HIV Pharm High Yield Flashcards
What is the phase II metabolic process for antiretroviral drug elimination that tends to result in fewer drug-drug interactions?
glucuronidation
can see a typically self-limiting decrease in this with the use of tenofovir?
bone density
what is an early adenosine analog noteworthy for its adverse effects due to mitochondrial toxicity?
didanosine
What HIV drugs were/are considered to be teratogenic?
efavirenz and dolutegravir
what HIV drug leads to renal toxicity and what syndrome is associated with this?
tenofovir; fanconi syndrome
which class of HIV drugs is resistant to HIV-2?
NNRTI
new pro drug of tenofovir that has a higher intracellular concentration and less renal and bone toxicity?
alafenamide
what class of HIV drugs induce CYP3A4?
NNRTI
what is an example of an HIV drug that causes hepatic steatosis?
zidovudine
example of an HIV INSTI that will likely decline in use with availability of bicregravir from the same company?
elvitegravir
what is a serious NRTI toxicity associated with early agents such as stavudine?
peripheral neuropathy
what is the NNRTI approved for use in treatment-experienced people infected with HIV since it still works after HIV mutations that cause resistance to nevirapine and efavirenz?
etravirine
among the toxicities associated with some NRTI that is thought to be due to inhibition of DNA polymerase gamma?
myopathy
what HIV drug is a sulfa drug?
darunavir
what is the toxicity associated with atazanavir?
unconjugated hyperbilirubinemia
an NNRTI that had early studies done on it that demonstrated the need for combination therapy
nevirapine
early PI requiring 3x/day dosing, no longer used but still tested on for it’s unique ability to cause crystaluria/ renal stones
indianavir
what is the newest 1x/day INSTI, only available in combination, well absorbed in comparison to other NSTI, high genetic barrier to resistance and very well tolerated?
bictegravir
among early thymidine NRTI, notable for significant toxicities now associated with the drug class including CNS toxicities, fat wasting, and the ability to cause lactic acidosis and hepatic steatosis
stavudine
when boosted, it is a first choice protease inhibitor for treatment naive patients due to its long half life and reduced side effects, but can cause sulfa drug hypersensitivity reactions?
darunavir
newest/ best NNRTI with unique resistance mechanisms such that it works if resistance to efavirenz or rilpivirine and rilpivirine etravirine work if resistance to it; less significant drug-drug interaction and low incidence of typical side effects
doravirine
HIV INSTI with 14 hr half life; widely recommended for initial ART because while resistance can develop due to integrase mutations, there is a high genetic barrier to this resistance
dolutegravir
when boosted, a first-choice protease inhibitor for treatment naive HIV patients due to its long half life and reduced side effects
atazanavir
early HIV target since mammalian cells lack this
reverse transcriptase
the HIV drug class that is now the primary +1 addition to the NRTI backbone
INSTI
common side effect of efavirenz, but typically subsides and rearely leads to discontinuations of the drug
CNS toxicity
what hiv drugs cause renal insufficiency?
indinavir and tenofovir
first HIV PI, it’s short half-life caused troublesome pill burden and it is among the agents well known for promoting irreversible lipodystrophy with long term use
saquinavir
what is recommended every six months for HIV patients using TDF because of potential adverse effects?
urinalysis due to potential adverse effects on kidney
what could happen when HIV drugs with activity against HBV are discontinued?
rebound of HBV
chronic inflammation and/or reactivation of autoimmune disease as lymphocyte levels increase during ART
immune reconstrunction
what is the NNRTI that is recommended for treatment naive patients, susceptible to mutations but not the one that quickly inactivate nevirapine and efacirenz- meaning they will will work
rilpivirine
first generation INSTI, seems likely to be replaced
raltegravir
what HIV drugs is HBV sensitive to?
tenofovir and emtricitabine and lamivudine
what important drug is not sensitive to HBV?
abacavir
why is resistance to PIs slow to develop and seldom a cause for treatment failure?
typically 4-5 mutations are required for HIV to develop resistance to PIs
first generation NNRTI, has some typically self-limiting CNS side effects seldom requiring drug discontinuation
efavirenz
ending of generic drug name that suggests the drug is an HIV PI?
-navir
