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Heme > HIV Drugs > Flashcards

HIV Drugs Flashcards

1
Q

Name the “entry inhibitors.”

A

Enfuviritide

Maraviroc

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2
Q

Enfuviritide MOA.

A

Peptide that binds to gp41 and prevents membrane fusion

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3
Q

Maraviroc MOA.

A

CCR5 antagonist

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4
Q

Name the nucleoside reverse transcriptase inhibitors: NRTIs.

A 
Abacavir
Lamivudine
Tenofovir disoproxil
Zidovudine (AZT)
Emtriciatbine
Didanosine
Stavudine
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5
Q

MOA of NRTIs.

A

Prodrugs converted to triposphates that competitively inhibit binding of natural nucleotides to dNTP-binding site of reverse transcriptase AND act as chain terminators via insertion into growing strand.

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6
Q

Why do NRTIs stop growing DNA strand?

A

they lack 3’ hydroxyl group

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7
Q

Name the non-nucleoside reverse transcriptase inhibitors: NNRTIs.

A

Efavirenz

Nevirapine

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8
Q

MOA of NNRTIs.

A

bind to a site on reverse transcriptase different than NRTIs and do NOT compete with nucleoside triphosphates but simply inhibit it

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9
Q

List the HIV-1 protease inhibitors.

A

Atazanavir
Ritonzvir
Amprenavir
other “navir”s

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10
Q

MOA of HIV-1 protease inhibitors.

A

inhibit the viral protease processing of proteins to “mature them”

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11
Q

List the DNA strand transfer inhibitor.

A

Raltegravir

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12
Q

MOA of Raltegravir.

A

Binds to integrase and inhibits integration of viral dsDNA into host genome

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13
Q

What is the only anti-HIV drug that is NOT taken orally?

A

enfuviritide

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14
Q

What drugs have UGT conjugation?

A

abacavir
emtricitabine
atazanavir
raltegravir

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15
Q

What drug has metabolism by alcohol dehydrogenase?

A

abacavir

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16
Q

What drug has metabolism by oxidation?

A

emtricitabine

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17
Q

What drug is catabolized to amino acid?

A

enfuvirtide

18
Q

What drugs are you worried about CYP interactions?

A

NNRTIs
PIs
Maraviroc

19
Q

What drug is a P-gp substrate?

A

maraviroc

20
Q

Why do you need to genotype HIV viruses?

A

There are different serotypes of the virus. You cannot assume that the viral infection your patient has is a naïve virus!

21
Q

What antifungals do you need to avoid with CYP metabolized HIV drugs?

A

voriconazole is a CYP inhibitor

22
Q

What antibiotics do you need to avoid with CYP metabolized HIV drugs?

A

rifampin/rifabutin is an inducer

may need to double the dose

23
Q

What herb do you need to avoid with CYP metabolized HIV drugs?

A

St. John’s Wort (inducer of CYP)

24
Q

What herb/food do you need to avoid with saquinavir?

A

garlic will have interaction with saquinavir

25
Q

What 2 adverse effects are broadly seen with HAART therapy? Why?

A

ALMOST ALL HIV DRUGS LEAD TO PERIPHERAL NEUROPATHY (dysfunciton of mitochondrial oxidative metabolism)/LIPODYSTROPHY!!!

26
Q

Why do you give ritonavir with low doses with other PIs?

A

Ritonavir used in low doses as a BOOSTER so you can give other PIs with it at lower doses/increase their effectiveness

27
Q

What adverse effects are commonly seen with NRTIs?

A

May also cause lactic acidosis!! May also cause hepatic disease/pancreatitis! RASH.

28
Q

Nevarapine is contraindicated with what?

A

NOT with hypersensitivity and hepatic disease.

29
Q

Abacavir is contraindicated with what?

A

NEVER take abacavir with hypersensitivity and hepatic disease!!!

30
Q

What drugs rely on an acidic environment to be absorbed?

A

ataznavir and raltegravir

31
Q

When taking a protease inhibitor, what should you be concerned about?

A

THINK OF CARDIOTOXICITY!! (also hypokalemia and other lowered ions)

32
Q

What drugs have carb/lipid metabolism effects and hepatotoxicity?

A

protease inhibitors

33
Q

What NRTIs are recommended for pregnant women?

A

lamivudine, zidovudine

34
Q

What NNRTIs are recommended for pregnant women?

A

nevirapine

35
Q

What PIs are recommended for pregnant women?

A

Lopinavir

Ritonavir

36
Q

Prophylaxis for pneumocystis jiroveci.

A

trimethoprim-sulfamethoxazole

37
Q

Prophylaxis for M. tuberculosis

A

isoniazid + pyridoxine

38
Q

Prophylaxis for Toxoplasmosis

A

trimethoprim-sulfamethoxazole

39
Q

Prophylaxis for CMV

A

ganciclovir

40
Q

Prophylaxis for fungal infections and yeast infections.

A

Fluconazole

Heme (10 decks)

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