Bug-Drug Quiz #3 Flashcards


Set Details Share
created 1 year ago by abedfordpowell
3 views
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:

1

What (7) agents are nucleoside/tide reverse transcriptase inhibitors? (NRTIs)

1. Abacavir

2. Lamivudine

3. Emtricitabine

4. Tenofovir

5. Zidovudine

6. Stavudine

7. Didanosine

2

What are class adverse effects of NRTIs?

Anemia

Granulocytopenia

Myopathy

Peripheral neuropathy

Pancreatitis

3

Which NRTI is a synthetic guanosine analog?

Abacavir

4

Which agent is associated with HLA-B*5701?

Abacavir

5

Which agent is associated with a hypersensitivity run (fever, abdominal pain, GI complaints)

Abacavir

6

Which agent is associated with an increased half life when taken with large doses of ethanol?

Abacavir

7

Which two NRTI's should not be used together?

Lamivudine

Emtricitabine

8

Which two agents are cytidine analogues active against HIV-1, HIV-2, and HBV?

Lamivudine

Emtricitabine

9

Which two NRTIs have low affinity for DNA therefore low toxicities?

Lamivudine

Emtricitabine

10

3TC ADE's?

Headache

Neutropenia

Nausea

11

FTC ADE's?

Hyperpigmentation of the skin, especially in sun-exposed areas

12

Which NRTI has high levels of resistance with M184V and M184I?

Emtricitabine

13

Which NRTI is a derivative of 5-AMP that lacks a complete ribose ring?

Tenofovir

14

Which NRTI is the only nucleotide analogue on the market?

Tenofovir

15

Which NRTI is used for HIV pre-exposure prophylaxis?

Tenofovir

16

Which NRTI is associated with Fanconi syndrome (excessive amount of phosphorus, glucose, protein, and uric acid in the urine)?

Tenofovir

17

ADE's of Tenofovir?

1. Fanconi syndrome

2. Osteomalacia

3. Decreased BMD

18

Which version of Tenofovir is rapidly hydrolyzed to the active form?

TDF

19

Which version of Tenofovir is taken up into t-cells and then is converted to tenofovir?

TAF

20

Which version of tenofovir is associated with lower levels of circulating TFV?

TAF

21

Which NRTI is used to prevent congenital transfer of HIV?

Zidovudine

22

ADEs of Zidovudine:

Nail hyperpigmentation

Skeletal myopathy

Mitochondrial toxicity

Bone marrow suppression (anemia, leukopenia)

23

ADEs of Stavudine?

Peripheral neuropathy

Progressive motor neuropathy- Guillian-Barre syndrome

Lactic acidosis

Hepatic steatosis

Lipoatrophy

24

Which NRTI is acid labile and administered with an antacid buffer?

Didanosine

25

ADEs of Didanosine

Pancreatitis (mitochondrial toxicity)

Optic neuritis

26

Which class of agents bind to the hydrophobic pocket in the p66 unit of the HIV-1 reverse transcriptase?

NNRTIs

27

NNRTI's are active against HIV-1/ other retroviruses? T/F

False

28

NNRTI's have activity against host cell DNA polymerases?

False

29

Efavirenz:

Bioavailability increased with high-fat meal

Poor CNS penetration

Should be taken at bedtime on an empty stomach

30

Which NNRT is associated with dysphoris/vivid dreams/ insomnia?

Efavirenz

31

Which NNRTI is associated with QTc prolongation?

Efavirenz

32

Which NNRTI is associated with rash/ SJS?

Efavirenz

33

Which NNRTI has the best side effect profile?

Rilpivirine

34

Rilpivirine retains activity against efavirenz resistant strains? T/F

True

35

Higher concentrations of which NNRTI is associated with QTc prolongation?

Rilpivirine

36

Which agent should be used if baseline VL >100,000 or CD4 <200

Efavirenz

37

Which NNRTI has a pH dependent absorption?

Rilpivirine

38

Which NNRTI is associated with rash/ SJS/ TENS?

