Immuno Meds and Treatments

Question 1

NRTIs

Answer 1

Abacavir - hypersensitivity rxns
Emtricitabine
Lamivudine
Zidovudine - BM suppression (anemia, neutropenia)
Tenofovir - kidney injury, bone loss

MOA: inhibit production of DNA from viral RNA, preventing incorporation of viral DNA into host genome

S/E:
Lactic acidosis
Lipodystrophy

Question 2

NNRTIs

Answer 2

Efavirenz - teratogenic, neuropsych - nightmares, depression
Etravirine
Rilpivirine

MOA: inhibit reverse transcriptase by blocking the transcription of DNA from viral RNA

S/E: rash

Question 3

Protease inhibitors

Answer 3

Atazanavir - hyperbilirubinemia
Darunavir
Fosamprenavir
Lopinavir
Ritonavir - booster, inhibits CYP450

MOA: interfere with viral replication and cause production of nonfunctional viruses

S/E:
hyperglycemia
hypertriglyceridemia
GI tox - N/V/D

Question 4

Integrase inhibitors

Answer 4

Elvitegravir
Dolutegravir
Raltegravir

MOA: block integration of the viral genome into host genome

well tolerated

Question 5

CCR5 antagonists

Answer 5

Maraviroc

MOA: block CCR5 coreceptor binding, preventing the entry of virus into the cell

Question 6

Fusion inhibitors

Answer 6

Enfuvirtide

MOA: bind to gp41 and prevent the fusion of HIV viruses to CD4 cells

Question 7

Azothioprine

Answer 7

purine synthesis inhibitor - prevent organ rejection

S/E:
Bone marrow suppression
Leukopenia

Do not give with allopurinol - metabolized by xanthine oxidase

Question 8

Tacrolimus

Answer 8

IL-2 inhibitor - prevent organ rejection

S/E:
nephrotoxicity when given systemically
Hepatotoxicity

Question 9

S/E of corticosteroids

Answer 9

cushingoid features
osteoporosis
diabetes

Question 10

Muromonab

Answer 10

Antibody immunosuppressant - prevent organ rejection

S/E leukopenia

Question 11

Rapamycin

Answer 11

IL-2 inhibitor - prevent organ rejection

S/E:
thrombocytopenia
Hyperlipidemia

Risk pneumonitis, metabolic syndrome

Question 12

Mycophenolate

Answer 12

Purine synthesis inhibitor - prevent organ rejection
used in lupus nephritis

S/E: leukopenia

Risk: lymphoma

Teratogen - ear, face, 1st trimester miscarriage

Question 13

Anti-thrombocyte globulin

Answer 13

Antibody immunosuppressant - prevent organ rejection

S/E: depletes T cell population

Question 14

Hydroxychloroquine

Answer 14

prevent organ rejection
Used in lupus and RA

S/E: macular degeneration
GI effects

Question 15

Thalidomide

Answer 15

prevent organ rejection

Teratogen - flipper limb deformity