Shared Flashcard Set

Details

HIV Important Points
HIV/AIDS
40
Pharmacology
Professional
09/13/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
HIV Virus was Isolated in...
Definition
1985
Term

 

HIV went from acute disease to chronic disease in...

 

Why?

Definition

1996

 

Introduction of Protease Inhibitors

Term
The most prevelant mode of transmission globally is _____________ contact, at 75%.
Definition

heterosexual

 

This is due to the problem in Sub-Saharan Africa

Term
Name two reasons HIV infection rates have increased.
Definition

1) Decrease in perceived threat (decrease in condom use)

 

2) Drug in the South - Meth abuse

Term
Rank states regarding incidence of HIV:
Definition

1. D.C.

30. Kentucky

Last: North/South Dakota or Montanna

Term

Who said this:

"If it doesn't make sense, it is probably not true."

Definition

Judge Judy

 

haha - :) I bet you liked that!

Term

 

Rank the three main methods of transmission in the U.S.

Definition

1. MSM 35%

2. Heterosexual Contact 31%

3. Injection drug use 12%

 

 

IDU decreased because of clean needles!!!!!!!!!!

Term

Someone told you they got HIV from giving oral sex. 

 

That is ...........

Definition
RIDICULOUS!!!
Term

Which version of the virus is most common in the US?

 

Which is most common in Africa?

 

Which is most Virulent?

Definition

HIV-1

 

HIV-2

 

HIV-1

Term
HIV's ability to mutate frequently and replicate at a high rate is a recipe for...
Definition
Resistance!
Term

Name the 5 drug targets in HIV infection.

 

What is the next target going to be?

Definition

1. CD4 receptor

2. R5 co-receptor

3. Reverse Transcriptase

4. Integrase

5.  Protease

 

Next target: X4 co-receptor

Term

True or False:

 

A doubtful risk body fluid (e.g. sweat, tears, saliva, vomitus, urine, stool) becomes high risk if it is bloody.

Definition
TRUE
Term

Post Exposure Prophylaxis is intended for what population?

 

 

What is the drug therapy used to treat these patients?

Definition

PEP is for: ocupational needle sticks, or sexual assault

 

Combivir 1 PO BID

Kaletra 2 caps BID

both for 1 month

Term
A woman is pregnant, what precautions should you take for the fetus?
Definition

Put her on 3 drug therapy.

 

If she refuses she should AT LEAST be on AZT

 

AZT protects the baby, NOT MOM.

Term
Does AZT get into the breast milk?
Definition

It doesn't matter because that is ridiculous!

 

Why are you asking? The baby should not be breast fed!

Term

Routine HIV testing should be done how often?

 

What age range of people?

Definition

Every Year

 

 

13-64

 

It doesn't matter if you are gay, bi, tri, married, or single. 

Term
HIV ELISA test leads to a lot of False Positives because...
Definition

It is highly sensitive but not specific.

 

Therefore if someone tests positive you should tell them they were reactive and you need to do additiaonl testing.

Term
Once you have a reactive HIV ELISA test you should...
Definition
Do a Western Blot to confirm HIV positive.
Term
The patient is said to have "AIDS" when the patient's CD4 counts are...
Definition

1.  <200: this is if the counts are or ever have been <200

 

2.  OR is HIV positive and has or ever had an AIDS-defining illness such as TB, PCP, toxoplasmosis, MAC

Term

True or False:

 

All patients who have AIDS have HIV.

Definition
TRUE
Term

TRUE or False:

 

All patients who have HIV have AIDS.

Definition
False
Term
When should you initiate HIV therapy?
Definition

When Symptomatic OR CD4 cell count is <350cells/mm3

 

therapy is considered when CD4 count is <500.

Term
Why don't we start HIV therapy when they are diagnosed?
Definition

1. Cost

2. Resistance

3. Quality of Life (SE are bad)

Term
What are the 2 goals of therapy when treating HIV?
Definition

1.  Reduce and maintain HIV RNA levels at an undetectable level (<48 copies/ml)

 

2.  Preserve or increase the CD4 count.

Term
Standard of Care for HIV therapy is....
Definition

3 antiretrovirals

 

Most potent combo: 2 NRTI and a PI

 

Alternative: 2 NRTI and 2 NNRTI (preferably efavirenz)

 

Salvage therapy: 2 PI, integrase inhibitor, enfurvitide, co-receptor blocker.

Term
Define Ritonavir Boosting.
Definition

Producing a favorable drug interaction by combining low dose of ritonavir with another PI, thus enabling the PI to be dosed at a reduced pill burden.

 

Ex: Kaletra.  (Combo: Lopinavir/Ritonavir)

 

For low dose boosting ritonavir does not "count" as an antiretroviral when considering therapy

Term
Ritonavir is a potent _____ inhibitor.
Definition

CYP450

 

This is the most potent CYP450 inhibitor in the pharmacy.

 

Long list of DI

Can cause cushings in a person with a corticosteriod inhaler.

Term
When using this drug, the patient's next stop is Hospice.
Definition

CD4 receptor inhibitor

 

The drug is: Enfurvitide.

Term
Treatment failure is when....
Definition

The viral burden is detectable.

 

Thus it is NOT UNDETECTABLE!

 

 

Term
Patient JP is on drugs ABC and has failed treatment.  What is your next step without doing resistance testing?
Definition

D/C drugs ABC

 

Start drugs DEF

Term
You should use this resistance testing early in the disease.
Definition

Genotypic

 

It is cheaper!

Term
You should use this resistance testing late in the disease.
Definition

Phenotypic

 

This is more costly because you have to culture the virus in cells.

More like antibiotic suceptability.

More accurate than genotypic.

Term
Innate immunity is when someone has 2 bad copies of this receptor.
Definition

R5

 

This is important because almost all of the HIV (95%) in the US use R5 to enter the cell.

Term
When an individual has one bad copy and one good copy of R5 they are considered to be a....
Definition

Slow progressor.

 

This person will live for years with HIV or without showing symptoms.

Term
The only effective HIV vaccine is what type?
Definition

Live attenuated.

 

Who wants to be in this Phase 3 trial and sign a consent form that says you may be infected with HIV?

 

The proof of concept is hard to prove because of the high variability in the high-risk populations.

 

 

Term
What is the problem of testing for Antibody generation after giving the vaccine?
Definition
Antibodies toward HIV do NOT neutralize the virus!
Term
What is the time frame for the window of opportunity for HIV intervention in a patient with an accidental needle stick?
Definition

24-48 hours / 1-2 days

 

After this time you are past the point of no return.  This means that the HIV virus has invaded the CD4--> MEMORY CELLS

Term
We have drugs to stop viral replication in 5 different places, why is it that we still cannot irradicate the virus?
Definition

Because the virus sits in CD4 memory cells in a latent phase.

 

Because the memory cells are there for a long time, they are permant seeds of the virus

 

Time extrapolation: Patient would have to be on antivirals for 100 years to kill out the virus in the latent CD4 cells....ridiculous.

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