovir alafenamide
Tenofovir disoproxil fumarate
Zidovudine

Question 9

what strands are NRTIs active against

Answer 9

HIV 1 and HIV 2

Question 10

what NRTIs are active against hepatitis B

Answer 10

Lamivudine
Emtricitabine
Tenofovir

Question 11

MOA NRTIs

Answer 11

intracellular phosphorylation –> active triphosphate form inhibits oral replication through competitive binding

Question 12

BBW for NRTIs

Answer 12

lactic acidosis

Question 13

what do you have to test before starting Abacavir

Answer 13

HLA-B*5701

Question 14

who should avoid Abacavir

Answer 14

those who test positive for HLA-B*5701
CAD and risk factors for CAD

Question 15

what NRTIs should not be combined

Answer 15

lamivudine and emtricitabine – they are structurally similar and will compete

Question 16

main ADE of tenofovir

Answer 16

kidney injury
bone loss

Question 17

what was the first antiretroviral med for HIV

Answer 17

Zidovudine

Question 18

what NRTI significant reduces in utero transmission from mother to fetus and is often given during L&D

Answer 18

Zidovudine

Question 19

what medication should not be used with zidovudine

Answer 19

stavudine

Question 20

what GI illness is lamivudine associated with

Answer 20

pancreatitis

Question 21

what NRTI combo is technically first line

Answer 21

Abacavir/Lamivudine

Question 22

what does TAF stand for

Answer 22

tenofovir alafenamide

Question 23

what does TDF stand for

Answer 23

tenofovir disoproxil fumarate

Question 24

between TAF and TDF, which is administered at lower doses

Answer 24

TAF (TAF will have decreased plasma levels but increased intracellular concentrations)

Question 25

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Answer 25

Doravirine Efavirenz Etravirine Nevirapine Rilpivirine

Question 26

what NNRTI should not be used for treatment naive patients

Answer 26

etravirine

Question 27

what are NNRTIs active against

Answer 27

ONLY HIV1

Question 28

what medication is associated with depression and is contraindicated in patients with clinical depression

Answer 28

Efavirenz (NNRTI)

Question 29

Integrase Strand Transfer Inhibitors (INSTIs)

Answer 29

Bictegravir Cabotegravir Dolutegravir Elvitegravir Raltegravir

Question 30

Protease Inhibitors

Answer 30

Atazanavir Atazanavir-cobocistat Darunavir Darunavir-cobicistat Fosemprenavir Lopinavir/ritonavir Nelfinavir Ritonavir Tipranavir Indinavir

Question 31

what class of meds is also administered with a boosting agent? what are those boosting agents?

Answer 31

Protease inhibitors Ritonavir or Cobicistat

Question 32

MOA protease inhibitors

Answer 32

competitively inhibit the cleavage of the Gag-Pol poly proteins in HIV-infected cells which is crucial for viral maturation --> production of immature visions that are not infectious

Question 33

Post-attachment inhibitors

Answer 33

Ibalizumab

Question 34

MOA post-attachment inhibitors

Answer 34

MAB that binds to CD4 molecule which does not prevent attachment, but prevents viral entry

Question 35

what does PrEP stand for

Answer 35

pre-exposure prophylaxis

Question 36

options for PrEP and what is recommended for most

Answer 36

tenofovir disoproxil fumarate-emtricitabine (Truvada) - recommended for most tenofovir alafenamide-emtricitabine (Descovy) injectable - Cabotegravir

Question 37

What does PEP stand for

Answer 37

post-exposure prophylaxis

Question 38

options for PEP

Answer 38

tenofovir disoproxil fumarate-emtricitabine plus an INSTI (raltegravir or dolutegravir) raltegravir seems to be what is recommended for occupational exposure

Question 39

prophylactic treatment for coccidiomycosis

Answer 39

fluconazole is < 250 cells/microL

Question 40

prophylactic tx for pneumocystis

Answer 40

TMP-SMX if < 200 cells/microL

Question 41

prophylactic tx for toxoplasma

Answer 41

TMP-SMX if < 100 cells/microL