HIV Pharmacology

Question 1

First Aid HIV Drugs

Name as many nucleoside reverse transcriptase inhibitors as you can.

ADELSTZ

Answer 1

Abacavir

Didanosine

Emtricitabine

Lamivudine

Stavudine

Tenofovir

Zidovudine

Question 2

First Aid HIV Drugs

Name as many non-nucleoside reverse transcriptase inhibitors as you can.

DEN

Answer 2

Delavirdine

Efavirenz

Nevirapine

Question 3

First Aid HIV Drugs

Name as many protease inhibitors as you can.

ADFILRS

Answer 3

Atazanavir

Darunavir

Fosamprenavir

Indinavir

Lopinavir

Ritonavir

Saquinavir

Question 4

First Aid HIV Drugs

Name as many integrase inhibitors as you can.

DER

Answer 4

Dolutegravir

Elvitegravir

Raltegravir

Question 5

First Aid HIV Drugs

What are the main classes of HIV pharmacotherapy?

Answer 5

Nucleoside reverse transcriptase inhibitors

Non-nucleoside reverse transcriptase inhibitors

Protease inhibitors

Integrase inhibitors

Fusion inhibitors

Question 6

First Aid HIV Drugs

What are the strongest indications for antiretroviral therapy?

Answer 6

CD4+ counts < 500 / mm³

OR

High viral load

Question 7

First Aid HIV Drugs

Antiretroviral therapy typically involves a regimen of how many drugs?

Which ones?

Answer 7

3

2 NRTIs + 1 integrase inhibitor

Question 8

First Aid HIV Drugs

Which options for antiretroviral therapy are active against both HIV-1 and HIV-2?

Answer 8

All except NNRTIs

Question 9

First Aid HIV Drugs

Why is ART typically administered as at least three drugs?

Answer 9

To prevent resistance

Question 10

First Aid HIV Drugs

Via what general mechanism do nucleoside reverse transcriptase inhibitors work in treating HIV?

Answer 10

Competitive inhibition of nucelotide binding to reverse transcriptase

Question 11

First Aid HIV Drugs

Nucleoside reverse transcriptase inhibitors terminate ____ synthesis because they lack ___‘-hydroxyl groups.

Answer 11

Nucleoside reverse transcriptase inhibitors terminate DNA** synthesis because they lack **3‘-hydroxyl groups.

Question 12

First Aid HIV Drugs

Every NRTI is a nucleo_ide except __________ which is a nucleo_ide.

Answer 12

Every NRTI is a nucleoside except Tenofovir which is a nucleotide.

Question 13

First Aid HIV Drugs

All nucleoside reverse transcriptase inhibitors must be ____________ed in order to function properly.

Answer 13

All nucleoside reverse transcriptase inhibitors must be phosphorylated in order to function properly.

Question 14

First Aid HIV Drugs

Which NRTI can be used for general prophylaxis and during pregnancy to decrease risk of fetal transmission?

Answer 14

Zidovudine

Question 15

First Aid HIV Drugs

What toxicities are associated with NRTI use?

Answer 15

Bone marrow suppression,

peripheral neuropathy,

lactic acidosis (except not Tenofovir)

Question 16

First Aid HIV Drugs

How can the bone marrow suppression associated with NRTI use be reversed?

Answer 16

G-CSF + erythropoeitin

Question 17

First Aid HIV Drugs

Abacavir is contraindicated in which patients due to increased risk of hypersensitivity?

Answer 17

Those with HLA-B*5701

Question 18

First Aid HIV Drugs

What side effect is associated with zidovudine use but not the other NRTIs?

Answer 18

Anemia

Question 19

First Aid HIV Drugs

What side effect is associated with didanosine use but not the other NRTIs?

Answer 19

Pancreatitis

Question 20

First Aid HIV Drugs

True/False.

Though NRTIs and NNRTIs bind to different sites on reverse transcriptase, both require phosphorylation to be active.

Answer 20

False.

NRTIs and NNRTIs bind to different sites on reverse transcriptase, but only NRTIs require phosphorylation to be active.

Question 21

First Aid HIV Drugs

What side effects are associated with NNRTI use?

Answer 21

Rash and hepatotoxicity

Question 22

First Aid HIV Drugs

What side effects are associated specifically with efavirenz use?

Answer 22

Vivid dreams and CNS symptoms

Question 23

First Aid HIV Drugs

Assembly of HIV virions depends on HIV-1 protease (encoded in the _____ gene).

Answer 23

Assembly of HIV virions depends on HIV-1 protease (encoded in the pol gene).

Question 24

First Aid HIV Drugs

Which protease inhibitor ‘boosts’ other drug concentrations by inhibiting cytochrome P-450?

Answer 24

Ritonavir

Question 25

First Aid HIV Drugs

What toxicities are associated with protease inhibitor use?

Answer 25

Hyperglycemia, GI intolerance, lipodystrophy;

nephropathy, hematuria

Question 26

First Aid HIV Drugs

What toxicities are associated with indinavir use?

Answer 26

Thrombocytopenia

Question 27

First Aid HIV Drugs

As rifampin decreases protease inhibitor concentrations, how should HIV-positive patients be treated for TB?

Answer 27

With rifabutin instead

Question 28

First Aid HIV Drugs

What toxicity is associated with integrase inhibitor use?

Answer 28

Creatine kinase increase

Question 29

First Aid HIV Drugs

Name the mechanism of action of enfuvirtide.

Answer 29

Binds gp41

(preventing viral entry)

Question 30

First Aid HIV Drugs

What side effects are associated with enfuvirtide use?

Answer 30

Skin reaction at injection site

Question 31

First Aid HIV Drugs

Name the mechanism of action of maraviroc.

Answer 31

Binds T cell CCR-5

(inhibiting interaction with gp120)

Question 32

First Aid HIV Drugs

How can the function of the fusion inhibitors enfuvirtide and maraviroc be remembered?

Answer 32

Enfuvirtide inhibits fusion.

Maraviroc inhibits docking