HIV Pharmacotherapy

Card Set Information

Author:
giddyupp
ID:
64012
Filename:
HIV Pharmacotherapy
Updated:
2011-02-04 11:48:55
Tags:
HIV Pharmacotherapy PHPR523 Test2
Folders:

Description:
HIV Pharmacotherapy
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user giddyupp on FreezingBlue Flashcards. What would you like to do?


  1. What is the life cycle of HIV?
    • Binding
    • Fusion
    • Reverse transcription
    • Nuclear localization/uncoating
    • Integration
    • Transcription
    • Splicing
    • Translation +/- modification
    • Assembly/budding
    • Maturation
  2. What agents are used to target budding in HIV?
    Miraviroc
  3. What are the characteristics of Maraviroc?
    • Blocks CCR5 receptor (need a Tropism test before using this agent)
    • Acceptable for tx naive pts (not DOC or even alternative)
    • 3A4 substrate
    • Myopathy
  4. What agents are used to target fusion in HIV?
    Enfuvirtide
  5. What are the characteristics of Enfuvirtide?
    • Last line, salvage tx
    • Difficult to get into solution
    • Must be refridgerated
    • Skin nodules
  6. What agents are used to target reverse transcriptase conversion of viral RNA to DNA in HIV?
    • NRTIs
    • NNRTIs
  7. What are the NRTIs used for HIV?
    • Abacavir
    • Didanosine
    • Emtricitabine
    • Lamivudine
    • Stavudine
    • Tenofovir disaproxil fumarate
    • Zidovudine
  8. What are the NNRTIs used for HIV?
    • Delavirdine
    • Efavirenz
    • Etravirine
    • Nevirapine
  9. What are the characteristics of Abacavir?
    • Tremendously effective NRTI
    • No food effect
    • Alcohol increases levels
    • life-threatening hypersensitivity (need a HLA-B*5701 test to use)
  10. What are the characteristics of Didanosine?
    • Good secondary drug
    • Take on empty stomach
    • Pancreatitis (common)
    • Peripheral neuropathy
  11. What are the characteristics of Emtricitabine?
    • Similar to Lamivudine
    • V. long half-life (39h)
    • Good tolerance and compliance
  12. What are the characteristics of Lamivudine?
    • Great combo drug
    • Can resensitize to Zidovudine
    • Caution discontinuing in Hep B pts (rebound hepatitis)
    • Very little SE
  13. What are the characteristics of Stavudine?
    • Falling out of favor as 2nd line
    • Pancreatitis
    • Peripheral neuropathy
    • Metabolic syndrome
    • Lipodystrophy
  14. What are the characteristics of Tenofovir?
    • V. effective
    • a nucleotide (requires 1 less phosphorylation than other NRTIs)
    • Give with food
    • Big DI with Didanosine
    • Nephrotoxic
    • Hepatotoxic
    • HA
    • NVD
  15. What are the characteristics of Zidovudine?
    Bone marrow suppression (neutropenia and anemia)
  16. What are the class side effects of NRTIs?
    • Lactic acidosis
    • Peripheral neuropathy ("D" drugs)
    • Watch dosing in renal dysfunction
  17. What are the class effects of NNRTIs?
    • Rash
    • Hepatotoxicity
    • Complete cross-resistance (except Etravirine)
    • multiple DI
  18. What are the characteristics of Delavirdine?
    • Least effective NNRTI
    • 3A4 inhibitor
  19. What are the characteristics of Efavirenz?
    • Most used/effective NNRTI
    • Take on an empty stomach
    • Mixed 3A4 inhibition/induction
    • CNS SE (give at night)
  20. What are the characteristics of Etravirine?
    • Newest approved
    • Take after a meal
    • No cross-resistance
  21. What are the characteristics of Nevirapine?
    • 2nd most used NNRTI
    • 3A4 inducer (self-induces)
    • Most hepatotoxic NNRTI (don't use if CD4 >250 in females and >400 in males)
    • Avoid in severe liver dysfunction
    • Least metabolic SE
  22. What agents are used to inhibit integration of viral DNA into cellular DNA in HIV?
    Raltegravir
  23. What are the characteristics of Raltegravir?
