Part 11-2 Treatment of Infection

Question 1

AIDS

Answer 1

Associated with human immunodeficiency virus (HIV)

Question 2

HIV

Answer 2

Retrovirus that attacks T4 lymphocytes

Question 3

Loss of lymphocytes…

Answer 3

Impaired immune function

• Opportunistic infections
• Certain Cancers

Question 4

Anti-HIV drugs

Answer 4

Reverse transcriptase inhibitors (RTIs)
-Nucleoside RTIs
-Nonnucleoside RTIs
Protease inhibitors
HIV entry inhibitors
Integrase inhibitors

Question 5

Reverse Transcriptase Inhibitors Action

Answer 5

Prevent conversion of viral RNA to viral DNA

Question 6

Reverse Transcriptase Agents

Answer 6

Nucleoside RTIs: act as false substrate

Non-nucleoside RTIs: block active site on reverse transcriptase

Question 7

Protease inhibitors

Answer 7

HIV protease: key enzyme in final steps of HIV synthesis

Inhibitors mimic viral components to block protease function
-“avir” agents

Question 8

HIV entry inhibitors

Answer 8

Impair ability of HIV to fuse with and enter host lymphocytes

Question 9

Integrase inhibitors

Answer 9

Inhibit HIV integrase…enzyme that splices viral DNA into host cell DNA

Question 10

Anti-HIV drugs adverse effects

Answer 10

Myopathy, neuropathy (RTIs, integrase inhibitors)
Lipdystrophy syndrome (Protease inhibitors, integrase inhibitors)
Others: blood dyscrasias, GI distress, Immune rxns

Question 11

Anti-HIV drugs combination strategies

Answer 11

Highly active antiretroviral therapy
Usually 2 nucleoside RTIs and 1 nonnucleoside RTI
Other drugs added or substituted to maintain antiviral effects and avoid resistance

Question 12

Other common medications in AIDS

Answer 12

Treatment of opportunistic infections
-antibacterials
-antivirals
-other antimicrobials
Treatment of cancers
-interferons, others

Question 13

Fungal Infections

Answer 13

Mycosis
Infections often superficial or local
-easy to treat
Other mycoses are systemic
-Serious problem especially in immunocompromised host
-can effect lung or other tissues

Question 14

Common antifungal drugs

Answer 14

Imidazoles

Others

Question 15

Imidazoles

Answer 15

Contain -“azole” suffix
Inhibit enzymes that synthesize membrane components
-should be specific to fungal cell
Local versus systemic use determined by toxicity
-can use more toxic drugs locally

Question 16

Other antifungals

Answer 16

Generally impair membrane integrity or biochemistry of fungal cells
Various local and systemic preparations

Question 17

Amphotericin B

Answer 17

Most common antifungals, systemic infection

Question 18

Antifungal problems

Answer 18

Topical-local use:
-Few serious side effects
-Excessive use may cause resistance
Systemic Use:
-Headache, GI problems
-Hepatotoxicity, blood dyscrasias