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What are the defining characteristics of viruses?
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What are the steps of HIV replication inside a host cell?
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What are the general therapeutic goals for treatment of HIV infection?
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What are the recommended HIV medications for treatment as prevention?
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What is the mechanism of action of reverse transcriptase inhibitors?
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What are examples of reverse transcriptase inhibitors?
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What is the mechanism of action of protease inhibitors?
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What are examples of protease inhibitors?
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What are the mechanisms of action of integrase strand inhibitors?
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What are examples of integrase strand inhibitors?
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What are the mechanisms of action of entry inhibitors and attachment inhibitors?
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What are examples of entry inhibitors?
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How can perinatal transmission of HIV be prevented through pharmacotherapy?
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What are the procedures for achieving postexposure prophylaxis after occupational HIV exposure?
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What are viruses considered to be?
Nonliving agents that infect bacteria, plants, and animals.
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What type of parasite are viruses?
Intracellular parasite.
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Where must viruses be to replicate?
In a host cell.
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What surrounds a virus?
A capsid (protein coat).
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What genetic material do viruses contain?
Either RNA or DNA.
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What may viruses have that triggers an immune response?
Lipid envelope with protein spikes.
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Viruses are considered _______ that infect bacteria, plants, and animals.
Viruses are considered nonliving agents that infect bacteria, plants, and animals.
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Viruses are intracellular _______ that must be in a host cell to replicate.
Viruses are intracellular parasites that must be in a host cell to replicate.
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The structure of viruses includes a _______ and may contain _______ or _______.
The structure of viruses includes a capsid and may contain RNA or DNA.
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What do many viruses infect?
Bacteria only
Animals only
Specific host cells
Plants only
What do many viruses infect?
Bacteria only
Animals only
Specific host cells
Plants only
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What can trigger an immune response in viruses?
Capsid
RNA
DNA
Protein spikes
What can trigger an immune response in viruses?
Capsid
RNA
DNA
Protein spikes
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What do viruses need from host cells?
To produce energy
To grow larger
To replicate
To survive indefinitely
What do viruses need from host cells?
To produce energy
To grow larger
To replicate
To survive indefinitely
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What information is contained in the DNA of viruses?
Information needed for replication.
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What image illustrates the components of a virus?

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What image shows bacteriophages attacking bacteria?

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What are mature virus particles called?
Virions
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Do most viruses require pharmacotherapy?
No, most viruses are self-limiting.
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What is an example of a virus that causes the common cold?
Rhinovirus
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Which virus is fatal if left untreated?
HIV
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What can herpesviruses cause if left untreated?
Significant pain and disability
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What is a challenge of antiviral therapy?
Viruses mutate rapidly, making drugs ineffective.
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Why is it difficult for drugs to find viruses?
Drugs may injure normal cells while targeting viruses.
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Are antiviral drugs specific to one virus?
Yes, each antiviral drug is specific to one particular virus.
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What does HIV stand for?
Human Immunodeficiency Virus
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What receptor does HIV target?
CD4 receptor on T4 lymphocyte
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What enzyme does HIV use to make viral DNA from RNA?
Reverse transcriptase
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What happens to virions after they bud from the host cell?
They can infect other T4 lymphocytes
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What is the role of protease in HIV replication?
Enables virion to infect other T4 lymphocytes
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What is the result of HIV infection on the immune system?
Gradual destruction of the immune system
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Why is HIV called a retrovirus?
Because of the reverse synthesis process
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What syndrome is caused by HIV?
Acquired immunodeficiency syndrome (AIDS)
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What characterizes AIDS?
Profound immunosuppression leading to opportunistic infections
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What types of infections are commonly associated with AIDS?
Opportunistic infections and malignancies
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How has HIV changed in terms of its fatality?
HIV has gone from being rapidly fatal to a manageable chronic disease.
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What is required to remain symptom free from HIV?
Pharmacotherapy is required to remain symptom free.
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When should pharmacotherapy for HIV begin?
Pharmacotherapy should begin immediately after diagnosis.
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What is one goal of HIV pharmacotherapy?
To reduce HIV RNA load in the blood to an undetectable level or less than 50 copies/mL.
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What is another therapeutic goal of HIV treatment?
Restore and preserve the immune system.
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What should be suppressed to an undetectable level in HIV treatment?
Plasma HIV RNA level should be suppressed to undetectable.
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What is a key benefit of effective HIV treatment for mothers?
Decreased risk of transmission from mother to child.
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What is the goal of antiretroviral therapy (ART)?
To achieve undetectable levels of HIV RNA or less than 200 copies/ml in the blood.
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What does the CD4 T-lymphocyte count estimate?
The degree of immune system damage caused by the HIV virus.
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What is the purpose of the viral load test in HIV treatment?
To estimate how rapidly the virus is replicating in the body.
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How many drugs are typically required for antiretroviral therapy (ART)?
At least 2 drugs, usually more.
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What are common adverse effects of antiretroviral therapy (ART)?
Nausea, diarrhea, rash, lipid abnormalities, hepatotoxicity, neuropathy, increased cardiovascular events.
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What is a critical requirement for the success of antiretroviral therapy (ART)?
Strict adherence to the medication regimen, often 3 or 4 times a day, indefinitely.
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What is the most common mechanism of action (MOA) of antiretroviral therapies (ARTs)?
To inhibit viral replication.
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What are the main classes of drugs for HIV and AIDS?
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What is an example of a nucleoside reverse transcriptase inhibitor?
