med chem quiz 10

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med chem quiz 10
2012-12-09 12:52:12
anti viral

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  1. NRTI
    acid labile - do not take with fruit juice
    one of the most potent drugs used and least tolerated
    once a day dosing - chew or crush with 4 oz of water
    take on an empty stomach
    didanosine - videx
  2. NRTI
    well tolerated
    increased levels with TMP/SMZ - lowers metabolic clearance
    lactic acidosis
    lamivudine - epivir
  3. NRTI
    dosing based on weight
    increased neuropathy caused by TB drugs
    measure creatinine kinase for muscle degradation
    comes in extended release
    stavudine - zerit
  4. NRTI
    hypersensitivity tied to human leulocyte antigen (HLA)B 5701 allele - more common in whites than african blacks and asians
    hypersensitivity (rash) withiin first three weeks
    do not ever restart therapy
    metabolized by alcohol dehydrogenase
    abacavir sulfate - ziagen
  5. first NRTI
    neutropenia - fever, chills, unusual tiredness - decrease dose if count <500
    increased bone marrow toxicity
    zidovudine - retrovir
  6. NRTI
    pediatric use
    does not inhibit glucuronidation
    <4% bound to plasma protein - no loading dose
    F - rapidly absorbed
    emtricitabine - emtriva
  7. Main side effect of NNRTI's
    steven johnsons syndrome
  8. NNRTI
    >50% will experience CNS side effects
    known teratogen
    efavirenz - sustiva
  9. NNRTI
    black box warning - increased liver enzyme, rare but fatal hepatitis
    nevirapine - viramune
  10. NNRTI
    compliance issues - 4 tabs TID
    limit viagra
    antacid rule
    delaviridine mesylate - rescriptor
  11. NNRTI
    do not combine with another NNRTI - resistance
    if patient can't swallow, dissolve in a glass of water
    2 tabs bid after a meal
    metabolized by TON of enzymes
    include 100mg ritonavir
    etravirine - intelence
  12. NNRTI
    do not combine with another NNRTI - resistance
    use in treatment naive adult patients
    QT elongation possible
    check viral load 100,000 copies/ml
    rilpivirine - endurant
  13. nucleotide analogue
    phosphonate prodrug
    take with high fat meal
    resistance - expressing K65R mutation
    not a CYP450 substrate
    tenofovir - viread
  14. HIV protease inhibitor
    PR & QT prolongation if used with ritonavir
    4% bioavailability - must be taken with a high fat meal
    extreme caution in hemophiliacs
    SE - insulin resistance
           elevated liver enzymes
    saquinavir mesylate - invirase
  15. most poorly tolerated of the anti-virals due to severe diarrhea and severe flu like symtoms that do not wane
    HIV protease inhibitors
  16. HIV protease inhibitor
    extremely severe diet restrictions
    SE - nephrolithiasis, take >1.5 liters of water or more per day to avoid.
    must be stored in its original container
    indinavir - crixivan
  17. HIV protease inhibitor
    most potent, poorly tolerated
    potent inhibitor of CYP3A4
    must be taken with high fat meal
    must be kept in refrigerator
    ritonavir - norvir
  18. HIV protease inhibitor
    must be taken with a high fat snack
    swallow quickly - prone to dissolve in the mouth
    nelfinavir - viracept
  19. HIV protease inhibitor
    many big pills - 3 400s BID
    formulated with vitamin E
    amprenavir - agenerase
  20. HIV protease inhibitor
    prodrug of amprenavir - agenerase (AMP)
    no vitamin E
    fosamprenavir - lexiva
  21. HIV protease inhibitor
    azapeptide inhibitor
    absorption increased with food 70%
    metabolized by UGT1A1
    atazanavir - reyataz
  22. HIV protease inhibitor
    first non-peptide based agent
    refrigerate capsules prior to dispensing and do not store above 77 degrees
    must be taken with 200mg ritonavir
    tipranavir - aptivus
  23. HIV protease inhibitor
    non-peptide based agent
    take with 100mg ritonavir, increases 14X
    may result in new onset diabetes
    darunavir - prezista
  24. combo product that cuts infection rates if taken prophylactically
    emtricitabine and tenofovir - truvada
  25. HIV entry inhibitor
    reacts with glycoproteins on cell surface
    BID subQ
    effective in children 6-16
    $21,000 of year
    enfuvirtide - fuzeon "T-120"
  26. HIV entry inhibitor
    new class - CCR5 (not CXCR4, or D/M) coreceptor antagonist
    use trophism testing for compatability
    SE - postural hypotension
    maraviroc - selzentry
  27. INSTI - new class
    use in combination when viral strain is resistant to multiple agents
    eliminated via UGT1A1 glucuronidation
    monitor creatinine kinase
    raltegravir - isentress
  28. vaccine prophylaxis for HPV
    effective clinical trials for cancers and genital warts
    does not protect against infected virus but will protect against other serotypes (100 others)
    quadrivalent recombinant vaccine
  29. vaccine prophylaxis for HPV
    100% efficacy in preventing precancerous lesions due to HPV types 16 & 18 for up to 5.5 years
  30. HIV protease inhibitor
    co-formulated with ritonavir
    take with food
    lopinavir - kaletra
  31. NRTI
    very weak drug not used much any more
    zalcitabine - hivid