case 5 Flashcards

Question

ART

Answer 1

To treat HIV/AIDS, patients are often given a class of antiretroviral drugs called reverse transcriptase inhibitors ● Targets retroviruses ● Prevents conversion of RNA into DNA ● Prevents proliferation of virus ● Not a cure ● 2 types - Nucleoside/nucleotide and non-nucleoside/nucleotide

Answer 2

``` Stop reverse transcription by incorporating with the viral DNA ● abacavir (Ziagen) ● lamivudine (Epivir) ● stavudine (Stavudine) ● zidovudine (Retrovir) ○ Effective at stopping transmission in around 70% of pregnant patients ```

Answer 3

``` Inhibit reverse transcription by binding directly to the reverse transcriptase enzyme ● doravirine (Pifeltro) ● efavirenz (Sustiva) ● etravirine (Intelence) ● nevirapine (Viramune) ● rilpivirine (Edurant) ```

Answer 4

``` Bind to the active site of enzymes needed for the maturation of HIV ● Total of 10 FDA approved protease inhibitors ○ Examples are Ritonavir, Nelfinovir, and Amprenavir Side effects of Protease Inhibitors ● Dyslipidemia: elevated levels of cholesterol and triglycerides ● Insulin resistance ● Cardiovascular disease ● Can lead to toxicity ```

Answer 5

Without ART ● Viral load ultimately exceeds CD4 count ● AIDS can develop much quicker With ART ● CD4 count remains higher than viral load for much longer

Answer 6

``` Nausea and vomiting ● Diarrhea ● Difficulty sleeping ● Dry mouth (Xerostomia) ● Headache ● Nausea ● Rash ● Dizziness ● Fatigue ```

Answer 7

``` Taken after an exposure to HIV in order to prevent its transmission ● Must be taken within 72 hours of exposure ● Treatment lasts 28 days ● Prevents transmission in 80% of cases ● Nausea is a common side effect ```

Answer 8

HIV/AIDS patients should be able to tolerate most routine dental procedures ● Perform comprehensive intraoral soft tissue, periodontal, and hard tissue examination ● If there is a presence of HIV in the oral cavity, first priority is to relieve pain and treat infections ● Procedures should minimize bleeding ● Consult physician if needed

Answer 9

Invasive procedures (extractions and endodontics) should be cautioned ○ An effort to reduce bleeding during procedures should be made ○ Especially important if patient has low platelet count ○ HIV/AIDS patients are immunocompromised. Antibiotic prophylaxis should be considered to reduce chances of infection ● Routine procedures like dental restorations (implants, fillings) have not shown to pose greater risks to HIV/AIDS patients.

Answer 10

``` Gloves (should never be reused) ● Protective eyewear ● Mask ● Safe handling/disposal of sharp objects (needles) ● Disposal of all PPE ● Sterilization ● Administer post-exposure prophylaxis within 72 hours if exposure occurs ```

Answer 11

``` HIV can be transmitted by dental tools ● Autoclaves are used to sterilize dental equipment and eliminate viruses like HIV ● All dental tools must be disinfected, as well as heat sterilized ```

Answer 12

Looks for antigens and antibodies of HIV in the patient ● Most common (18-45 days after exposure) Antibody Test: Only looks for antibodies in the patient ● Most rapid tests for HIV fall under this category (23-90 days after exposure)

Answer 13

normal patients have between 500-1200 cells/mm3, less than 200 indicates onset of AIDS

Answer 14

``` Test for copies of RNA ● Less than 20 is ideal ● Less than 10,000 is low ● Over 100,000 is high ● Patients can have counts of over 1 million ```

Answer 15

CD4 T cell levels should be tested for prior to invasive procedures ○ If less than 50 cell/mm3, consider antibiotic prophylaxis in order to prevent opportunistic disease. ○ Emphasize good oral health care post-procedure to prevent opportunistic disease. ■ Patient should inform dentist immediately if any unusual pain or discomfort occur post-procedure. ○ Neutrophil count less than 500 cell/mm3 may also warrant antibiotic prophylaxis ■ Measured using absolute neutrophil count (ANC)

case 5 Flashcards

(40 cards)