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Chapter 20
Infectious Disease Drugs
49
Pharmacology
Professional
04/01/2013

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Cards

Term
What does the HIV infection infect?
Definition
CD4 + T Cells
Term
What does the HIv virus do after infecting the cells? What occurs after this?
Definition
-releases RNA into host cell
-reverse transcriptase
Term
What is reverse transcriptase?
Definition
viral enzyme makes viral DNA from RNA
Term
What are two things that occur as a result of this?
Definition
-nucleoside analogies
-nonnucleoside analogies
Term
What do nucleoside analogies do?
Definition
block DNA chain directly
Term
What do nonnucleoside analogies do?
Definition
inhibit enzyme directly
Term
What does protease do?
Definition
matures virus so it can inhibit other cells
Term
What does antiretroviral therapy for HIV do?
Definition
aims to reduce viral load of HIV
Term
WHat happens to the HIV virus after the RNA is released into the host cell?
Definition
-Viral DNA enter nucleus
-integrase occurs
Term
What is integrase?
Definition
viral enzyme outs viral DNA into host (T) cell DNA
Term
What occurs as a result of integrase?
Definition
permanent insertion, cannot kill virus without killing cell
Term
What happens after integrase?
Definition
cell produces viral particles which leave the cell to infect other cells
Term
Does antiretroviral therapy and anti-HIV medications work the same?
Definition
no, they have different mechanisms
Term
How do reverse transcriptase inhibitors work?
Definition
insert into HIV DNA to block it
Term
What are the 2 categories of reverse transcriptase inhibitors?
Definition
-nucleoside analogues(block DNA chain directly)
-nonnucleoside analogues(inhibit enzyme directly)
Term
What is a drug example of nucleoside analogues?
Definition
-zidovudine(AZT, Retrovir)
-tenofovir(Viread)
Term
What is a drug example of nonnucleoside analogues?
Definition
nevirapine(VP, Viramune)
Term
What do intregrase inhibitors do?
Definition
competitive inhibitor that blocks HIV DNA from inserting into host genome
Term
Are intregrase inhibitors used for everyone with HIV?
Definition
no, it is reserved for people with the more resistant forms
Term
What is an example of an intregrase inhibitor?
Definition
raltegravir- Isentress®
Term
How do protease inhibitors work?
Definition
work in the viral particle to clear viruses in bloodstream to prevent them from entering new cells
Term
What are some examples of protease inhibitors?
Definition
1.Indinavir (Crixivan®)
2.Ritonavir (Norvir®)
3.Atazanavir (Reyataz®)
4.Darunavir (Prezista®)
Term
How do fusion inhibitors work? Example
Definition
prevents mature virus particles from getting into cells

enfuvirtide- Fuzeon®
Term
What does HAART therapy stand for?
Definition
Highly
Active
Antiretroviral
Therapy
Term
What is HAART therapy?
Definition
-a triple coctail
-combination of 3 drugs in at least 2 classes of antiretroviral medications
Term
What does HAART therapy aim to do?
Definition
reduce the viral load below detectable limits, helps prevent development of resistance in HIV
Term
When someone is on HAART therapy are they always on multiple pills?
Definition
no, sometimes multiple medications are put together into one pill
Term
What is Truvada® a combination of?
Definition
2 RT inhibitors-
emtricitabine + tenofovir
Term
What is Epzicom® a combination of?
Definition
combination of 2 RT inhibitors-
lamivudine + abacavir
Term
What is Kaletra® a combination of?
Definition
combination of 2 protease inhibitors- ritonavir + lopinavir
Term
What is Atripla®?
Definition
combination of 3 RT inhibitors-
emtricitabine, tenofovir, and efavirenz
Term
What are some drug interactions seen with antiretrovirals?
Definition
-aspirin
-acetaminophen
-NSAIDS
-Antibiotics
-Local anesthetics
-Etc.
Term
What are some adverse reaction of antiretrovirals?
Definition
-bone marrow suppression
-nausea/vomiting
-dizziness
-paresthesias
-vision effects
-skin reactions
-Etc.
Term
What is TB?
Definition
bacterial infection contracted by inhalation
Term
How long ca TB remain latent? How many latent infections develop active?
Definition
-can be latent for years
-1/10 latent develop active
Term
What is the mortality rate for untreated active TB?
Definition
50% mortality rate
Term
How is TB diagnosed?
Definition
-through skin test or chest X-ray
-blood test has been developed
Term
is drug resistance seen with TB?
Definition
yes, many strains have drug resistance
Term
What is nonresistant latent TB infection treated with? For how long?
Definition
-Isoniazid (INH)
-9 months
Term
What is suspected resistant latent TB infection treated with?
Definition
rifampin + pyrazinamide
Term
What are the 2 phases of treatment with active TB? How long is each phase?
Definition
-initial phase(2 months)
-continuation phase(4-7 months)
Term
What medications are taken in the initial phase?
Definition
INH, rifampin, pyrazinamide, and ethambutol
Term
What medication combination is taken in the continuation phase?
Definition
INH + rifampin
Term
What can isoniazid drugs cause?
Definition
hepatitis, this risk is increased with alcohol and acetaminophen
Term
What saliva changes does rifampin?
Definition
makes it red/orange
Term
What does rifampin do to the CYP 450 enzymes?
Definition
induces them, increases rate of metabolism for many drugs
Term
TB drugs often interact with what kind of drugs?
Definition
HIV drugs, HIV patients are more susceptible to TB infection due to being immunocompromised
Term
What are HIV patients more likely to have?
Definition
opportunistic infections due to a weak immune system
Term
Should pts with active TB go to the dentist?
Definition
NO, wait until 2 months into treatment
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