    • Recently moved to 1st line
    • Myopathy (worse than Maraviroc - check CPK routinely)
    • HA
    • NVD
  24. What agents are used to inhibit protease assembly and maturation in HIV?
    • Atazanavir
    • Darunavir
    • Fosamprenavir
    • Indinavir
    • Lopinavir/Ritonavir
    • Nelfinavir
    • Ritonavir
    • Saquinavir
    • Tipranavir
  25. What are the class effects of the PIs?
    • Generally accepted as most effective
    • Kind of work like vaccines because they make the live virus non-virulent
    • 3A4 inhibition
    • Lipodystrophy
    • Dyslipidemia
    • Hyperglycemia
    • Elevation of transaminases
  26. What are the characteristics of Atazanavir?
    • Most used PI
    • Boost with Efavirenz and Tenofovir
    • Take with food
    • Big interaction with PPIs and H2 blockers
    • Hyperbilirubinemia (usually not problematic)
    • maybe less metabolic effects than other PIs
  27. What are the characteristics of Darunavir?
    • 1st line PI
    • Boost with Ritonavir
    • Take with food
    • Sulfonamide moiety
  28. What are the characteristics of Fosamprenavir?
    • Alternative PI
    • Rash
  29. What are the characteristics of Indinavir?
    • Take on empty stomach (unless boosted)
    • V. labile to humdity
    • Great distribution to various tissues
    • Nephrolithiasis (drink 6 additional 8oz glass of water/d)
  30. What are the characteristics of Lopinavir/Ritonavir?
    • 1st line or salvage
    • Take with food (42% alcohol)
    • Refrigerate to extend shelf-life
    • DOC in pregnancy
  31. What are the characteristics of Nelfinavir?
    Take with food
  32. What are the characteristics of Ritonavir?
    • Used as a booster, not as a PI
    • Refrigeration extends shelf-life (capsules only)
    • Greatest 3A4 inhibition
    • Most metabolic effects?
  33. What are the characteristics of Saquinavir?
    • Salvage tx
    • ECG abnormalities (QT prolongation)
    • NVD
  34. What are the characteristics of Tipranavir?
    • Salvage tx
    • Unique resistance profile
    • Refrigeration extends shelf-life
    • Sulfonamide moiety
    • Intracranial hemorrhage (v. rare)
  35. What are the combination products used in HIV?
    • Atripla (Efavirenz + Emtricitabine + Tenofovir)
    • Trizivir (Abacavir + Lamivudine + Zidovudine)
    • Kaletra (Lopinavir + Ritonavir)
    • Combivir (Lamivudine + Zidovudine)
    • Truvada (Emtricitabine + Tenofovir)
    • Epzicom (Abacavir + Lamivudine)
  36. What is the preferred NNRTI-based regimen for HIV in therapy naive pts?
    Atripla (Efavirenz + Emtricitabine + Tenofovir)
  37. What is the alternative NNRTI-based regimen for HIV in therapy-naive pts?
    • Efavirenz + Epzicom (Abacavir + Lamivudine) or Combivir (Zidovudine + Lamivudine)
    • Navirapine + Combivir
  38. What is the preferred PI-based regimen for HIV in therapy-naive pts?
    • Atazanavir + Ritonavir + Truvada (Emtricitabine + Tenofovir)
    • Darunavir + Ritonavir + Truvada
  39. What is the alternative PI-based regimen for HIV in therapy-naive pts?
    • Atazanavir + Ritonavir + Epzicom (Abacavir + Lamivudine) or Combivir (Zidovudine + Lamivudine)
    • Fosamprenavir + Ritonavir + Epzicom or Combivir or Truvada
    • Kaletra (Lopinavir + Ritonavir) + Epzicom or Combivir or Truvada
  40. What is the preferred INSTI-based regimen for HIV in therapy-naive pts?
    Raltegravir + Truvada (Tenofovir + Emtricitabine)
  41. What is the preferred regimen for HIV in pregnant women?
    Kaletra (Lopinavir + Ritonavir) + Combivir (Zidovudine + Lamivudine)
  42. What is the procedure for Post Exposure Prophylaxis?
    • Determine HIV status of source
    • Begin 2-3 drug regimen ASAP (<2h)
    • Consult with ID physician to determine risk of transmission and duration of tx

What would you like to do?

Home > Flashcards > Print Preview