Antivirals Flashcards
Adverse drug effects of antiretrovrials used to manage HIV ____ adverse drug effects of macrolides use to manage pneumonia.
a. Are only individually predictable compared to universal
b. Are less than
c. Are equal to
d. are greater than
D. Are greater than
In patients with HIV/AIDs, mucocutaneous manifestations are closely related to CD4 counts and can be used as predictors of immune status.
a. True
b. False
a. True
Patients with approrpriate ART therapy have reduced incidence of mucocutaneous infections such as oral candidiasis. So when these oral infections manigest, it is often an early predictor of ART failure or immune status change (reduced CD4).
How many days of antiretroviral therapy is needed for HIV post-exposure prophylaxis (PEP)?
a. 56
b. 28
c. 14
d. 7
b. 28
Start within 72 hours.
Usually Truvada (emtricitabine and tenofovir PLUS either dulutegravir or raltegravir) BID.
About $3200.
Test for HIV-1 and -3 post-exposure, minimum.
Rather than repeat doses of PEP for people who re-expose (shar needes, have anal sex), consider PrEP.
Clinical guidelines recommend that all patietns with HIV receive treatment, regardless of CD4 count.
a. True
b. False
a. True
Yes, by the International AIDS society - USA. No conflicting guidelines nationally or internationally.
The selection of antiretroviral therapy (ART) regimen in patients with HIV should be guided by patients’:
a. Previous treatment hx
b. Drug-resistant testing results
c. Both drug-resistant testing resutls AND previous tx hx.
b. Drug-resistant testing results
In HIV resistance, testing is done by genotyping.
Note, selection of antibacterials and antifungals also follow this guidance.
When switching ART regimens to counter drug-resistant HIV, what should the clinician consider?
Check as many as apply.
a. At least one drug should have high lipid solubility
b. The new regimen should include at least 2 fully active drugs
c. The drugs should be based on drug resistance characteristics
d. The drugs should have different mechanisms of action
e. The drug selection should be based on CD4 count
b. The new regimen should include at least 2 fully active drugs
c. The drugs should be based on drug resistance characteristics
d. The drugs should have different mechanisms of action
Which of the following must be monitored in patietns after switching their ART regimen?
Check all that apply.
a. Plasma HIV viral load
b. Patient report of noncompliance due to intolerable ADR(s)
c. CD4 count
d. Serum levels of the selected drugs
a. Plasma HIV viral load
b. Patient report of noncompliance due to intolerable ADR(s)
c. CD4 count
Newer generation ART agents are ____ compared to older generation ART agents.
a. Less toxic
b. Less effective
c. Unable to be evaluated for effectiveness with CD4 counts
d. Less potent
a. Less toxic
Newer agents are generally less toxic, more potent/more effective at lower doses.
Does the following monitoring occur when your patient with HIV starts to recieve ART?
* Screen for Hep B, C prior to ART
* BMP/basic chemistry prior to starting or if modifying ART and every 6 m
* Test serum Creat about every 6 m - concern with a bump of 0.4
* ALT, AST, total bili before starting and with modifying ART and every 8 weeks after a change then q6m
* Random fasting lipid and glucose before starting and with any modification in ART and every 12 m
* Urinalysis before starting and with ART modification and every 12 m, q6m if on TDF
* CBC with diff when starting modifying ART and every 12 m and whenever drawing a CD4
* Viral load every 8 weeks with start or change
* CD4 count every 12 m and more often when CD4 count drops and with starting any change in drug therapy
* Do a pregnancy test entry into care, ART start or change
a. True
b. False
a. True
What causes acyclovir-induced nephrotoxicity when administered IV?
a. The formation of toxic metabolites
b. Decreased glomerular filtration rate
c. The precipitation of acyclovir in the renal tubule
d. Direct tubular cytotoxic injury
e. Hypersensitivity interstitial nephritis
c. The precipitation of acyclovir in the renal tubule.
Match the ADRs/Toxicities to ARV therapy with the expected category.
A. Long Term
B. Short Term
- Diabetes
- Accelerated vascular disease
- Kidney dysfunction
- Bone loss
- GI (N/V/D)
- CNS: dizziness, SI, abnormal dreams
- Hypersensivitiy reaction
- Dyslipidemia
Long term:
1. Diabetes
2. Accelerated vascular disease
3. Kidney dysfunction
4. Bone loss
5. GI (N/V/D)
7. Hypersensivitiy reaction
8. Dyslipidemia
Short Term
5. GI (N/V/D)
6. CNS: dizziness, SI, abnormal dreams
7. Hypersensivitiy reaction
The virostatic effects of NRTI with dividing HIV-1 ______ the virostatic effect of NRTIs with latent HIV-1.
a. Greater than
b. Less than
c. Equal to
a. Greater than
Latent bugs, no matter bacterial, fungal, or viral, are notoriously difficult to stop with a drug.
MOA of microbials - needs dividing cells or cells that are actively making proteins/growing/active
