PHARM: Anti-HIV drugs

Question 1

What does p24 in ELISA indicate?

Answer 1

HIV (p24 is a capsule protein that incr viral load)

Question 2

What are two other sx in primary HIV syndrome

Answer 2

HAND: HIV assoc neurologic dysfxn
Seroconversion: HIV ab negative for first few months then converts to positive

Question 3

What are the four types of HIV therapy

Answer 3

Reverse Transcriptase Inhibs
Entry inhibs
Protease inhibs
Integrase inhibs

Question 4

Which type of HIV drug is involved in salvage therapy?

Answer 4

Entry inhibitors!

Question 5

What are the 2 entry inhibitors?

Answer 5

Enfuvirtide and Maraviroc

Question 6

Which drugs end in “navir”?

Answer 6

Protease inhibitors!

Question 7

Which drugs end in “gravir”?

Answer 7

Integrase inhibitors

Question 8

Which drug besides protease inhibs suppresses Cytochrome P450?

Answer 8

Colbicisat

Question 9

What do NRTIs do?

Answer 9

Disrupt chain elongation (inhib DNA poly)

Question 10

Main toxicity of NRTI?

Answer 10

Mitochondrial toxicity

Question 11

What is Tenofovir?

Answer 11

only nucleotide RT inhib phosphorylated once

Question 12

What do entry inhibitors Enfuvirtide and Maraviroc do?

Answer 12

Enfuvirtide- changes gp40 (proteolytic hydrolysis met, not 450)
Maraviroc- CCR5 costim inhib

Question 13

Integrase inhibs sxe

Answer 13

Steven johnsons

met by glucor not 450

Question 14

HAART tx?

Answer 14

need at least THREE drugs from at least 2 diff categories

Question 15

Which drug should we use first in HAART, but what if pt has obesity/CV issues?

Answer 15

protease inhibs, unless CV issues then use NRTI (2) + NNRTI etc

Question 16

Whats an example of a combo of HAART to avoid?

Answer 16

avoid 2 NNRTIs

Question 17

An ex of a sxe with a protease inhib

Answer 17

insulin resistance

Question 18

Which drug is v strong inhib of P450 so can use w PI to make it stronger?

Answer 18

ritonavir

Question 19

Adv to phenotype testing? Disadv?

Answer 19

Adv: direct, can do partial res
Disadv: cutoffs not standardized, less sensitive than geno, $$$

Question 20

What conversion rxn is inv in dTMP synth

Answer 20

DHF to THF via DHF reductase (produces deoxythymy, a DNA synth component)

Question 21

Hematochromatosis

Answer 21

Chronic excess of total body iron (eg issue with abs or frequent transfusions)

Question 22

Which defs cause microcytic vs megaloblastic anemia?

Answer 22

Microcytic-iron def

Megaloblastic-B12 and folate def

Question 23

What is pernicious anemia caused by?

Answer 23

defect in INTRINSIC FACTOR which helps with B12 absorption

Question 24

What to G-CSF and GM-CSF do?

Answer 24

tx, hematopo GFs which improve rbc count, stim granulocytes (neutros) and myleoid cells

Question 25

Why would renal failure cause anemia

Answer 25

kidneys produce EPO!

Question 26

What is epoeitin-alpha?

Answer 26

Recomb EPO for renal failure, acts on receptors on ery progens in bone marrow to stim rbc prod (receptor agonist)

Question 27

2 forms of EPO that have longer half lives?

Answer 27

``` Darbepoeitin alpha (glycosylated form) Methoxy.......beta ```

Question 28

EPO tox/complications?

Answer 28

HTN and thrombosis

Question 29

What do u treat with EPO?

Answer 29

chronic and end stage renal dis

Question 30

who gets iron def

Answer 30

women bc blood loss and vegetarians/malnourished

Question 31

iron supplements

Answer 31

ferrous sulfate gluconate and fumaarate

Question 32

IV iron

Answer 32

iron dextran, sodium ferric gluconate complex, iron sucrose

Question 33

Why cant iron be given in hemolytic anemia

Answer 33

iron stores elev in this

Question 34

in which anemia should iron NOT be given

Answer 34

hemolytic anemia

Question 35

which ppl shoudl have folate supp

Answer 35

pregnancy!

Question 36

If megaloblastic anemia, what should be ruled out before dx with folic acid def?

Answer 36

b12 def

Question 37

B12 is produced by gut bacteria and needs ___produced by ____ to absorb iron in the ____

Answer 37

IF, gastric parietal cells, intestine

Question 38

which def causes neuro issues

Answer 38

b12

Question 39

2 forms of b12 and which has longer half life

Answer 39

hydroxycobalamin

Question 40

what conversions does b12 do

Answer 40

homocystine AND methylmalonyl coa

Question 41

How is iron conv and abs by ints

Answer 41

iron abs as ferrous Fe2+ hem via DMT1 transporter in int. stored as ferritin when iron needed, ferrious iron transf across BL by ferroportin then oxidized to ferric Fe3 by ferroxidase -ferric complexed with transferrin and transp to blood

Question 42

Tx of acute iron intox

Answer 42

DEFEROXAMINE (common in kdis)

Question 43

Tx of chronic iron intox

Answer 43

DEFERASIROX or above iron chelators

Question 44

what do b12 and folic acid help w

Answer 44

DNA SYNTH OF RBC

Question 45

Why is folic acid monoTx contraind in tx of pernicious anemia?

Answer 45

bc doesnt tx b12 neuro issues!