questions Flashcards
T/F: antibiotics are not effective against viral infections
true
how do protease inhibitors work?
interfere with step eight of the HIV lifecycle.
-they blocked cleavage of long train viral proteins
what are some more serious adverse effects of nucleotide analogues?(2)
- nephrotoxicity
2. hepatitis may worsen on discontinuation
with the exception of ______, why are NNRTIs only used in combination with NRTIs and PIs?
nevirapine
-because resistance develops rapidly
penciclovir is administered ______.
topically
what 4 types of drugs are used for the treatment of viral hepatitis?
- nucleoside analogues
- interferons
- nucleotide analogues
- protease inhibitors
define: adherence
closely following or hearing to the treatment regimen
T/F: amantadine acts against influenza B but not influenza A
false.
acts against influenza A but not influenza B
zanamivir is not recommended for patients with __________.
pulmonary disease
-it has been reported to produce bronchospasm and deterioration in pulmonary function
when are HIV-infected patients diagnosed with AIDS?
when there CD4 cell count falls below 200 cells/mm3(cubed) or if they develop and AIDS defining illness
define: drug resistance testing
Laboratory test to determine whether an individual’s HIV strain is resistant to any anti-HIV medications
T/F: all nucleoside analogues are used in the treatment of HBV
false
all but ribavirin
________ is formulated for oral use and ________ is formulated as a powder for oral inhalation
- oseltamivir
2. zanamivir
________ are not technically antiviral agents.
interferons
-instead, they protect uninfected cells by promoting resistance to virus infection
define: antiviral
medication that is able to inhibit viral replication
what 8 drugs are protease inhibitors?
- fosamprenavir
- atazanavir
- darunavir
- indinavir
- nelfinavir
- ritonavir
- saquinavir
- tipranavir
nucleoside and nucleotide analogues are used to treat _____.
hepatitis B virus
what are possible side effects of NRTI’s?(9)
liver problems muscle inflammation and weakness diabetes abnormal fat distribution high cholesterol decreased bone density skin rash pancreatitis leukopenia
______ are used for the treatment of hepatitis B virus and hepatitis C virus
interferons
define: antiretroviral
medication that interferes with the replication of retroviruses. (HIV is a retrovirus)
what drug has greater oral absorption and treats the same conditions as acyclovir, but requires less frequent dosing?
valacyclovir
penciclovir is an active metabolite of _________, and indicated for the treatment of herpes labialis (cold sore)
famciclovir
define: antiviral resistance
ability of a virus to overcome the suppressive of action of antiviral agents
____ is required to have a boxed warning in the package regarding reports of fatal and nonfatal intracranial hemorrhage
tipranavir
______ is an oral powder stable for six hours, once mixed with food or liquid (if refrigerated)
nelfinavir
define: CD4 count
number of CD4 cells in a sample of blood
what neuraminidase inhibitors are used in the treatment of influenza?(2-generic name)
- oseltamivir
2. zanamivir
what are common adverse reactions to acyclovir, famciclovir, ganiclovir, penciclovir and valacyclovir?(7)
diarrhea nausea vomiting headache fatigue dizziness confusion
how do neuraminidase inhibitors work?
inhibit virus proliferation by blocking the virus release from the host cell. this limits the spread of the virus
what are the 3 important ways that NNRTIs differ from NRTIs?
- NNRTIs are noncompetitive inhibitors of reverse transcriptase
- they do not need to be activated by host enzymes
- they are not effective against HIV-2
define: cross resistance
development of resistance to one drug in a particular class that results in resistance to other drugs in that class
define: virion
infectious particles of a virus
what allergic reactions are associated with the use of drugs used in the treatment of influenza?(2)
- facial edema
2. oropharyngeal
what factors influence the outcome of antiviral therapy? (5)
- stage of illness
- dose of antiviral used
- ability of virus to penetrate the CNS
- ability of the virus to remain latent within the host
- development of antiviral resistance
what adverse reactions are associated with the use of telaprevir?
hint: 1, but detailed
DRESS
-DRESS symptoms include rash, fever, facial edema, hepatitis and nephritis.
what are some adverse effects of nucleotide analogues?(7)
headache abdominal pain diarrhea nausea dyspepsia flatulence asthenia
PIs are administered as combination therapy; most are recommended to be given along with ______.
ritonavir
define: highly active antiretroviral therapy
combination of three or more antiretroviral medications taken in a regimen
T/F: foscarnet may produce hair loss, tinnitus, hearing loss, arrhythmias and heart failure
true
H1N1 and H3N3 are strains of influenza A that are susceptible to the effects of _______.
hint: classification
neuraminidase inhibitors
nausea and vomiting, coughing, dizziness, and headache are common side effects to the use of_______ and _____.
- oseltamivir
2. zanamivir
what is neutropenia?
drop in white blood cell count
define: host
individual infected with a virus
________ interfere with ___ viral replication.
- protease inhibitors
2. hepatitis C virus (HCV)
define: oncovirus
A virus that is a causative agent in cancer
define: viral load
amount of materials from the virus that get released in the blood when the HIV reproduces.
what are the six classes of antiretrovirals?
- nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)
- nonnuclear side reverse transcriptase inhibitors (NNRTIs)
- protease inhibitors (PIs)
- fusion inhibitors
- chemokine receptor antagonist, type 5
- HIV integrase stand inhibitor
define: virustatic
able to suppress viral proliferation
define: virus
intracellular parasite that consists of a DNA and RNA core surrounded by a protein coat and sometimes an outer covering of lipoprotein
what are the most common adverse reactions associated with interferons?
flulike symptoms:
fever, chills, headache, fatigue, muscle ache, and joint pain
what are other adverse reactions caused by interferons?(5)
nausea vomiting diarrhea dizziness depression
_____ is indicated for the treatment of cytomegalovirus retinitis in patients with AIDS
cidofovir
_____ may also produce the adverse reactions: irritation and discoloration of the skin
penciclovir
______ is teratogenic and classified in pregnancy category D
efavirenz
what are some common side effects of protease inhibitor: boceprevir(4)
fatigue
anemia
nausea
headache
______ is indicated for the treatment of HBV and RSV.
ribavirin
what are more serious adverse effects of raltegravir?(5)
rhabdomyolysis depression suicidal ideation thrombocytopenia increased cancers
entecavir is effective against _______-resistant HBV.
lamivudine
what are too serious adverse effects associated with the use of interferons?
- drop in white blood cell count
2. drop in platelet count
HAART is also known as _______
an AIDS cocktail
_______ was the first available antiretroviral.
zidovudine
-introduced in 1987
what is thrombocytopenia?
drop in platelet count
what does DRESS stand for?
drug reaction with eosinophilia and systemic symptoms
______ is effective against RNA and DNA viruses
ribavirin
The most common adverse effects of entecavir and lamivudine are: (4)
headache
fatigue
dizziness
nausea
what is HBV and HCV?
HBV- hepatitis B virus
HCV- hepatitis C virus
what are some adverse reactions of protease inhibitors?
- can elevate triglyceride, cholesterol, and blood glucose levels and insulin resistance.
- cause redistribution of fat (accumulating in stomach, and loss in limbs and face)
Tamiflu is indicated for the treatment of _______.
influenza
what is an advantage and disadvantage of virus mutation?
advantage- may results in a virus that is not able to reproduce
disadvantage- often result in adaptations that make it easier for the virus to exist in new environments and hosts
Side effects associated with almost all NRTIs are:(5)
headache stomach upset fatigue or insomnia muscle ache diarrhea
why is it difficult to develop a vaccine to prevent virus infection?
because viruses continually mutate.
for example, each year, a new vaccine must be developed for the latest strain of influenza
what 2 drug classifications are used in the treatment of influenza?
- inhibitors of viral uncoating
2. neuraminidase inhibitors
what inhibitor of viral uncoating is used in the treatment of influenza A?
amantidine
define: human immunodeficiency virus
virus that causes acquired immunodeficiency syndrome
define: AIDS
The most severe form of human immunodeficiency virus.
T/F: proteins inhibitors produced nausea, vomiting, and diarrhea
true
what does AIDS stand for?
acquired immunodeficiency syndrome
what are the adverse allergic reactions to fusion inhibitors?(7)
rash chills fever stuffiness hypertension nausea vomiting
T/F: risk associated with nevirapine is greatest in the first 6 to 18 weeks of therapy, and more common in women than men
true
what are the most common side effects of maraviroc?(5)
colds cough fever rash dizziness
define: mother to child transmission
transmission of the HIV from an HIV infected mother to her baby drink pregnancy, delivery, or through breastmilk (called perinatal transmission)
define: CD4 T lymphocyte
White blood cells that fight infection
psychosis and other emotional changes have been reported with the use of _________.
hint: classification
neuraminidase inhibitors
what 7 drugs are NRTIs?
- abacavir
- didanosine
- emtricitabine
- lamivudine
- stavudine
- tenofovir
- zidovudine
numerous drug interactions are seen when ______ are administered concurrently with benzodiazepines and proton pump inhibitors (-prazoles)
NNRTIs
______ may be administered orally to pregnant women and intravenously during delivery and as a suspension to neonates.
zidovudine
- should begin at 14 weeks of pregnancy
- showing to reduce mother to child transmission of HIV
what are the adverse effects of raltegravir?(4)
headache
dizziness
diarrhea
GI upset
saquinavir should be taken ______.
with food
to avoid the formation of kidney stones,______ should be taken with at least 1.5 L of water daily
indinavir
which NRTI may cause nail discoloration?
zidovudine
_______ may cause dizziness, drowsiness or insomnia, abnormal dreams, confusion, abnormal thinking, impaired concentration, amnesia, agitation, hallucinations, depersonalization, and euphoria
efavirenz
what is a common ending for protease inhibitors(PIs)?
-navir
what three drugs are classified as NNRTIs?
- delavirdine
- efavirenz
- nevirapine
which NNRTI has a short half-life and must be given in multiple daily doses?
delavirdine
what is pregnancy category D?
drug should not be administered in the first trimester of pregnancy and women taking the drug should be advised to avoid pregnancy
what is a common side effect of all NNRTIs?
rash
nevirapine is associated with _______ any FDA has required changes in the package labeling to warn of this adverse effect.
fatal liver toxicity
what are some other adverse effects reported for maraviroc?(3)
myocardial infarction
hepatotoxicity
priest infections or cancers
what is currently the only drug in the class fusion inhibitors?
enfuviritide
how are fusion inhibitors administered?
must be administered by subcutaneous injection into the thigh, arm, or abdomen.
what is the adverse reaction of fusion inhibitors?(5)
irritation pain redness itchiness formation of nodules and cysts at site of injection
