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18 Cards in this Set
- Front
- Back
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What is the difference between NRTIs and NNRTIs
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NRTIs - involved with the DNA process. interfere with and ultimately inhibit reverse transcriptase. Didanosine, Lamivudine, Tenofovir, Zidovudine, Emtricitabine
NNRTIs - do directly inhibit reverse transriptase. Efavirenz, Nevirapine |
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When should HIV therapy be started?
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any one of the following:
HIV + plus: AIDS defining illness CD4 <350 HIV associated nephropathy current hep B pregnant |
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What should be used in HIV+ pregnant women?
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2 NRTIs + 1 PI
lopinavir + zidovudine + lamivudine Also need C-section |
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What is the treatment and prophylaxis for Pneumocystis?
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TMP-SMX
Prophylaxis should be started if CD4 is <200 or if theres an oropharyngeal cadidiasis |
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What is the treatment and prophylaxis for Toxoplasmosis?
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T - TMP-SMX or pyrimethamine + sulfadiazine or clindamycin + leucovorin
P - TMP-SMX |
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What is the prophylaxis against coccidioidomycosis?
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Fluconazole or itraconazole
those living in an endemic area (southwest US), have positive IgM/IgG to Coccidioides immitis, and have CD4 <250 |
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What is the prophylaxis of histoplasmosis?
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Itraconazole
CD4 <150 or endemic area (eastern/central US) |
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When should PPV be administered?
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CD4>200 who have not received the vaccine within the last 5 years.
Those with a CD4 count <200, vaccine can be considered in special circumstances |
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When do you use Inactivated influenza vaccine?
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annually to all HIV+ pts. Live version is contraindicated
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When would you use MMR?
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all HIV+ pts with a CD4 >500
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When do you use HBV vaccine?
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all HIV+ pts who have never been exposed or have never been vaccinated.
Within 96 hours of exposure to chicken pox/shingles, those who have never been vaccinated, have no VZV history, have no VZV antibodies |
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When is interferon and ribavirin used?
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Treatment of chronic hep C in general pts.
HIV+ pts with acute HCV to prevent chronic. |
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What are the 50s antibiotics? 30s?
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50 - Chloramphenicol (static), Erythromycin (static - macrolides), Clindamycin (protein synthesis inhibitor)
30 - Tetracycline (static), Aminoglycosides (cidal) |
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What is the MOA of Aminoglycosides? Tetracyclines? Chloramphenicol? Erythromycin? Clindamycin?
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A - block initial steps of protein synthesis causing misreading of mRNA code.
T - block the acceptor site for incoming aminoacyl tRNA. No AA are available for protein synthesis. Ch - physically blocks the action of peptidyl transerase. The AA can't be joined to form a protein. E - block translocation. The AA canot be shifted into their proper position to allow for peptide bond formation. Cl - similar to chloramphenicol |
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What are sulfa antibiotics?
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sulfonamides - inhibit folate synthesis by bacteria.
prophylaxis and treatment of Toxoplasma and Pneumocystis. Combo with trimethoprim for empiric UTI. sulfadiazine, sulfisoxazole, sulfamethoxazole |
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What are the differences between 6-mercaptopurine and cytarabine?
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6 - inhibits de novo purine synthesis. Used especially for ALL
C - pyrimidine antagonist. Inhibits the redution of CDP to dCDP - DNA production ends. Used for non-lymphocytic leukemia. |
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How do fluoroquinolones work?
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inhibit bacterial DNA gyrase. preventing the replication of the DNA. Bacterium cannot copy adn utilize its own DNA.
good against G+ and G- |
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What is rifampin?
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transcription inhibitor.
bactericidal for intar- and extra-cellular Mycobacterium (especially TB) contact prophylaxis from N. Meningitidis and H. influenzae significant heptotox, bone marrow suppression, and thrombocytopenia. |
