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Skin > HIV Pharm > Flashcards

HIV Pharm Flashcards

1
Q

ART typically starts with….

A

2 NRTIs

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2
Q

Which NRTIs have lower affinity for DNA polymerase y?

A
  • emtricitabine
  • lamivudine
  • abacavir
  • tenofovir
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3
Q

Which NRTIs interfere with thymidine incorporation?

A
  • zidovudine

- stavudine

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4
Q

Which NRTIs interfere with cytosine/cytidine incorporation?

A
  • emtricitabine (cytosine)

- lamivudine (cytidine)

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5
Q

Aside from HIV, what other virus are emtricitabine and lamivudine active against?

A

HBV

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6
Q

What NRTI interferes with guanosine incorporation?

A

abacavir

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7
Q

Tenofovir disoproxil fumarate can lead to what adverse effects?

A
  • nephrotoxicity due to acute tubular necrosis, leads to Fanconi syndrome
  • decreased bone mineral density (transient)
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8
Q

Which NRTIs are commonly used in combination?

A

emtricitabine + tenofovir

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9
Q

Which NRTIs are not to be combined?

A

emtricitabine

lamivudine

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10
Q

What NRTI and INSTI combination is recommended for treatment-naive patients?

A

lamivudine + dolutegravir

unless HIV viral load is high

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11
Q

What drugs are integrase strand transfer inhibitors (INSTI)?

A
  • raltegravir
  • dolutegravir
  • bictegravir
  • elvitegravir
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12
Q

What drugs end in “-gravir”?

A

integrase strand transfer inhibitors

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13
Q

What population is raltegravir indicated for?

A

treatment-naive patients

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14
Q

what population is dolutegravir indicated for?

A

treatment-naive patients

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15
Q

What is the toxicity of dolutegravir?

A

must avoid in pregnancy

- can cause neural tube defects

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16
Q

Which INSTI has a high barrier to resistance?

A

Dolutegravir

17
Q

Bictegravir is available in what form of administration?

A

fixed-dose single tablet regimen

18
Q

Which protease inhibitor is the most potent CYP3A4 inhibitor?

A

ritonavir

19
Q

protease inhibitors competitively inhibit the activity of what enzyme?

A

virus aspartyl protease

20
Q

What toxicity is associated with indinavir?

A

unique crystaluria/renal stones

21
Q

What are the toxicities associated with darunavir?

A
  • increase cholesterol/triglycerides
  • fat redistribution syndrome
  • rash/hypersensitivity (because its a sulfa drug)
22
Q

What population is atazanavir indicated for?

A

treatment-naive patients

23
Q

What toxicities are associated with atazanavir?

A
  • unconjugated hyperbilirubinemia (not associated with hepatitis)
24
Q

Which protease inhibitor is generally used after other protease inhibitors fail?

A

lopinavir

25
Q

Which drugs inhibit CYP3A4 to “boost” the potency of protease inhibitors?

A
  • ritonavir

- cobicistat

26
Q

Which “line” are NNRTIs typically used now?

A

third

27
Q

NNRTIs are only active against which HIV?

A

HIV-1

HIV-2 is resistant

28
Q

Which drugs are considered NNRTIs?

A
  • nevirapine
  • efavirenz
  • etravirine
  • rilpivirine
  • doravirine
29
Q

Which NNRTI is the first of its kind to be approved for once daily dosing?

A

efavirenz

30
Q

What population is etravirine indicated for?

A

treatment-experienced

31
Q

What is unique about the clinical applications of etravirine?

A

still works even if there are mutations that disrupt activity of other NNRTIs

32
Q

What population is rilpivirine indicated for?

A

treatment-naive

33
Q

What population is doravirine indicated for?

A

treatment-naive

34
Q

What is enfuvirtide?

A

HIV fusion inhibitor (entry blocker)

  • 36 aa peptide*
  • for treatment-experienced
  • not active against HIV-2*
  • must be administered parenterally*
35
Q

What is maraviroc?

A

CCR5 blocker (entry blocker)

  • only active for CCR5 trophic virus
  • expensive to get test to determine tropism
  • orally active
36
Q

Before starting ART, what should those of childbearing potential get done?

A

pregnancy test

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