last midterm ever

Question 1

What adverse effects are associated with nucleoside reverse transcriptase inhibitors?

Answer 1

mitochondrial toxicity and lactic acidosis

Question 2

What adverse reactions are associated with non-nucleoside reverse transcriptase inhibitors?

Answer 2

rash

Question 3

What adverse effects are associated with protease inhibitors?

Answer 3

GI Intolerance, insulin resistance, lipodystrophy

Question 4

What adverse effects are associated with integrase strand transfer inhibitors?

Answer 4

weight gain

Question 5

What medications are contrainidcated in HLA-B*5701 positivity?

Answer 5

anything with abacavir

Question 6

What medication requires HIV RNA <100,000 copies to be started?

Answer 6

anything with rilprivine

Question 7

What HIV medications interact with acid reducers?

Answer 7

raltegravir interacts with Al/Mg
Atazanivir and rilpivirine are reduced by acid reducers; rilpivirine is CI with PPIs
Ca/Fe with dolutegravir/bictegravir needs to be with food
(PO INSTIs)

Question 8

protease inhibitors have drug interactions with what classes of drugs?

Answer 8

statins, PDE5 inhibitors, benzodiazepines, corticosteroids

Question 9

What is the MOA of amphotericin B?

Answer 9

binds to ergosterol which withdraws it from the membrane

Question 10

What is the MOA for terbinafine (allylamines)?

Answer 10

inhibits squalene epoxidase and therefore interrupts ergosterol synthesis

Question 11

What is the MOA of azoles?

Answer 11

inhibits 14 a-demethylase

Question 12

What is the MOA of echinocandins?

Answer 12

inhibits synthesis of B-1-3 glucan cell wall component

Question 13

What is the treatment of choice for MAC?

Answer 13

clarithromycin 500 mg PO BID + ethambutol 15mg/kg daily
or azithromycin 500-600 mg PO daily
tx for 12 months

Question 14

What is inidicated for primary prophylaxis for MAC?

Answer 14

azithromycin 1200 mg PO weekly

Question 15

what is indicated for secondary prophylaxis of MAC?

Answer 15

clarithromycin 500 mg PO BID with ethambutol +/- rifabutin

Question 16

What is the MOA of isoniazid?

Answer 16

inhibition of InhA a component of FAS II which prevents the addition of side chains (mycolic acid synthesis) in the arabinoglycan layer

Question 17

What adverse effects are of concern in Isoniazid?

Answer 17

hepatitis, peripheral neuropathy

Question 18

What is the MOA of pyrazinamide?

Answer 18

activity is pH dependent
converted by pncA & inhibits panD which inhibits coenzyme A synthesis

Question 19

What adverse effects are of concern in pyrazinamide?

Answer 19

joint pain, hepatitis

Question 20

What is the MOA of ethambutol?

Answer 20

inhibits mycobacterial arabinosyl transferases