HIV drugs and antibiotics that can't be used in pregnancy Flashcards Preview

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Flashcards in HIV drugs and antibiotics that can't be used in pregnancy Deck (19):
1

typical HAART therapy

give 2 nucleoside reverse transcriptase inhibitors and one non-nucleoside reverse transcriptase inhibitor or 1 protease inhibitor or 1 integrase inhibitor

2

protease inhibitors: drug name, mechanism

all of these drugs end in -navir.
recall that virion assembly requires HIV-1 protease, which cleaves the products of HIV mRNA into functional parts. protease inhibitors prevent the maturation of new viruses.

3

ritonavir considerations

this is a protease inhibitor that can boost other drug concentrations by inhibition cytochrome P-450.

4

toxicity of protease inhibitors

hyperglycemia, GI intolerance, lipodystrophy. indinavir can cause nephropathy and hematuria

5

NRTIs. Exceptions within this group?

nucleoside reverse transcriptase inhibitors. these all inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain (they lack a 3' OH group). tenofovir is a nucleotide, all others are nucleosides that must be phosphorylated to be active.

6

What drug is used to decrease the likelihood of fetal transmission during pregnancy?

ZDV (zidovudine, used to be called AZT)

7

toxicity of the NRTIs

bone marrow suppression (may be reversed with G-CSF and erythropoietin), peripheral neuropathy, lactic acidosis (except tenofovir), rash, anemia (ZDV), pancreatitis (esp. didanosine)

8

Efavirenz

this is an NNRTI (non-nucleoside reverse transcriptase inhibitor). others include nevirapine, and delaviridine. these bind to RT at a side different from NRTIs. they don't require phosphorylation to be active or compete with nucleotides.

9

NNRTI toxicities

all case rash and hepatotoxicity. vivid dreams and CNS symptoms are seen with efavirenz. delaviridine and efavirenze are contraindicated in pregnancy

10

integrase inhibitor

raltegravir. this inhibits HIV genome integration into the hose cell by reversibly inhibiting HIV integrase.

11

raltegravir toxicity

hypercholesterolemia

12

enfuvirtide: mechanism

binds gp41 to inhibit viral entry and can cause skin rxn at injection site

13

maraviroc mechanism

binds CCR-5 on surface T cells/monocytes to inhibit interaction with gp120.

14

interferon mechanism

these are glycoproteins usually made by virus infected cells. they exhibit many antiviral and antitumor properites

15

IFN-alpha

used for chronic hep B and C, kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcionoma, and malignant myeloma.

16

IFN-beta

used in multiple sclerosis

17

IFN-gamma

used in chronic granulomatous disease

18

toxicities of interferons

neutropenia and myopathy

19

what antibiotics should be avoided in pregnancy?

sulfonamides (kernicteris) aminoglycosides (ototoxic), fluoroquinolones (cartilage damage), clarithromycin (embryotoxic), tetracyclines (discolored teeth and inhibition of bone growth), ribavirin (teratogenic), griseofulvan (teratogenic), chlormphenicol (grey baby syndrome) (SAFe Children Take Really Good Care)