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Step 1 Microbiology - First Aid 2017 > HIV therapy > Flashcards

HIV therapy Flashcards

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1
Q

HIV protease inhibitor that inhibits cytochrome P-450

A

Ritonavir

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2
Q

Suffix for Protease inhibitors

A

-navir

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3
Q

Mechanism of NRTIs

A

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

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4
Q

NRTIs lack what that leads to DNA chain termination

A

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

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5
Q

Only NRTI that is a nucleotide

A

Tenofovir - all others are nucleosides

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6
Q

This is needed to activate NRTIs

A

Phosphorylation

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7
Q

All NRTIs are associated with these side effects

A

Mitochondrial toxicity, lactic acidosis

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8
Q

NRTIs that may cause peripheral neuropathy

A

Lamivudine, stavudine, didanosine

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9
Q

NRTIs that treat Hepatitis B

A

Lamivudine and tenofovir

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10
Q

NRTI that does not require phosphorylation for activation

A

Tenofovir

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11
Q

NRTI used in pregnancy and breastfeeding to reduce vertical transmission

A

Zidovudine

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12
Q

Zidovudine side effect

A

Myelosuppression leading to anemia and neutropenia, and lipodystrophy

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13
Q

NRTIs that cause lipodystrophy (central adiposity)

A

Zidovudine and Stavudine

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14
Q

Side-effect of didanosine

A

Pancreatitis

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15
Q

NRTI contraindicated in HLA-B57:01 allele mutation

A

Abacavir

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16
Q

Complication of Abacavir in HLA-B57:01 mutation

A

Delayed type IV hypersensitivity reaction resulting in rash

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17
Q

NRTI that causes hyperpigmentation of palms and soles

A

Emtricitabine

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18
Q

NNRTIs

A

Delavirdine, Efavirenz, Nevirapine (DEN)

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19
Q

NNRTIs contraindicated in pregnancy

A

Delavirdine and Efavirenz (ED)

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20
Q

NNRTI that causes vivid dreams and CNS symptoms

A

Efavirenz

21
Q

Complication common to all NNRTIs

A

Rash (SJS-TEN) and hepatotoxicity

22
Q

Do NNRTIs require activation

A

No - phosphorylation not needed

23
Q

Mechanism of NNRTIs

A

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

24
Q

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

A

NNRTIs

25
Q

Protease inhibitor mechanism

A

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

26
Q

Protease inhibitor side effects

A

Hyperglycemia from insulin resistance, dysliipidemia, lipodystrophy

27
Q

Protease inhibitor that causes nephrolithiasis

A

Indinavir

28
Q

Protease inhibitor that boosts the concentration of other drugs

A

Ritonovir

29
Q

CYP450 inducer used in TB, reduces protease inhibitor concentrations

A

Rifampin

30
Q

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

A

Rifabutin

31
Q

Cells infected in HIV

A

CD4+ T-cells, macrophages, and dendritic cells

32
Q

What gene codes for virion core proteins

A

gag structural gene

33
Q

Core proteins coded by gag structural gene

A

p24 and p7

34
Q

HIV viral proteins needed for infiltratrion

A

gp41 and gp120 envelope proteins

35
Q

Gene that codes for gp41, gp120 envelope proteins

A

env structural gene

36
Q

gp120 mechanism for entry into host cell

A

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

37
Q

Entry inhibitor that binds CCR5

A

Maraviroc

38
Q

Maraviroc mechanism

A

Binds CCR5 on CD4 host cell preventing gp120 binding

39
Q

HIV envelope protein that facilitates fusion to host cell

A

gp41

40
Q

Fusion inhibitor that binds gp41

A

Enfuvirtide

41
Q

Enfuvirtide mechanism

A

Binds gp41 inhibiting viral entry

42
Q

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

A

Endoplasmic reticulum

43
Q

HIV therapy drugs that inhibit reverse transcriptase

A

NRTIs and NNRTIs

44
Q

Resistance to NRTIs and NNRTIs is due to what

A

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

45
Q

Integrase inhibitors

A

Raltegravir, Elvitegravir, Dolutegravir

46
Q

Prevents transcription of viral mRNA

A

Integrase inhibitors

47
Q

HIV therapy drugs that increase creatine kinase levels

A

Integrase inhibitors

48
Q

Mutations in pol gene can lead to…

A

Resistance to NRTIs, NNRTIs, integrase and protease inhibitors

49
Q

Side effect of integrase inhibitors

A

Rhabdomyolysis (increased CK levels)

Step 1 Microbiology - First Aid 2017 (7 decks)

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