Anti-retrovirals

Question 1

Which RX has an AE that causes nephrotoxicity and bone mineral density changes?

Answer 1

Tenofovir

Question 2

Which anti-retroviral can cause PR or QTc prolongation? What is generally recommended prior and after starting this RX?

Answer 2

Saquinavir

EKG

Question 3

Which RX binds to gp41 on virus and prevents fusion w/ host cell membrane?

Answer 3

Enfuvirtide

Question 4

When should NRTI treatment be suspended?

Answer 4

When you see rising aminotransferase levels, hepatomegaly, or unknown cause of metabolic acidosis

Question 5

Which RX is used to boost bioavailiability and pharmacokinetics of protease inhibitors?

Answer 5

Ritonavir

Question 6

Tenofovir is distinct because it has a _______ in the parent molecule?

Answer 6

Phosphate

Question 7

Which RX has an AE that causes:

1. Inj. site reactions
2. Hypersensitivity
3. Increase % of bacterial pneumonia

Answer 7

Enfuvirtide

Question 8

Which RXs are non-nucleoside reverse transcriptase inhibitors (NNRTIs)?

Answer 8

1. End w/ “virine” (3)
2. End w/ “virenz” (1)
3. End w/ “virapine” (1)

Question 9

Which class has a black box warning of lactic acidosis syndrome?

Answer 9

NRTIs

Question 10

Which RXs are binding/fusion inhibitors?

Answer 10

1. Maraviroc
2. Enfuvirtide
3. Ibalizumab

Question 11

Which anti-retroviral can cause kidney stones?

Answer 11

Indinavir

Question 12

Protease inhibitor short-term AE?

Answer 12

1. GI problems
2. Hyperbilirubinemia (atazanavir + indanavir)
3. Bleeding risk
4. Hepatoxicity

Question 13

Protease inhibitor long-term AE?

Answer 13

1. Hyperlipidemia
2. Lipodystrophy
3. Insulin resistance
4. Hypertension
5. Diabetes?

Question 14

Which class has AE of lipatrophy?

Answer 14

NRTIs

Question 15

Enfuvirtide AE?

Answer 15

1. Inj. site reactions (forms nodules + thick+
2. Hypersensitivity
3. Increase % of bacterial pneumonia

Question 16

Emtricitabine unique AE?

Answer 16

Pigmentation of soles/palms

Question 17

Enfuvirtide MOA?

Answer 17

Binds to gp41 on virus and prevents fusion w/ host cell membrane

Question 18

Which RXs are protease inhibitors for HIV?

Answer 18

End w/ “navir”

EX: Atazanavir

Question 19

Which RXs are integrase inhibitors?

Answer 19

End w/ “gravir”

EX: Raltegravir

Question 20

Abacavir AE?

Answer 20

Cardiovascular toxicity

Question 21

NNRTIs AE?

Answer 21

1. Stevens-Johnson syndrome
2. Hepatoxicity (more severe in nevirapine)
3. Elevated liver enzymes (more severe in nevirapine)

Question 22

Which RX is an CCR5 inhibitor?

Answer 22

Maraviroc

Question 23

Which RX are sulfonamides and pts w/ sulfonamides should be treated w/ caution using this RX?

Answer 23

Darunavir
Tipranavir
Fosamprenavir

Question 24

Fosamprenavir AE?

Answer 24

Rash + oral paresthesias

Question 25

Maraviroc MOA?

Answer 25

CCR5 inhibitor; binds to CCR5 co-receptor on host cell and prevents HIV from binding

Question 26

Which class has AE of mitochondrial toxicity?

Answer 26

NRTIs

Question 27

Which RX has a chance of cardiovascular toxicity?

Answer 27

Abacavir

Question 28

Which RX has a black box warning of fatal hepatitis and intracranial hemorrhage?

Answer 28

Tipranavir

Question 29

Which class of anti-retrovirals has some sulfonamides in them?

Answer 29

Protease inhibitors specifically: Darunavir Tipranavir Fosamprenavir

Question 30

Maraviroc AE?

Answer 30

1. General stuff (rash, cough) 2. Upper respiratory infections 3. Hepatotoxicity

Question 31

What is the black box warning of Tipranavir?

Answer 31

Fatal hepatitis and intracranial hemorrhage

Question 32

Which RXs are nucleoside reverse transcriptase inhibitors (NRTIs)?

Answer 32

1. End w/ "vudine" 2. Tenofavir (disoproxil/alafenamide) 3. Emtricitabine 4. Abacavir

Question 33

Which anti-retroviral should not be used in the first trimester of pregnancy?

Answer 33

Efavirenz

Question 34

Indinavir AE?

Answer 34

Kidney stones

Question 35

NRTI MOA?

Answer 35

Has to be tri-phosphorylated by host 1. Thymidine kinase 2. Thymidylate kinase (Rate-limiting) 3. Pyrimidine ND kinase Binds/inhibits reverse transcriptase enzyme

Question 36

Which RX causes a rash + oral paresthesias?

Answer 36

Fosamprenavir

Question 37

Saquinavir AE?

Answer 37

PR and QTc prolongation

Question 38

Tenofovir AE?

Answer 38

1. Nephrotoxicity | 2. Bone mineral density changes

Question 39

Which RX has AE of pigmentation of soles/palms?

Answer 39

Emtricitabine

Question 40

NRTIs AE?

Answer 40

1. Mitochondrial toxicity 2. Peripheral neuropathy 3. Pancreatitis 4. Lipoatrophy 5. Black box = lactic acidosis syndrome

Question 41

We know that Maraviroc is a CCR5 receptor antagonist, what unique MOA does this RX have?

Answer 41

Active against viruses that have become resistant to antiretroviral agents of other classes

Question 42

HLA-B*5701 genotype is associated w/ what RX?

Answer 42

Abacavir

Question 43

K103N mutation is associated w/ what RX?

Answer 43

NNRTIs