Virology

Question 1

HIV NRTIs

Answer 1

competitively inhibit nucleotide binding to RT and terminate DNA chain

Abacavir, didanosine, emtricitabine, lamivudine, stavudine, tenofovir, zidovudine (can use for general prophylaxis and during pregnancy)

side fx: BM suppression, lactic acidosis, periph neuropathy

Question 2

HIV NNRIs

Answer 2

Bind RT at diff site form NRTIs, don’t need phosphorylation to be active or compete w/ nucleotides

Delavirdine, efavirenz, nevirapine

Side fx: rash, hepatotoxicity. Efavirenz: C/I in preg; vivid dreams. Delavirdine C/I in preg

Question 3

HIV Protease inhibitors

Answer 3

-navir suffix
“navir (never) tease a protease”

Prevent maturation of new viruses by inhibiting HIV-1 protease (pol gene)

Side fx: hyperglc, GI intolerance, lipodystrophy, nephropathy, hematuria, thrombocytopenia

Ritonavir boosts other drug concentrations by inhibiting P450. Rifamin decreases protease inhibitor concentrations; use rifabutin instead

Question 4

HIV Integrase inhibitors

Answer 4

-tegravir suffix

Inhibit HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase

Can increase creatine kinase

Question 5

HIV fusion inhibitors

Answer 5

Enfuvirtide: binds gp41, inhibiting viral entry. Can cause skin rxn at injection site

Maraviroc: binds CCR-5 on surface of T cells/monocytes, inhibiting interaction w/ gp120

Question 6

Reye syndrome

Answer 6

Caused by treating viral infxn with aspirin. Aspirin metabolites reduce beta-oxidation by reversible inhibition of mitochondrial enzymes

Reye of sunSHINE:
Steatosis of liver/hepatocytes
Hypoglc/Hepatomegaly
Infxn (VZV, flu)
Not awake (coma)
Encephalopathy: cerebral edema, d/t increased ammonia (hyperammonemia induces astrocyte edema, increasing ICP)