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Terms in this set (75)
T/F: Viruses need a host organism to survive.
2 types of viruses:
enveloped viruses with an RNA genome
infect the host cell by transcribing viral RNA into DNA by reverse transcriptase & integrating viral DNA & host DNA together
oncogenic retroviruses that cause sarcomas & leukemias in animals
retroviruses that cause slow progressive degenerative disorders (HIV)
HIV (1, 2) is predominant in the USA while HIV (1, 2) is confined to West Africa. HIV is believed to be derived from SIV.
HIV comes from _________.
modes of transmission of HIV:
transmission of HIV by blood transfusions, IV drug use, healthcare workers with needlestick injuries, & muco-cutaneous exposure
There is increased risk of getting HIV if your sexual partner has _______.
HIV transmission that occurs when babies get HIV from their infected mothers either in utero during birth or through breast feeding
HIV-1 gene that codes for RT
HIV-1 gene that codes for core proteins for the protein envelope
HIV-1 gene that codes for proteins involved with the ability of the virus to infect the host & rate of replication
HIV-1 gene that regulates the rate of transcription of genes
During ________, proteins on the surface of the viral envelope such as gp120 & gp41 bind with CD4 & CCR5/CXCR4 on the host cell.
antiviral drug class that blocks attachment of HIV-1
During ______, gp41 proteins on the virus surface become exposed after attachment of gp120 to CD4 of the host. This allows the viral envelope & the host cell membrane to come into contact, & the neurocapsid of the virus enters the host cell.
antiviral drug class that blocks fusion
Reverse transcription occurs in the ______ of the host cell. Once viral DNA is produced, it enters the nucleus of the host cell.
antiviral drug classes that block RT:
Viral DNA is combined with host DNA via the enzyme _______.
antiviral drug class that blocks integration:
New viral proteins are made from viral mRNA as 1 large protein. ________ must cleave the large protein to make smaller functional proteins.
antiviral drug class that blocks large viral protein cleavage
The final step of the viral life cycle is called _______. The genetic material enclosed in the nucleocapsid merges with the deformed host cell membrane & pinches off to form a new virus particle.
T/F: HIV-1 replicates with a very high efficiency, usually at a rate of about 1 billion particles/day.
HIV-1 _______ as it replicates, making it difficult to treat.
______ cells & ______ are the target for HIV-1. They cause destruction of the cells, infect precursor cells, & destroy the microenvironment to prevent immune cell synthesis.
_______ is a progression of HIV that results in destruction of the microenvironment of lymphoid tissue, preventing the production of new immune cells.
drug classes for treatment of AIDS:
selective, competitive inhibitors of HIV protease
HIV-1 ______ bind reversibly to the active site of HIV protease, preventing cleavage of the polyprotein & blocking vial replication.
_______ are indicated as part of combination therapy & appear to be the most effective antiretroviral drug available in acutely & chronic HIV-1 infected cells.
PIs affect (early, late) stage virus replication.
In the presence of PIs & NRTIs, _______ viruses continue to replicate.
PIs are metabolized by _________.
_______ are analogs of naturally occurring nucleosides that incorporate themselves into the viral genome during viral DNA transcription & inhibit DNA polymerase activity.
________ cause termination of DNA elongation because they lack a 3' hydroxyl group.
________ are indicated for the management of HIV infection as components of combination HAART.
______ prevent acute infection of susceptible cells but have little effect on cells already infected by HIV.
The only drug shown to reduce perinatal HIV transmission is _________.
_______ are RT inhibitors that are not analogs of naturally occurring nucleosides & bind directly to RT.
Resistance to NNRTIs occurs when mutations inside the ________ prevent the drugs from binding there, or when a single mutation alters the opening of the pocket sufficiently to block NNRTIs from entering.
________ & _______ are next generation NNRTIs that can alter their shape & position to enter & bind to the pocket on RT in HIV that carries 1st generation NNRTI resistance.
Standard doses of individual PIs result in trough levels that are only slightly higher than the effective antiviral concentration. Combining other PIs with the PI _______ boosts trough levels of other PIs.
_______ combinations often lead to more convenient regimens in terms of pill burden, scheduling, & elimination of food restrictions. They also may prevent efavirenz or nevirapine-induced drug interactions.
inhibition of GI CYP450
inhibition of hepatic CYP450
Ritonavir increases plasma concentrations of other PIs by 2 mechanisms:
Combination of ritonavir with saquinavir causes increased _______ concentrations due to inhibition of GI & hepatic CYP450.
peak, trough, half-life
Combination of ritonavir with lopinavir causes increases in ______, ______, & _______.
Combination of ritonavir with PIs other than saquinavir or lopinavir causes increases in ______ & _______. GI CYP450 inhibition is relatively minimal with hepatic GI inhibition being the main cause of increases.
Patients who have progressed to _______ are often treated with complicated combinations of drugs & the potential for multiple drug interactions must be considered.
The use of _______ to treat active TB is problematic in AIDS patients receiving a PI. PIs affect the metabolism of this drug, and this drug lowers the blood level of PIs so that they are suboptimal for antiretroviral therapy.
While rifampin is CIed with use of PIs, use of ______ at a reduced dose can be considered.
Wasting & anorexia may prevent patients from adhering to the dietary requirements for efficient absorption of certain ________. Bone marrow suppression associated with zidovudine & the neuropathic effects of stavudine & didanosine may combine with the direct effects of HIV to render the drugs intolerable.
Hepatotoxicity associated with certain _______ may limit the use of these drugs, especially in patients with underlying liver dysfunction.
The absorption & half-life of certain drugs may be altered by antiretrovirals, particularly the PIs & NNRTIs whose metabolism involves the _______ pathway.
Nevirapine is an (inducer, inhibitor) of CYP450.
Delavirdine is an (inducer, inhibitor) of CYP450.
_______ is a mixed inducer/inhibitor of CYP450.
PIs (inhibit, induce) CYP450.
CYP450 inhibitors have the potential to (increase, decrease) blood levels of drugs metabolized by this pathway, sometimes improving the PK profile & the potential to contribute additive antiviral effect. These effects, however, can sometimes result in life-threatening drug toxicity.
1st domain of integrase that helps integrase form multimers
3 domains of integrase:
Since _______ or a protein resembling this enzyme is not found in human cells, it is a good target for HIV therapy.
Enfuvirtide is the only _______ available for the treatment of HIV.
first antiretroviral drug that targets the host cell rather than the virus directly; CCR5 antagonist
While the occurrence of severe lactic acidosis & hepatic steatosis during use of _______ is rare, it is associated with a high fatality rate.
T/F: Risk factors for lactic acidosis & hepatic steatosis with NRTI use includes female gender, obesity, & prolonged use, although some cases have been reported to occur without known risk factors.
Hyperglycemia & DM are AEs associated with _______. Beta cell dysfunction & peripheral insulin resistance are the proximate causes of hyperglycemia.
changes in body fat distribution that is an AE of anti-HIV drugs; lipodystrophy syndrome or pseudo-Cushing's syndrome
Hyperlipidemia may occur in the 1st month of ______ use.
Increased spontaneous bleeding episodes in patients with hemophilia A & B have been observed with use of _______.
The risk for osteopenia & osteoporosis is significantly higher in patients taking _______ anti-HIV drugs.
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