HIV therapy

Question 1

HIV protease inhibitor that inhibits cytochrome P-450

Answer 1

Ritonavir

Question 2

Suffix for Protease inhibitors

Answer 2

-navir

Question 3

Mechanism of NRTIs

Answer 3

Inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain in 3’ to 5’ direction

Question 4

NRTIs lack what that leads to DNA chain termination

Answer 4

3’ OH group needed for phosphodiester bond formation in 3’ to 5’ direction

Question 5

Only NRTI that is a nucleotide

Answer 5

Tenofovir - all others are nucleosides

Question 6

This is needed to activate NRTIs

Answer 6

Phosphorylation

Question 7

All NRTIs are associated with these side effects

Answer 7

Mitochondrial toxicity, lactic acidosis

Question 8

NRTIs that may cause peripheral neuropathy

Answer 8

Lamivudine, stavudine, didanosine

Question 9

NRTIs that treat Hepatitis B

Answer 9

Lamivudine and tenofovir

Question 10

NRTI that does not require phosphorylation for activation

Answer 10

Tenofovir

Question 11

NRTI used in pregnancy and breastfeeding to reduce vertical transmission

Answer 11

Zidovudine

Question 12

Zidovudine side effect

Answer 12

Myelosuppression leading to anemia and neutropenia, and lipodystrophy

Question 13

NRTIs that cause lipodystrophy (central adiposity)

Answer 13

Zidovudine and Stavudine

Question 14

Side-effect of didanosine

Answer 14

Pancreatitis

Question 15

NRTI contraindicated in HLA-B57:01 allele mutation

Answer 15

Abacavir

Question 16

Complication of Abacavir in HLA-B57:01 mutation

Answer 16

Delayed type IV hypersensitivity reaction resulting in rash

Question 17

NRTI that causes hyperpigmentation of palms and soles

Answer 17

Emtricitabine

Question 18

NNRTIs

Answer 18

Delavirdine, Efavirenz, Nevirapine (DEN)

Question 19

NNRTIs contraindicated in pregnancy

Answer 19

Delavirdine and Efavirenz (ED)

Question 20

NNRTI that causes vivid dreams and CNS symptoms

Answer 20

Efavirenz

Question 21

Complication common to all NNRTIs

Answer 21

Rash (SJS-TEN) and hepatotoxicity

Question 22

Do NNRTIs require activation

Answer 22

No - phosphorylation not needed

Question 23

Mechanism of NNRTIs

Answer 23

Direct binding and allostering inhibtion of HIV reverse transcriptase halting DNA polymerase activity

Question 24

Jaundiced yellow glow and liver spots within 6 weeks indicates treatment with these HIV drugs

Answer 24

NNRTIs

Question 25

Protease inhibitor mechanism

Answer 25

Inhibit HIV POL genes that make HIV proteases needed to cleave polypeptide products of HIV and mRNA into functional parts

Question 26

Protease inhibitor side effects

Answer 26

Hyperglycemia from insulin resistance, dysliipidemia, lipodystrophy

Question 27

Protease inhibitor that causes nephrolithiasis

Answer 27

Indinavir

Question 28

Protease inhibitor that boosts the concentration of other drugs

Answer 28

Ritonovir

Question 29

CYP450 inducer used in TB, reduces protease inhibitor concentrations

Answer 29

Rifampin

Question 30

Alternate drug used in TB to avoid lowering protease inhibitor concentrations in HIV patients

Answer 30

Rifabutin

Question 31

Cells infected in HIV

Answer 31

CD4+ T-cells, macrophages, and dendritic cells

Question 32

What gene codes for virion core proteins

Answer 32

gag structural gene

Question 33

Core proteins coded by gag structural gene

Answer 33

p24 and p7

Question 34

HIV viral proteins needed for infiltratrion

Answer 34

gp41 and gp120 envelope proteins

Question 35

Gene that codes for gp41, gp120 envelope proteins

Answer 35

env structural gene

Question 36

gp120 mechanism for entry into host cell

Answer 36

Binds to host cell CD4 molecule and chemokine receptor CXCR4 or CCR5

Question 37

Entry inhibitor that binds CCR5

Answer 37

Maraviroc

Question 38

Maraviroc mechanism

Answer 38

Binds CCR5 on CD4 host cell preventing gp120 binding

Question 39

HIV envelope protein that facilitates fusion to host cell

Answer 39

gp41

Question 40

Fusion inhibitor that binds gp41

Answer 40

Enfuvirtide

Question 41

Enfuvirtide mechanism

Answer 41

Binds gp41 inhibiting viral entry

Question 42

Envelope proteins gp41 and gp120 are sent to what cell structure before exiting infected cell

Answer 42

Endoplasmic reticulum

Question 43

HIV therapy drugs that inhibit reverse transcriptase

Answer 43

NRTIs and NNRTIs

Question 44

Resistance to NRTIs and NNRTIs is due to what

Answer 44

Mutations in the viral pol gene that produce enzymes resistant to binding

Question 45

Integrase inhibitors

Answer 45

Raltegravir, Elvitegravir, Dolutegravir

Question 46

Prevents transcription of viral mRNA

Answer 46

Integrase inhibitors

Question 47

HIV therapy drugs that increase creatine kinase levels

Answer 47

Integrase inhibitors

Question 48

Mutations in pol gene can lead to...

Answer 48

Resistance to NRTIs, NNRTIs, integrase and protease inhibitors

Question 49

Side effect of integrase inhibitors

Answer 49

Rhabdomyolysis (increased CK levels)