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Pharmacology 3 > Module 3: Chapter 46 HIV drugs > Flashcards

Module 3: Chapter 46 HIV drugs Flashcards

1
Q

what cells are necessary for normal immune fn

A

CD4

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2
Q

what is the fn of the CDR4 cell

A

recognizes foreign antigens and infected cells

helps activate the antibody-producing B lymphocytes

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3
Q

what cells induce cell-mediated immunity

A

CD4

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4
Q

is HIV bacteria or a virus

A

retrovirus

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5
Q

how can you tell the difference btw. a retrovrius and virus

A

difference is in the genetic material

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6
Q

How does CD4 activate T cells to destroy antigens

A

activate B lymphocytes
which produce antibodies activating T cell
T8 Killer cell attacks antigen

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7
Q

Binding between what two things begins an HIV infection

A

gp120 on HIV virus to CD4 receptor on a cell

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8
Q

what happens one the virus is bound to the cell

A

viral envelope and the plasma membrane fuse

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9
Q

What types of cells have a CD4 protein receptor site

A

monocytes
macrophages
certain nerve cells

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10
Q

what happens in the cell once GP120 attaches to a CD4 receptor

A

in the cell viral RNA is transcribed into a single strand of viral DNA

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11
Q

what cells does the HIV virus have an infinity for

A

CD4 cells

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12
Q

how is HIV infection tested

A

initially made by a screening test followed by a confirmatory assay

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13
Q

Are screening tests highly sensitive or highly specific

A

highly sensitive

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14
Q

are confirmatory assays highly sensitive or highly specific?

A

highly specific

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15
Q

combination use of screening tests and confirmatory assays produces results thatare

A

highly accurate

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16
Q

what was the first class of drugs approved by the FDA to treat HIV infection and AIDS

A

nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

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17
Q

what are NRTIs chemically similar to

A

human nucleotides “building blocks” of DNA

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18
Q

what must NRTI’s do to be effective?

A

convert to their active forms.

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19
Q

what do NRTIs do?

A

inhibit reverse transcriptase an enzyme critical to HIV replication

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20
Q

what is the prototype drug for NRTI’s

A

zidovuidine (AZT, ZDV, Retrovir)

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21
Q

what 3 conditions is zidovudine commonly used to treat

A

epstein-Barr Virus
hepatitis B virus
HIV infection

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22
Q

how is zidovudine administered

A

parenterally or orally

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23
Q

where is zidovudine commonly metabolized? excreted?

A

liver
kidneys
the usual

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24
Q

how does zidovudine work

A

inhibits the synthsis of DNA by reverse transcriptase

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25
Q

are there any contraindications or precautions to zidovudine therapy

A

hypersensitivity
breast-feeding
lactic acidosis

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26
Q

what are some adverse effect of zidovudine

A 
GI symptoms
headache
seizures
somnolence
hematologic toxicities
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27
Q

what are known drug interactions for zidovudine

A 
ganciclovir
acetaminophen
interferon beta-1b
probenecid 
rifampin
trimethoprim
valproic acid
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28
Q

what do you need to assess for regarding female patients and zidovudine

A

assess pregnancy and lactation

understanding of HIV transmission

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29
Q

when should zidovudine be administered

A

1 hour before meals

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30
Q

what type of diet should a patient undergoing zidovudine have

A

low fat

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31
Q

what should be done to minimize adverse effects regarding patients zidovudine

A

IM injections

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32
Q

how often should laboratory data be obtained for a patient receiving zidovudine

A

every 2-4 weeks

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33
Q

what are absolute contraindications regarding zidovudine use

A

hypersensitivity
breast-feeding
existing lactic acidosis

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34
Q

what is the second class of drugs used to treat HIV infection

A

nonnucleoside reverse transcriptase inhibitors (NNRTIs)

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35
Q

NNRTI’s stand for

A

nonnucleoside reverse transciptase inhibitors

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36
Q

Do NNRTI’s only affect HIV-1 or HIV-2

A

HIV-1

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37
Q

how do NNRTIs work

A

inhibit a specific site on the reverese transciptase that is required to carry out the process of DNA synthesis

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38
Q

what is the prototype drug for NNRTIs

A

efavirenz (Sustiva)

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39
Q

What is Sustiva used for

A

to treat HIV-1 infection

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40
Q

why do NNRTIs not work on HIV-2

A

, they do not reverse transciptase in HIV-2

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41
Q

How is efavirenz administered

A

orally

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42
Q

is efavirenz protein bound?

A

yes

43
Q

where does efavirenz metabolized?

excreted?

A

liver

urine and feces

44
Q

how does efavirenz work?

A

inhibits HIV reverse transciptase

45
Q

what are some adverse effects for efavirenz

A 
diziness
impaired concentration
insomnia
abnormal dreams
hallucinations
46
Q

what drugs interact with efavirenz

A

drugs that are metabolized by P-450 CYP3A4

47
Q

What pregnancy class is efavirenz

A

category D

48
Q

how many times a day is efavirenz administered? is there a preferred time(s)?

