HIV

Question 1

What kind of virus is HIV?

Answer 1

Retrovirus and lentivirus

Question 2

What enzyme allows RNA to be converted into DNA?

Answer 2

Reverse transcriptase

Question 3

What enzyme allows HIV viral maturation?

Answer 3

Protease

Question 4

What enzyme allows viral genes to enter nucleus and host DNA?

Answer 4

Integrase

Question 5

When should antiretroviral therapy (ART) be started?

Answer 5

All HIV (+) patients

Question 6

Should ART be used in pregnancy? Why of why not?

Answer 6

Yes. prevents transmission and provides clinical benefit to mother

Question 7

In what condition should ART initiation be delayed?

Answer 7

cryptococcal meningitis

-can increase mortality if started to early, refer to specialist

Question 8

Preferred Regimen to treat AIDS

Answer 8

NNRTI-base
-efavirenz/tenofovir/emtricitabine
Protease Inhibitor- based
-Darunavir or Ataxanavir + tenofovir/emtricitabine
INST- based
-Raltegravir + tenofovir/emtricitabine

Question 9

Post exposure HIV prophylaxis should include

Answer 9

3 anti-HIV drugs, 4 week minimum

-Dual NRTI+ protease inhib or INSTI

Question 10

Pre-exposure prophylaxis should include

Answer 10

tenovir/emtrictabine daily

-ie to prevent transmission from mother to baby

Question 11

Dose a NRTI

Answer 11

Truvada

one tablet daily

Question 12

Dose a NNRTIs

Answer 12

Atripla

one tablet daily

Question 13

Dose a protease inhibitor

Answer 13

Prezista 800mg

one table daily, long with Truvada

Question 14

Dose a fusion inhibitor

Answer 14

Enfuvirtide(Fuseon) 90mg

Inject subq twice a day

Question 15

Dose an integrase strand transfer inhibitor

Answer 15

Isentress 400mg

1 tablet twice a day, with Truvada

Question 16

Dose a CCR5 inhibitor

Answer 16

Selzentry 300mg

1 tablet twice a day

Question 17

How are NRTIs excreted from the body

Answer 17

renally

30-49 adjust dose, <30 not recommended

Question 18

General class effect ADR seen in NRTI:
what drugs in this class is this generally not seen

Answer 18

Lactic Acidosis, Hepatomegaly

-not generally seen with abacavir, emtricitabine, lamivudine, tenofovir

Question 19

Who does no one continue to prescribe the NRTIs didanosine and stavudine?

Answer 19

Peripheral Neuropathy

Question 20

How are NNRTIs metabolized?

Answer 20

CYP3A

can act as an inhibitor or inducer

Question 21

MOA NRTI

Answer 21

integrate into structure, changing RNA/DNA, leading to host cell death

Question 22

MOA NNRTI

Answer 22

block activity of reverse transcriptase

Question 23

Name 2 NRTIs

Answer 23

Emtricitabine (Emitra)

Tenofovir (Viread)

Question 24

Name 2 NNRTIs

Answer 24

Efavirenz (Sustiva)
Delaviridine (Rescriptor)
Etravirine (Intelence)
Nevirapine (Viramune)
Rilpivirine (Endurant)

Question 25

ADRs of efavirenz

Answer 25

dizzy, depression, insomnia, HA, rash, increase total cholesterol, triglycerides, HDL, GI symptoms

Question 26

Name 3 protease inhibitors

Answer 26

atazanavir (reyataz) darunavir (prezista) ritonavir (norvir)

Question 27

What drug class reduces viral shedding?

Answer 27

protease inhibitors

Question 28

How are protease inhibitors metabolized?

Answer 28

CYP3A4

Question 29

What drug interaction could affect effectiveness of a protease inhibitor?

Answer 29

stomach pH drugs H2blocker, PPI also keep in mind CYP3A4 metabolism

Question 30

Atazanavir can be used _______ an H2 blocker or________ after a PPI

Answer 30

with or 10 hours after H2blocker | 12hrs after PPI

Question 31

What drug group can lead to new onset diabetes or worsen a diabetics control?

Answer 31

Protease Inhibitors | -monitor blood sugar

Question 32

What drug is used to increase maximum concentration of concomitant protease inhibitor

Answer 32

Ritonavir

Question 33

What ADR would you be concerned for with atazanavir?

Answer 33

nephrolithiasis

Question 34

What ADR would be watch for usin Darunavir?

Answer 34

pancreatitis, sulfonamide cross-reactions

Question 35

Name a fusion inhibitor

Answer 35

enfuvirtide (fuseon)

Question 36

Name the only HIV drug given by injection

Answer 36

enfuvirtide (fuseon)

Question 37

Which HIV drug would be a pneumonia risk

Answer 37

Fuseon

Question 38

Name an integrase strand inhibitor

Answer 38

Elvitegravir which is integrated into | Raltelgravir (Isentress)

Question 39

what is cobicistat

Answer 39

CYP3A inhibitor that allos elvitegravir to obtain therapeutic levels

Question 40

ADRs of Isentress

Answer 40

Skin & Hypersensitivity- SJS | Myopathy

Question 41

ADR concern for patient on statins and integrase strand inhibitor

Answer 41

rhabdomyolysis

Question 42

Name a CCR5 Inhibitor

Answer 42

Maraviroc (Selzentry)

Question 43

How are ccr5 inhibitors metabolized

Answer 43

CYP3A

Question 44

ADRs of Selzentry

Answer 44

Hepatotoxicity w/allergic features Myocardial ischemia/infarction postural hypotension