Quiz 1 Reverse Flashcards Preview

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Flashcards in Quiz 1 Reverse Deck (45):
1

1. Retrovirus2. Lentivirus - slow w/ long incubation period Able to replicate in non-dividing cells

What special types of virus is HIV?

2

ANY - doesn't matter the count, start ART -strength of recommendation inc. as CD4 cell count dec.

What CD4 count should AIDS Pts get Tx?

3

YES

Should pregnant ladies take ART?

4

NO - can inc. mortality

Should AIDS Pts w/ cryptococcal meningitis take ART?

5

1. NRTI2. NNRTI3. Protease inhibitors4. CCR5i5. Fusion inhibitors6. Integrase strand transfer inhibitors

What are the classes of ART drugs?

6

1. Emtricitabine - Emtriva2. Tenofovir - VireadTry to get into RNA structure

What are the NRTI & how do they work?

7

NRTI (Emtricitabine & Tenofovir)

Which ART does not undergo CYP metabolism?

8

NRTI (Emtricitabine & Tenofovir)

Which ART drug do you dose adjust for renal impairment?

9

1. Emtricitabine - Emtriva2. Tenofovir - Viread

What combo is in Truvada?

10

1. Efavirenz - Sustiva ADR - neuro & psychiatric

What are the NNRTI & common ADRs?

11

1. NNRTI (Sustiva)2. Protease inhibitors 3. CCR5i

Which ART drugs are metabolized by CYP3A4?

12

1. Sustiva (NNRTI)2. Truvada (Emtricitabine + Tenofovir (NRTI))

What combo is in Atripla?

13

1. Atazanavir - Reyataz2. Darunavir - Prezista3. Ritonavir - Norvir Inhibits viral assembly - virus can't get out of cell Monitor glucose in diabetic Pt

What are the protease inhibitors for ART & how do they work & what should you monitor?

14

Atazanavir PPIs - 12h apartH2 - w/in 10h

What ART drug should you be careful w/ PPIs or H2 blockers?

15

1. Inhibits 1st pass metabolism of other protease inhibitors 2. Inhibition of CD4 p-gp

What is ritonavir boosting?

16

Fusion inhibitors - Enfuvirtide - Fuseon

What is the only ART drug given by injection?

17

1. Enfuvirtide - Fuseon effects gp-41 structure

What are the fusion inhibitors & how do they work?

18

Fusion inhibitors - Enfuvirtide - Fuseon

Which ART drug inc. risk of pneumonia?

19

1. Raltelgravir - Isentress Prevents HIV DNA from getting into host DNA

What are the integrase strand transfer inhibitors & how do they work?

20

1. SJS2. Myopathy - careful w/ statins

Name some ADRs of ISTIs

21

1. Maraviroc - SelzentryInhibits cell entryGood early on but must determine tropism

What are the CCR5i & how do they work?

22

1. Hepatotoxicity2. MI/Myocardial ischemia3. Postural HOTN

Name some ADRs of ISTIs

23

1. Truvada2. Isentress4 wks min, start w/in 72hRisk estimated 0.3%

What are the recommended drugs for PEP?

24

1. Truvadaor just 2. Tenofovir

What are the recommended drugs for PrEP?

25

1. Prezista - protease inhibitor 2. Isentress - ISTIs

Which ART drugs must you take with truvada?

26

Ball others are RNA

Which hepatitis virus is DNA based?

27

all children (1 y/o) - fecal-oral transmisson1. Havrix2. Vaqta3. Twinrix (Hep A & B)

What are the recommendations for Hep A vaccine?

28

1. Newborns to 18 y/o2. Occupational exposure3. Hemodialysis Pts4. Frequent blood product recipients

Who should get Hep B vaccines?

29

Acute blood exposure - gives passive immunity w/in 7-14 days Covers 75% of people

Who gets Hep B immunoglobulins?

30

1. Inferferon-alpha - 16 wks2. Peginterferon - 48 wks3. Nucleoside analogs - min 1 yr

How do you treat Hep B?

31

Both1. Interferon2. Ribavirin

What is the standard of care for Hep C Tx?

32

1. Entecavir - Baraclude-act on reverse transcriptase2. Sofosbuvir - Sovaldi (also used in Hep C) -act on DNA polymerase

What are the nucleoside analogs for Hep B Tx & how do they work?

33

1. Cirrhotic Pts w/ hepatic decompensation from viral breakthrough2. Pts w/ suboptimal responses to initial monotherapy3. Pts coinfected w/ HIV4. Pts who have had a liver transplant

When is dual nucleoside analog therapy used in Tx of Hep B?

34

All injectable1. Interferon alpha-2B - Intron-A2. Interferon alfacon-1 - Infergen3. Peginterferon alpha 2A - Pagasys4. Peginterferon alpha-2B - Pegintron Careful w/ renal & hepatic impairment

What are the interferons? (For Hep B&C)

35

1. HA2. Fatigue3. Fever4. Psych changes - depression, confusion5. Bone marrow suppression6. Rashes & SJS7. GI problems

ADRs of interferons

36

Tx of Hep CPeginterferon Synergistic effect 1. Renal impairment2. Hepatic impairment3. Pregnant - teratogenic & embryocidal

What do you need to use Ribavirin with to work & when should you not use it?

37

1. Hemolytic anemia 2. Pulm toxicity3. Worsening of underlying cardiac disease4. Flu-like Sx5. GI complaints6. Pysch - depression, emotional lability, irritability, impaired concentration

ADRs Ribavirin

38

1. Bocepravir - Victrelis-Wk 4 & above2. Telaprevir - Incivek -First 12 wks then stop

What are the protease inhibitors for Hep C & when can you use them?

39

Genotype of Hep C

What does the length of therapy for Ribavirin depend upon?

40

1. Ribavirin2. Peginterferon

What do you need to use Protease inhibitors for Hep C with?

41

Anemiadec. dose if seen

Significant ADRs of Bocepravir (Victrelis)?

42

1. Anemia2. Hemorrhoids3. Anorectal discomfort4. Rash - Black box warning...SJS & MSOF

Significant ADRs of Telaprevir (Incivek)?

43

Hemagglutinin componentNeuraminidase component NEED vaccine every year!!!

How do you name influenza

44

Both used for prevention & Tx1. Oseltamivir - Tamiflu-use 36-48h from onset of Sx2. Zanamivir - Relenza (inhaled)Stops neuraminidase from cleaving sialic acid & hemagglutinin bond so virus gets stuck & can't shed

What are the neuraminidase inhibitors for flu & how do they work?

45

Tx of flu - usually only if Pt has allergy to Tamiflu1. Rimantadine - Flumadine2. Amantadine - Symmetrel (also Parkinson's drug)Works on M2 channel to prevent uncoating of virus...can't get into nucleusRenally adjusted

What are the adamantanes & how do they work?