A

once

at bedtime

49
Q

what should a patient do if they miss a dose of efavirenz

A

take the next dose as soon as they remember unless it’s for the next day

50
Q

what is one way that the adverse effects of efavirnez can be minimized

A

on an empty stomach

51
Q

what is important patient and family education regarding efavirenz therapy

A

importance of adherence to drug therapy

advise pts. experienceing depression, anxiety, behavior changes, and those feeling paranoid or manic to contact the health care provider immediately

52
Q

what ongoing assessment is necessary in a patient being treated with efavirenz

A

periodic examinations and blood monitoring

53
Q

What pregnancy category is efavirenz

A

D

teratogenic during all trimesters

54
Q

What is the third major class of drugs used in treating HIV infection and AIDs

A

protease inhibitors

55
Q

what class of drugs has changed the opinion of experts as to the ultimate fatality of HIV and AIDS

A

preotease inhibitors

56
Q

what class of HIV drugs is the most potent anti-HIV drugs

A

Preotease Inhibitors

57
Q

what is the prototype drug for protease inhibitors

A

saquinavir (Invirase)

58
Q

What is the purpose of saquinavir

A

treating HIV infection in adults

59
Q

how is saquinavir administered

A

orally

60
Q

true or false: saquinavir has great bioavailability

A

false, poor bioavailability

61
Q

where is saquinavir exreted

A

feces and urine

62
Q

how does saquinavir work?

A

competetive inhibitor or HIV protease, an enzyme required for HIV replication

63
Q

are there any precautions or contraindications regarding saquinavir

A

hypersensitivity

children under age 16

64
Q

What are the adverse effects of squinavir

A 
Nausea
diarrhea
stomach discomfort
insomnia
headahce
65
Q

are there any drug interactions for squinavir?

A

interacts with drugs that are metabolized by P-450 CYP3A4

66
Q

what things should be assessed for regarding saquinavir

A

pregnancy or lactation

patients ability to adhere to drug therapy

67
Q

When shoudl saquinavir tablets be administered

A

2 hours after eating a full meal

68
Q

what should be administered with each dose of squinavir

A

ritonavir

69
Q

what can be done to decrease GI distress if it is experienced during saquinavir treatment

A

small frequent meals

70
Q

if a patient complains of headahces during saqunavir treatment what should be adminsitered

A

acetaminophen

71
Q

What are two key pieces of information that the patient and family need to be educated on regarding squinavir

A

periodic clinical and blood monitoring

S & S of diabetes

72
Q

due to the poor bioavailability of squinavir given alone , what medication is commonly given in combination with saquinavir to increase bioavailability

A

ritonavir: significantly inhibits squinivars metabolism resulting in an increased serum concentration of squinavir

73
Q

what does HAART stand for

A

highly active antiretroviral therapy (for HIV)

74
Q

what is the newest class of HAART therapy approved for management of HIV disease

A

Integrase inhibitors

75
Q

what is integrase

A

enzyme that is a key component that allows converted HIV viral DNA to enter the host cell

76
Q

how do integrase inhibitors work?

A

block or inhibit the host cell DNA to produce genetic material for new viruses

77
Q

what is the prototype for integrase inhibitors

A

raltegravir (Isentress)

78
Q

what is raltegravir commonly used for

A

HIV strains that are resistant to multiple antiretroviral regimens and epereince ongoing viral replication while reciving HAART

79
Q

what is the half life for raltegravir

A

9 hours

80
Q

how is raltegravir metabolized? excreted?

A

liver

feces, urine

81
Q

How does raltegravir work?

A

HIV virus integrase strand transfer inhibitor

82
Q

known contraindications for raltegravir?

A

use cautiously with drugs that can cause muscle problems

83
Q

what are the adverse effects of raltegravir?

A 
diarrhea
nausea
abdominal distension
pain
flatulence
headache
fatigue
84
Q

known drug interactions with ratlegravir

A

many HAART medications
firampin
proton pump inhibitors

85
Q

what should be assessed for regarding raltegravir

A

wheterhe treatment expereinced or treatment naive

86
Q

what pregnancy category is raltegravir

A

C

87
Q

what needs to be stressed with raltegravir?

A

need for safe sex

88
Q

does raltevir need to be given with food

A

with or without is fine

89
Q

true or false: RAltegravir should not be used as monotherapy

A

true

90
Q

what should a patient taking raltegravir take for common adverse effects

A

OTC medications

91
Q

what should be monitored for during raltegravir treatemtn

A

opportunistic diseases

92
Q

What pregnancy category is raltegravir

A

C - no well controlled studies, women should contact their prescriber immediately if they believe they are pregnant

93
Q

what are entry inhibitors also known as

A

fusion inhibitors

94
Q

what new class of drugs inhibits the HIV virus from binding to it, fusing with it and entering a human cell

A

entry inhibitors

95
Q

what is the prototype drug for entry inhibitors

A

enfuvirtide (Fuzeon)

96
Q

What is the purpose of enfuvirtide?

A

managing HIV infection in pts who have expereicend treatment failure

97
Q

how is enfuvirtide administered

A

SC

98
Q

how does enfuvirtide work

A

binds to the pg41 protein on the surface of HIV

99
Q

what are the adverse effects of enfuvirtide

A 
injection site rxn
anorexia
nausea
weight loss
fatigue
anxiety
headache 
insomnia
peripheral neuropathy
infections
100
Q

what pregnancy category is enfuvirtide

A

category B

101
Q

what lifestyle, diet and habit teaching should be done with patients on enfuvirtide therapy

A

avoid risk factors that predispose him or her to infection

102
Q

how can therapeutic effects be maximized for enfuvirtide

A

reconstitute it with sterile water and then allow the solution to sit for 10 mintues to ensure that the powder dissolves completely
aseptic technique important

103
Q

what ongoing assessment should be done for a patient taking enfuvirtide

A

assess the patient taking enfuvirtide for signs of infectious disorders such as pneumonia, sinusitis, herpes simplex, influenza and conjunctivitis

104
Q

what is a major adverse effect of enfuvirtide

A

injection site rxn

Pharmacology 3 (6 decks)

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