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Flashcards in HIV therapy Deck (18):
1

when is it widely indicated to start ART

CD

2

3 possible rationale for starting earlier

1. cohort studies that suggest MandM benefit
2. reduce HIV inflammation
3. decreasing transmission

3

5 absolute indications to start

1. opp. infeciton
2. pregnancy
3. HBV coinfection
4. HIV assoc. nephropathy
5. HIV assoc. thrombocytopenia

4

what is effect of drug pressure on virus

causes resistant bugs to survive

5

5 goals of ART

1. supress viral rep
2. restore CD4
3. reduce MandM
4. improve QOL
5. prevent onward transmission

6

5 main classes of ART and the replication points that they hit

1. Entry inhibs - CD4 binding
2. NRTIs -reverse transcriptase
3. NNRTIs - reverse transcriptase
4. integrase inhibs. - viral DNA integration
5. protease inhib. - assembly

7

MOA of NRTIs

nucleoside reverse transcripase inhibs - fake nucleosides

8

**4 main NRTIs and their 2 combos

1. lamivudine (3TC)
2. abacavir (ABC)
3. tenefovir (TDF)
4. Emtricitabine (FTC)

TDF/FTC - most common
ABC/3TC

9

MOA of NNRTIs

bind at pocket distant from active site and block RT

10

** NNRTI to know and the combo

efavirenz (EFV)

TDF/FTC/EFV

11

MOA of protease inhibitors

stops enzymes from cleaving parts to make structure

12

major problem with NNTRIs

common drug interactions

13

** 3 protease inhibs

1. ritonavir (RTV)- mostly booster
2. atazanavir (ATV)
3. darunavir (DRV)

14

how does booster work

CYP450 inhibitor so get more of other drugs in the system

15

what is MOA of entry inhibitors

blocks binding to CCR5 coreceptor or fusion once they are bound

16

***2 main integrase inhibs to know

1. elvitagravir
2. dolutagravir

17

what is extra non-ARV booster now used too

cobicistat - only available with TDF/FTC/ELV

18

Naming drugs

Protease Inhibitors - always end in -navir (ex. darunavir, atazanavir)
Integrase Inhibitors- always end in -gravir (ex. raltegravir, elvitegravir)
NNRTIs - always has - vir- in the middle (ex. efaVIRenz, rilpiVIRine)
NRTI's - anything that does not follow the above 3 rules
Exceptions:
the 2 entry inhibitors

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