Term
| Five types of HIV medications |
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Definition
| Entry inhibitors, nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside transcriptase inhibitors (NNRTI), integrase inhibitors, protease inhibitors |
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Term
| Name the fusion inhibitor and it MOA |
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Definition
| Enfuvirtide (Fuzeon), attaches to viral envelope and prevents fusion of HIV and CD4 |
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Term
| This HIV drug has to be reconstituted which limits adherence and it usually only used as a "salvage" treatment |
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Definition
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Term
| Name the entry inhibitor and its MOA |
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Definition
| Maraviroc (Selzentry), blocks entry of HIV into CD4 cell |
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Term
| This drug is only effective for the CCR5 subtype so you must run a Trofile assay first to make sure the patient has this subtype; this drug may also cause liver problems so LFT's must be checked regularly |
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Definition
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Term
| Tenofovir, Emtricitabine, Abacavir, Lamivudine, Zidovudine, Didanosine, Stavudine |
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Definition
| Nucleoside reverse transcriptase inhibitors (NRTI) |
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Term
| With this NRTI there can be a fatal hypersensitivity reaction so you must pre-screen with HLAB5701 test |
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Definition
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Term
| These two NRTI's are very friendly and also effective against hepatitis B (they shouldn't be used together because it would be duplicate therapy) |
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Definition
| Lamivudine, Emtricitabine |
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Term
| Name the nucleotide analog (NtRTI) |
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Definition
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Term
| This NTRI is used in labor and delivery |
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Definition
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Term
| These three NRTI's have mitochondrial AE's such as anemias, peripheral neuropathy, lactic acidosis, hepatic steatosis, pancreatitis, lipodystrophy, lipoatrophy |
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Definition
| Zidovudine, Didanosine, Stavudine |
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Term
| These two NRTI's aren't used as much because they can be toxic |
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Definition
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Term
| How are NRTI's taken and what is their MOA? |
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Definition
| PO, compete with the real nucleosides to terminate viral DNA chain and block replication of HIV |
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Term
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Definition
| Efavirenz, Nevirapine, Etravirine |
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Term
| This NNRTI may cause Steven's Johnson Syndrome |
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Definition
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Term
| This NNRTI is still effective even with the knock-out mutation |
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Definition
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Term
| What is the MOA of NNRTI's |
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Definition
| Binds non-competitively to active site on reverse transcriptase enzymes and prevents HIV RNA conversion to proviral DNA |
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Term
| How are NNRTI's taken and what is their half-life? |
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Definition
| PO (bioavailability increased with food); long half life (can lead to resistance |
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Term
| What are the main drug interactions of NNRTI's due to CYP450? |
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Definition
| Benzodiazepines, ergot derivatives, St. John’s Wort, Rifampin, “azole” anti-fungals |
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Term
| Name the integrase inhibitor and its MOA |
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Definition
| Raltegravir; Blocks integration of HIV DNA into host DNA |
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Term
| WHat is the side effect of Raltegravir (the integrase inhibitor) |
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Definition
| Very well tolerated; may cause hyperlipidemia |
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Term
| This is the booster that is given with protease inhibitors |
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Definition
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Term
| Name two protease inhibitors and the MOA |
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Definition
| Atazanavir, Darunavir; Blocks the “cleaving” process that allows for viral maturation (this produces noninfectious virions) |
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Term
| How are protease inhibitors taken and what is their half life? |
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Definition
| PO; very short (that's why you take them with the booster Ritonavir) |
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Term
| What are the drug interactions of protease inhibitors? |
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Definition
| Benzodiazepines, ergot derivatives, statins, CCB, St. John’s Wort, Rifampin |
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Term
| What are the three types of resistance testing? |
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Definition
| Genotyping, Phenotyping, Virtual Phenotyping |
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Term
| Which drug class is the most resistance to mutations (least likely to develop mutations)? |
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Definition
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Term
| Indications for starting ARV therapy |
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Definition
| History of AIDS defining illness, CD4 < 350, CD4 350-500, pregnancy, HIV associated nephropathy, hepatitis B |
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Term
| What are the preferred regimens? |
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Definition
| Emtricitabine-Tenofovir + (efavirenz; atazanavir and ritonavir; daranuvir and ritonavir; raltegravir) |
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Term
| This opportunistic infection can be carried in felines, comes from uncooked meat, causes fever/headache/seizures/ataxia and is identified by CT with ring enhancing lesions |
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Definition
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Term
| When should prophylaxis for toxo be started and what drug is used? |
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Definition
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Term
| What is the treatment for toxo? |
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Definition
| sulfadiazine + pyrimethamine |
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Term
| WHat are the treatment and prophylaxis for candida? |
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Definition
| No prophylaxis; treatment is fluconazole |
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Term
| This opportunistic infection is found in soil/water, gains access through the gut, causes weight loss, intermittent fevers, night sweats, abdominal pain, diarrhea, weakness |
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Definition
| Mycobacterium avium intercellulare (MAI) |
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Term
| What is the prophylaxis for MAI and when should it be started? |
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Definition
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Term
| What is the treatment for MAI? |
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Definition
| Azithromycin + ethambutol +/- rifabutin x 12 months |
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Term
| This opportunistic infection must be inhaled and comes from pigeon droppings, it usually presents like meningitis with headache, photosensitivity, low grade fever, malaise, neck stiffness, seizures |
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Definition
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Term
| What are prophylaxis and treatment for cryptococcus? |
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Definition
| no prophylaxis, Amphotericin B |
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Term
| This opportunistic infection can cause retinitis, colitis, pneumonia |
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Definition
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Term
| What is the treatment for CMV? |
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Definition
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Term
| This opportunistic infection presents with gradual progression of fever, nagging/dry/non-productive cough, exertional dyspnea |
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Definition
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Term
| What does the CT of PCP look like? |
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Definition
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Term
| What is the prophylaxis for PCP, when should it be started and what is the treatment? |
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Definition
| Prophylaxis and treatment is TMP/SMX and prophylaxis should be started at CD4 < 200 |
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