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SBL > HIV Pharm > Flashcards

HIV Pharm Flashcards

1
Q

HIV Goals (4)

A

Lower viral load, improve CD4 counts, prevent resistant, prevent inflammation/infection

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2
Q

Starting Treatment (4)

A

Emtricitabine + Tenofovir Alafenamide + Bictegravir

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3
Q

Negative HLA-B*5701 & HBV Tx (3)

A

Abacavir + Lamivudine + Dolutegravir

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4
Q

Only for Low Viral Load, No HBV, and Negative HLA-B*5701 (2)

A

Dolutegravir + Lamivudine

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5
Q

Other Options (6)

A

(Doultegravir or Raltegravir) + (Emtricitabine or Lamivudine) + Tenofovir (2)

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6
Q

HIV Cycle (4)

A

(1) Fuse and Enter the cell
(2) RT (competitive/noncompetitive)
(3) Integrate into genome (integrase)
(4) Cleave and mature (Protelolytic)

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7
Q

Maraviroc

A

(1) Entry inhibitor: CCR5 blocker

inhibited by CYP3A4, CXCR4 tropism, or GP120 V3 loop mutation

expensive, well tolerated

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8
Q

Enfuvirtide

A

(1) Fusion inhibitor: mimic gp41 and inhibit 6 helix membrane fusion (ONLY HIV-1)

not effective against, mutant gp41, HIV-2

expensive, parenteral injection

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9
Q

Zidovudine

A

(2) Thymidine (side) inhibit RT (all HIV and HTLV)

short t1/2, only IV, inhibit mito DNA polymerase (myopathy & hepatic steatosis) suppress bone marrow

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10
Q

Stauvudine

A

(2) Thymidine (side) inhibit RT (all HIV)

short t1/2, lipodystrophy (Fat wasting) and mito toxicity (peripheral neuropathy, lactic acidosis, hepatic steatosis)

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11
Q

Emtricitabine & Lamivudine

A

(2) Cytosine (side) inhibit RT (all HIV) Tx HBV

long t1/2, #1 in class, least toxic (E: hyper pigmented palm/soles of POC)

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12
Q

Abacavir

A

(2) Guanosine (side) inhibit RT
NOT FOR HLA-B*5701, HBV, of CAD hx

Longer t1/2, Fatal hypersensitivity!

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13
Q

Tenofovir (2) +1

A

(2) Adenosine (tide) inhibit RT Tx HBV

Decent t1/2 (1 day dosing)
Disoproxil Fumutrate (nephrotoxicity, falconi kidney dysfxn (malabsoprtion))

Alafendamide: less toxic, well tolerated, lower plasma concentration

Didanosine: (all HIV, HTLV-1) has high mitochondrial toxicity

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14
Q

Nevirapine

A

(2) NonComp, HIV-1 only, CYP3A4, adult/kid

Decent t1/2, resistance if treated alone, rash

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15
Q

Efavirenz

A

(2) NonComp, HIV-1 only, CYP3A4, adult/kid

Long t1/2, was considered teratogenic, CNS toxicity, rash,
use with Emtricitabine & Tenofovir

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16
Q

Etravirine

A

(2) NonComp, HIV-1 only, CYP3A4, adult/kid

High resistance to mutation, decent t1/2, rash, immune reconstitution syndrome (inflammatory disorder

17
Q

Rilpivirine

A

(2) NonComp, Naive HIV-1 only, CYP3A4, adult/kid

Decent resistance, long t1/2,
Adverse in kids (CNS, low cortisol, fat redistribution, immune reconstitution)

18
Q

Doravirine

A

(2) NonComp, Naive HIV-1 only, CYP3A4, adult/kid

Resistance mutations, decent t1/2, low toxicity

19
Q

Raltegravir

A

(3) Integrase, Naive all HIV

short t1/2, well tolerated

20
Q

Doltegravir

A

(3) Integrase, Naive all HIV, (-) UGR1A1, NOT FOR PREGNANCY

decent t1/2, high barrier to resistance

21
Q

Bictegravir

A

(3) Integrase, Naive all HIV, (-) UGR1A1

good t1/2m, high barrier to resistance, fixed dose, well tolerated

22
Q

Saquinavir

A

(4) Competitively inhibit aspartyl protease, all HIV, CYP3A4

NOT USED, short t1/2, high pill burden, Lipodystrophy

23
Q

Indinavir

A

(4) Competitively inhibit aspartyl protease, all HIV, CYP3A4

TOXIC crystaluria/renal stones, short t1/2

24
Q

Darunavir

A

(4) Competitively inhibit aspartyl protease, all HIV use for 1, #1 when boosted CYP3A4, post exposure prophylaxis

decent t/12, Sulfa drug (rxn), fat redistribution syndrome, immune reconstitution syndrome

25
Q

Azatanavir

A

(4) Competitively inhibit aspartyl protease, Naive all HIV, CYP3A4

elevated unconjugated hyperbbilirubinemai, fat redistribution, etc.

26
Q

Lopinavir

A

(4) Competitively inhibit aspartyl protease, all HIV, CYP3A4

Use if other PI don’t work
short t1/2, high triglycerides/cholesterol

27
Q

Ritonavir & Cobicistat

A

CYP3A4 inhibitors
All protease inhibitors (-avir)
Non-Nucleoside RT inhibitors (-ine)(HIV-1 only)
Entry inhibitor (Maraviroc)

SBL (3 decks)

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