Hiv Antivirals

Front 1

What are the 5 therapeutic targets within the retroviral life cycle?

Back 1

1) Chemokine and CD4 receptors
2)Attachment and fusion
3)Reverse Transcriptase
4)Integrase
5)Maturation

Front 2

What is a retrovirus?

Back 2

It is any group of viruses that contain two single-strand linear RNA molecules. It carries a genetic blueprint in the form of RNA instead of DNA.

Front 3

What does the CD4 receptors on T cells bind with on the surface of the viral particle?

Back 3

gp120

Front 4

What stabilizes the T cell/viral complex, allowing gp41-mediated fusion of the virus membrane with the target cell membrane?

Back 4

CCR5 chemokine

Front 5

This glycoprotein mediates fusion of the virus membrane with the target cell membrane?

Back 5

gp41

Front 6

What is the function of integrase?

Back 6

It incorporates viral DNA into the host DNA.

Front 7

What functions to copy viral RNA into viral DNA?

Back 7

reverse transcriptase

Front 8

This functions to clip newly created viral proteins into usable parts to be packaged for assembly.

Back 8

Protease

Front 9

Name the two HIV drug classes whose MOA is to block the actions of reverse transcriptase.

Back 9

NRTIs and NNRTIs

Front 10

What is the MOA of Protease Inhibitors?

Back 10

block HIV protease

Front 11

What is the MOA of Entry Inhibitors?

Back 11

They are all designed to prevent the entry of HIV into the cell.

Front 12

What are the 5 HIV drug classses?

Back 12

*NRTI
*NNRTI
*Protease Inhibitors
*Entry Inhibitors
*Integrase Inhibitor

Front 13

What does NRTI stand for?

Back 13

Nucleoside/Nucleotide Reverse Transcriptase Inhibitor

Front 14

What does NNRTI stand for?

Back 14

Non-nucleoside Reverse Transcriptase Inhibitor

Front 15

What are the 8 NRTIs?

Back 15

1) Abacavir
2) Didansosine
3) Tenofovir
4)Lamivudine
5) Emtricitabine
6) Zalcitabine
7) Stavudine
8) Zidovudine

Front 16

What are the 4 NNRTIs?

Back 16

1) Efavirenz
2) Nevirapine
3)Delavirdine
4)Etravirine

Front 17

What are the 8 Protease Inhibitors?

Back 17

1) Atazanavir
2)Darunavir
3) Fosamprenavir
4)Indinavir
5)Lopinavir
6) Nelfinavir
7)Saquinavir
8)Tipranavir

Front 18

What drug class does Indinavir belong to?

Back 18

Protease Inhibitor

Front 19

What drug class does Raltegravir belong to?

Back 19

Integrase Inhibitor

Front 20

What drug class does Saquinavir belong to?

Back 20

Protease Inhibitor

Front 21

What drug class does Maraviroc belong to?

Back 21

Entry Inhibitor

Front 22

What drug class does Zalcitabine belong to?

Back 22

NRTI

Front 23

What NRTI is a nucleoTIDE analog and only requires 2 phosphorylations?

Back 23

Tenofovir

Front 24

Which drug is associated with hypersensitivity syndrome related to the presence of HLA-B*5701?

Back 24

Abacavir

We must test for this mutation before starting a patient on this drug.

Front 25

Which NRTI is safe in pregnancy and also approved for HBV?

Back 25

Lamivudine

Front 26

This drug is not a 1st line choice due to ADRs such as fat wasting, peripheral neuropathy, lactic acidosis, and hepatic steatosis.

Back 26

Zalcitabine

Front 27

Which 2 NNTRIs are the most potent?

Back 27

Efavirenz and Nevirapine

Front 28

Which two Protease Inhibitors are sulfonamides?

Back 28

Darunavir and Tipranavir

Front 29

Redistribution of fat, leading to central obesity is a common side effect of this class of drug?

Back 29

Protease Inhibitor

Front 30

What class of drug does Enfuvirtide belong to?

Back 30

Entry Inhibitor

Front 31

Which drug has the side effect of hyperpigmentation of the skin?

Back 31

Emtricitabine

Front 32

What class of drug does Emtricitabine belong to?

