Quiz 5 Flashcards
tenofovir + emtricitabine 1
Truvada. Nucelotide RTI + nucleoside RTI. HIV-1, pre-exposure prophylaxis (PreP) of HIV-1 infection.
tenofovir + emtricitabine 2
MOA: Nucleoside and nucleotide reverse transcriptase inhibitor combination; each drug interferes with HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication
BBW: Lactic acidosis/severe hepatomegaly with steatosis; post-treatment acute exacerbation of Hep B; risk of drug resistance with use for PreP
SE: abnormal dreams, depression, diarrhea, dizziness, fatigue, headache, insomnia, nausea, and rash
tenofovir + alafenamide + emtricitabine 1
Brand: Descovy
Class: nucelotide RTI + nucleoside RTI
Indication: HIV (in combo w/ other antiretrovirals)
tenofovir + alafenamide + emtricitabine 2
MOA: each drug interferes with HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication
BBW: Lactic acidosis/severe hepatomegaly with steatosis; post-treatment acute exacerbation of Hep B
SE: nausea
tenofovir + alafenamide + emtricitabine + rilpivirine 1
Brand: Odefsey
Class: nucelotide RTI + nuceloside RTI + NNRTI
Indication: HIV
tenofovir + alafenamide + emtricitabine + rilpivirine 2
MOA: Tenofovir alafenamide & emtricitabine - compete with natural substrates and incorporate into viral DNA, resulting in termination of the DNA chain. Rilpivirine - noncompetitively incorporates into viral DNA & terminates the DNA chain
BBW: Lactic acidosis/severe hepatomegaly with steatosis; post-treatment acute exacerbation of Hep B
SE: nausea, HA, somnolence
tenofovir alafenamide + emtricitabine + elvitegravir + cobicistat 1
Brand: Genvoya
Indication: HIV
Class: nucleotide RTI + nuceloside RTI + integrase inhibitor + CYP450 inhibitor
tenofovir alafenamide + emtricitabine + elvitegravir + cobicista2
MOA: Tenofovir alafenamide & emtricitabine - compete with natural substrates and incorporate into viral DNA, resulting in termination of the DNA chain. Elvitegravir - inhibits the catalytic activity of integrase, preventing integration of the proviral gene into human DNA. Cobicistat - inhibits enzymes of the CYP3A subfamily & enhances systemic exposure to elvitegravir.
BBW: lactic acidosis, severe hepatomegaly, postreatment exacerbation of hepatitis B
SE: decreased bone mineral density, nausea
abacavir + lamivudine 1
Brand: Epzicom
Class: both are nucleoside RTIs
Indication: HIV
abacavir + lamivudine 2
ranscriptase inhibitor combination
BBW: Hypersensitivity reactions (esp. w/ HLA-B*5701 allele); Lactic acidosis/severe hepatomegaly with steatosis; post-treatment exacerbations of Hep B
SE: depression, headache, insomnia
abacavir + lamivudine + dolutegravir 1
Brand: Triumeq
Class: nucleoside RTI + nucleoside RTI + integrase inhibitor
Indication: HIV.
abacavir + lamivudine + dolutegravir 2
MOA: Abacavir & lamivudine - inhibit HIV-1 reverse transcriptase; they get incoporated into viral DNA and halt replication. Dolutegravir - inhibits the catalytic activity of integrase, thus preventing integration of the proviral gene into human DNA.
BBW: Hypersensitivity reactions (esp. in pts. w/ HLA-B*5701 allele); Lactic acidosis/severe hepatomegaly with steatosis; post-treatment exacerbations of Hep B
SE: hypersensitivity rxn to abacabvir component
lamivudine + zidovudine 1
Brand: Combivir
Class: both are nucleoside RTIs
Indication: HIV
lamivudine + zidovudine 2
MOA: both act synergistically to inhibit reverse transcriptase b/c they are phosphorylated in the cell & are incorporated into the DNA chain
BBW: hematologic toxicity in advanced HIV-1; Lactic acidosis/severe hepatomegaly with steatosis; post-treatment exacerbations of Hep B
SE: HA, N/V/D, nasal symptoms, cough dizziness, insomnia, neuropathy, sleep disorder, musculoskeletal pain,
dolutegravir 1
Brand: Tivicay
Class: Integrase Inhibitor
Indication: HIV
dolutegravir 2
MOA: Binds to the integrase active site and inhibits the strand transfer step of HIV-1 DNA integration into the host cell genome necessary for the HIV replication cycle
BBW: N/A
SE: hyperglycemia, hep B/C coinfection
raltegravir 1
Brand: Isentress
Class: Integrase Inhibitor
Indication: HIV
raltegravir 2
MOA: Raltegravir inhibits the catalytic activity of integrase, thus preventing integration of the proviral gene into human DNA
BBW: N/A
SE: headache, nausea, insomnia & fatigue
darunavir + cobicistat 1
Brand: Prezcobix
Class: protease inhibitor + CYP450 inhibitor
Indication: HIV
darunavir + cobicistat 2
MOA: inhibits HIV protease, which selectively inhibits the cleavage of HIV-encoded Gag-Pol polyproteins in virus infected cells and prevents the formation of mature infectious virus particles. Cobicistat increases darunavir exposure via inhibition of CYP3A metabolism
BBW: N/A
SE: N/V/D, HA, rash, abd pain
tenofovir + emtricitabine + elvitegravir + cobicistat
1
Stribild. Class: nuceotide RTI/antihepandnaviral + nuceloside RTI + integrase inhibitor + CYP450 inhibitor
Indication: HIV
tenofovir + emtricitabine + elvitegravir + cobicistat
2
MOAs: Elvitegravir inhibits the catalytic activity of integrase, thus preventing integration of the proviral gene into human DNA. Cobicistat inhibits enzymes of the CYP3A subfamily and enhances systemic exposure to elvitegravir. Emtricitabine and tenofovir interfere with HIV viral RNA dependent DNA polymerase activities resulting in inhibition of viral replication.
BBW: lactic acidosis, severe hepatomegaly, postreatment exacerbation of hepatitis B
SE: proteinuria, N/D
ritonavir 1
Norvir. Class: Protease Inhibitor
Indication: HIV
ritonavir 2
MOA: Binds to the site of HIV protease activity & inhibits cleavage of viral Gag-Pol protein precursors into individual functional proteins required for infectious HIV, resulting in the formation of immature, noninfectious viral particles
BBW: Coadministration with sedative hypnotics, antiarrhythmics, or ergot alkaloid preparations may result in potentially serious and/or life-threatening adverse reactions (hepatic metabolism effects)
SE: raised serum cholesterol, N/V/D, altered taste, asthenia, paresthesia, dizziness, arthralgia, dermatologic effects, cough, pain in throat
atazanavir + cobicistat 1
Evotaz. Class: protease inhibitor + CYP450 inhibitor
Indication: HIV
atazanavir + cobicistat 2
MOA: Atazanavir prevents the formation of mature virions by selectively inhibiting viral Gag and Gag-Pol polyproteins in HIV-1 infected cells. Cobicistat boosts atazanavir exposure.
BBW: N/A
SE: abnormal bilirubin, jaundice, scleral icterus, nausea