Nevirapine

39

Severe/fatal hepatitis has been reported with which NNRTI?

Nevirapine

40

Which class of agents are associated with cardiac conduction abnormalities, bleeding in hemophiliacs, and lipid accumulation?

Protease inhibitors

41

Which PI is available for pediatric patients?

Darunavir

42

Which PI has sulfa and may cause a rash?

Darunavir

43

ADEs of Darunavir

GI

Hypercholesterolemia

Hyper TGs

44

Which PI is pH dependent?

Atazanavir (better lipid profile)

45

Which PI may cause kidney stones?

Atazanavir

46

Which PI is also a potent CYP3A4 inhibitor?

Ritonavir

47

Higher doses of ritonavir lead to intolerability? T/F

True

48

Two unique ADEs of ritonavir?

Taste perversion (dose dependent)

Elevations in serum cholesterol and TG's

49

Which PI is associated with cystalluria and nephrolithiasis due to poor drug solubility?

Indinavir

- Need to drink 2L of water daily

50

COBI is a more potent and selective inhibitor of 3A4? T/F

True

51

Which class of agents prevent covalent bonding between host and viral DNA by interfering with divalent cations in enzymes catalytic core?

Integrase inhibitors

52

Integrase inhibitors produce a more rapid decline in plasma viral RNA over the first 3-4 months of therapy than other antiretrovirals and are overall better tolerated?

True

53

Which II AUC will be increased with a high fat meal?

Raltegravir

54

High fat meal would be associated with:

Efavirenz

Raltegravir

55

Which two II's are eliminated by UGT1A1?

Raltegravir

Dolutegravir

56

Two DDI with Raltegravir?

Atazanavir (inhibitor)

Rifampin (inducer)

57

Which II is associated with elevations in CPK and has a risk of rhabomyolysis

Raltegravir

58

Which agent shares cross resistance with mutations that affect raltegravir?

Elvitegravir

59

Elvitegravir is co-formulated with a 4 drug combination with COBI?

True

60

Elvitegravir is eliminated by CYP3A4?

True

61

Which II retains activity against viruses that have become resistant to RAL and EVG?

Dolutegravir

62

Which II is a one pill, once daily regimen?

Dolutegravir

63

Which II has a high barrier to resistance like Dolutegravir but is available as a combination agent?

Bictegravir

64

Which agent is a part of the smallest combo pill on the market?

Bictegravir

65

Cabotegravir

Apretude

66

Which II is available IM?

Cabotegravir

67

How often in Im Cabotegravir dosed?

Once monthly

68

IM Cabenuva requires a two month lead in with oral dose?

False- one month

69

What are the two DDI's of Cabotegravir that are mitigated with the IM formula?

PPI's

Rilpivirine

70

Cabotegravir ADEs:

Discomfort

Pain

Induration

Pruitis at injection site

Abdominal pain

71

Which entry inhibitor can only be used in HIV-infected adults who have baseline evidence of predominately CCR5-tropic virus?

Maraviroc

72

Which agent retains activity against viruses that have become resistant to other agents due to MOA?

Maraviroc

73

Maraviroc ADEs:

Cough, fever URTI

Orthostatic hypotension

CYP3A4 substrate

74

Enfuvirtide

Fuzeon

75

How is Fuzeon administered?

SQ BID

76

ADEs of Fuzeon?

HIGH RATE OF LOCAL INJECTION SITE RXNS

Eosinophilia

Bacterial pneumonia

77

Which agent is indicated to be used in conjunction with other antiretrovirals in treatment experiences patients with MDR infections currently failing therapy?

Ibalizumab (moAb)

- 2000 mg IV LD, followed by 800 mg IV MD

78

Which agent is approved for use in HIV-infected adults with heavy treatment experience and multi drug resistant HIV-1 infection currently failing treatment?

Fostemsavir

- 600 mg PO BID

79

Fostemsavir is a prodrug?

True

80

ADEs of Fostemsavir:

N/D

Transaminitis

CYP3A4 substrate