Med Chem HIV/Opportunistic Infections

Question 1

HIV is a retrovirus and had (single/double) stranded RNA

Answer 1

Double

Question 2

HIV infects which two types of cells?

Answer 2

CD4+ T cells and macrophages

Question 3

Which is the main strain of HIV found in North America?

Answer 3

HIV B

Question 4

Receptors involved in HIV infection

Answer 4

. CD4
. CXCR4
. CCR5

Question 5

Which two drugs are entry inhibitors?

Answer 5

. Enfuvirtide (fusion and penetration)
. Maraviroc (chemokine antagonist)

Question 6

HIV protease inhibitor examples

Answer 6

. Atazanavir
. Darunavir
. Fosamprenavir
. Indinavir
. Lopinavir
. Nelfinavir
. Ritonavir
. Saquinavir
. Tipranavir

Question 7

Integration, transcription and translation inhibitor examples

Answer 7

. Raltegravir
. Elvitegravir

Question 8

Lamivudine and apricitibine drug class

Answer 8

Reverse transcriptase inhibitors

Question 9

What are the 6 agents classified as NRTIs?

Answer 9

. Emtricitabine and lamivudine (cytosine analogs)
. Abacavir and didanosine (adenosine or guanine analogs)
. Stavudine and zidovudine (thymidine analogs)

Question 10

Nucleotide reverse transcriptase inhibitor example

Answer 10

Tenofovir disoproxil fumarate

Question 11

Non-nucleoside analog reverse transcriptase inhibitors MOA

Answer 11

Inhibit viral DNA replication by binding at the allosteric non-binding site of RT, causing a conformational change of the active site

Question 12

Protease function of HIV virus replication

Answer 12

Protease processes GAG and POL polyproteins into mature HIV components

Question 13

True or false: HIV protease inhibitors should be used with caution due to similarities in HIV protease and human protease

Answer 13

False. HIV protease inhibitors are specific to HIV protease due to significant differences from human protease

Question 14

Integrase inhibitor MOA

Answer 14

Prevent binding of the pre-integration complex to host cell DNA, thus, terminating the integration step of HIV replication

Question 15

Which of the following opportunistic infections typically presents with a symmetrical ground glass look in imaging?
a. PJP
b. TE
c. Cryptococcus
d. MAC

Answer 15

a. PJP

Question 16

Recommended therapeutic regimen for primary PJP prophylaxis?

Answer 16

. Bactrim DS qd

Question 17

Alternative therapeutic regimen for primary PJP prophylaxis?

Answer 17

. Dapsone 100mg PO daily
. Pentamidine (nebulized) 300mg/mo
. Atovaquone 1500mg PO daily

Question 18

Recommended therapeutic regimen for mild/moderate PJP vs moderate/severe PJP?

Answer 18

. Mild/moderate: Bactrim DS PO for 21 days
. Moderate/severe: Bactrim DS PO or IV for 21 days

Question 19

When is secondary prophylaxis of PJP initiated?

Answer 19

After 21 day PJP treatment course

Question 20

CD4 count less than ___ cell/mm^3 puts immunocompromised patients at greatest risk for TE

Answer 20

50

Question 21

Recommended therapeutic regimen for primary TE prophylaxis?

Answer 21

. Bactrim DS qd

Question 22

What is the purpose of leucovorin?

Answer 22

Rescue therapy for mitigating toxicity associated with overdosage of folic acid antagonists