Back 32

NRTI

Front 33

This protease inhibitor is associated with the least amount of ADRs.

Back 33

Atazanavir

Front 34

Describe the MOA of Maraviroc

Back 34

Maraviroc is an entry inhibitor that targets CCR5. It prevents the binding of gp120. When this happens, gp41 fusion cannot occur. Thus, the virus cannot enter the cell.

Front 35

How can resistance occur?

Back 35

Resistance can occur with as little as one mutation in the virus, but it usually takes 3 to 5 mutations before the virus is resistant.
Monotherapy with the NNRTIs would almost cause automatic resistance to develop. This is the reason for multiple drug regimines.

Front 36

Injection site reactions are associated with this Entry Inhibitor.

Back 36

Enfuvirtide

Front 37

What adverse affects are listed in the packet for Raltegravir?

Back 37

none

Front 38

How are all the NNRTIs eliminated?

Back 38

hepatic metabolism

Front 39

What NNRTI is associated with psychotic dreams?

Back 39

Efavirenz

Front 40

Which protease inhibitor is a strong 3A4 inhibitor used sometimes to increase concentrations of other drugs?

Back 40

Ritonavir

Front 41

Which NRTI was the first nucleoside approved in 1987 and nicknamed AZT?

Back 41

Zidovudine

Front 42

Which drug is used to prevent transmission during pregnancy, IV during labor, and then syrup given to newborns?

Back 42

Zidovudine

Front 43

Which NNRTI is teratogenic?

Back 43

Efavirenz

Front 44

This drug class is associated with developing a rash.

Back 44

NNRTIs

Although rare, SJS could happen

Front 45

Which NNRTIs are inducers of 3A4?

Back 45

Nevirapine
Efavirenz
Etravirine

Front 46

Which NNRTI is an inhibitor of 3A4?

Back 46

Delavirdine

Front 47

This NNRTI is an inducer and substrate of 2B6 and 3A4.

Back 47

Efavirenz

Front 48

What is a possible HBV complication with Emtricitabine?

Back 48

resistance or flare-up of HBV is possible if Emtricitabine is discontinued and the drug was also being used to tx HBV.

Front 49

Which NNRTI has mixed metabolism, but is known as an inducer and inhibitor?

Back 49

Etravirine

Front 50

Which NRTI can cause dose dependent peripheral neuropathy and pacreatitis?

Back 50

Didanosine

Front 51

Name the two chemokine receptors.

Back 51

CCR5 and CxCr4

Note: CxCr4 is pretty advanced HIV or AIDs and the outlook is not too good.

Front 52

Which NRTI must be a buffered tablet due to its instability in acidic pH?

Back 52

Didanosine

Front 53

Which class of drugs bind to a hydrophobic pocket in the p66 subunit of reverse transcriptase as part of their MOA?

Back 53

NNRTI

Front 54

Do NRTIs require phosphorylation to become active?

Back 54

yes

Front 55

Do NNRTIs require phosphorylation to become active?

Back 55

no

Front 56

These drugs get incorporated into viral DNA and cause chain termination due to the missing 3' OH.

Back 56

NRTIs

Front 57

This drug is given as a prodrug called Disoproxil to improve oral absorption.

Back 57

Tenofovir

Front 58

Which drug is a purine analog of guanosine?

Back 58

Abacavir

Front 59

Which drug is a purine analog of adenosine?

Back 59

Didanosine

Front 60

Which drug is a pyrimidine analog of cytidine?

Back 60

Lamivudine

Front 61

Which drug 2 drugs are pyrimidine analogs of thymidine?

Back 61

Zalcitabine and Zidovidine (AZT)

Front 62

Which HIV antiviral is associated with myelosuppression?

Back 62

Zidovidine (AZT)

Front 63

Which Entry Inhibitor targets gp41?

Back 63

Enfuvirtide

Front 64

Describe the MOA of Enfuviritide

Back 64

When Enfuvirtide is introduced into the body, it binds to gp41 and prevents formation of the helix. Now, the virus can no longer enter the cell.

Front 65

Which drug class is associated with the side effect of cushingoid appearance and buffalo hump?

Back 65

Protease Inhibitors

Front 66

Which drug is used for post needlestick prophylaxis?

Back 66

Zidovudine (AZT)