Zidovudine (AZT, Retrovir)
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What is an example of a nonnucleoside reverse transcriptase inhibitor?
Efavirenz (Sustiva)
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What is an example of an integrase strand transfer inhibitor?
Dolutegravir (DTG, Tivicay)
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What is an example of a drug for herpesviruses?
Acyclovir (Zovirax)
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What is an example of a drug for influenza viruses?
(specific drug not provided in the text)
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What is an example of a drug for hepatitis viruses?
(specific drug not provided in the text)
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What is an example of a drug for coronavirus-19?
(specific drug not provided in the text)
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Which class of drugs includes zidovudine?
Protease inhibitors
Nucleotide reverse transcriptase inhibitors
Integrase inhibitors
Entry inhibitors
Which class of drugs includes zidovudine?
Protease inhibitors
Nucleotide reverse transcriptase inhibitors
Integrase inhibitors
Entry inhibitors
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Which class of drugs does efavirenz belong to?
Attachment inhibitors
Protease inhibitors
Entry inhibitors
Nonnucleoside reverse transcriptase inhibitors
Which class of drugs does efavirenz belong to?
Attachment inhibitors
Protease inhibitors
Entry inhibitors
Nonnucleoside reverse transcriptase inhibitors
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What is the prototype drug for integrase inhibitors?
Dolutegravir (DTG, Tivicay)
Acyclovir (Zovirax)
Efavirenz (Sustiva)
Zidovudine (AZT, Retrovir)
What is the prototype drug for integrase inhibitors?
Dolutegravir (DTG, Tivicay)
Acyclovir (Zovirax)
Efavirenz (Sustiva)
Zidovudine (AZT, Retrovir)
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The main classes of drugs for HIV and AIDS include: - _______ - _______ - _______ - _______ - _______ - _______
The main classes of drugs for HIV and AIDS include: - Nucleotide reverse transcriptase inhibitors (NtRTIs) - Nonnucleoside reverse transcriptase inhibitors (NNRTIs) - Protease inhibitors (PIs) - Entry inhibitors - Attachment inhibitors - Integrase inhibitors/miscellaneous antivirals
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An example of a drug for herpesviruses is _______.
An example of a drug for herpesviruses is Acyclovir (Zovirax).
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An example of a drug for influenza viruses is _______.
An example of a drug for influenza viruses is (specific drug not provided in the text).
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An example of a drug for hepatitis viruses is _______.
An example of a drug for hepatitis viruses is (specific drug not provided in the text).
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An example of a drug for coronavirus-19 is _______.
An example of a drug for coronavirus-19 is (specific drug not provided in the text).
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What is the goal of medication recommendations for HIV and AIDS?
Based on comorbid conditions and to improve adherence.
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How can sexual transmission of HIV be prevented?
By maintaining a viral load below 200 copies/mL of blood.
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What is Preexposure prophylaxis (PrEP)?
A method for preventing HIV transmission for HIV-negative individuals with HIV-positive partners or unknown status partners.
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How effective is PrEP in reducing HIV transmission to uninfected partners?
99% effective for uninfected sexual partners.
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What is the effectiveness of PrEP in reducing transmission among people who inject drugs?
74% effective.
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How often must PrEP be taken?
Daily.
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When should PrEP be started after potential exposure?
Within 72 hours of exposure.
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What should individuals still practice while taking PrEP?
Safe sex practices.
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Name three medications used for PrEP.
Truvada, Descovy, and Cabotegravir (Apretude).
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What are the three types of reverse transcriptase inhibitors?
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What is the mechanism of action of reverse transcriptase inhibitors?
The virus mistakenly uses zidovudine as nucleoside, creating a defective DNA strand.
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What is the primary use of reverse transcriptase inhibitors?
Used with other antiretrovirals for symptomatic and asymptomatic HIV-infected patients.
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What is another use of reverse transcriptase inhibitors in healthcare?
Post-exposure prophylaxis in HIV-exposed healthcare workers.
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How do reverse transcriptase inhibitors help in mother-to-fetus transmission?
They reduce the transmission rate from HIV-positive mother to fetus.
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What is the prototype drug for HIV infection?
Zidovudine (AZT)
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What is the therapeutic class of zidovudine?
Antiretroviral
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What is the pharmacologic class of zidovudine?
Nucleoside reverse transcriptase inhibitor (NRTI)
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What does zidovudine resemble in its structure?
Thymidine
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What enzyme mistakenly uses zidovudine during viral DNA synthesis?
Reverse transcriptase
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What is a common indication for zidovudine?
Prevent transmission of HIV from mother to fetus
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What are the combination products containing zidovudine?
Combivir and Trizivir
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What is the chemical name for AZT?
Azidothymidine
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Why is zidovudine not often used as a first-line drug?
Due to potential for resistance
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What is the action of zidovudine in HIV treatment?
It inhibits protein synthesis.
It creates a defective DNA strand.
It boosts the immune system.
It prevents viral entry into cells.
What is the action of zidovudine in HIV treatment?
It inhibits protein synthesis.
It creates a defective DNA strand.
It boosts the immune system.
It prevents viral entry into cells.
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Zidovudine is also known as _______.
Zidovudine is also known as AZT.
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Zidovudine is a _______ (NRTI).
Zidovudine is a nucleoside reverse transcriptase inhibitor (NRTI).
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The most frequent indication for zidovudine is to prevent the transmission of HIV from _______.
The most frequent indication for zidovudine is to prevent the transmission of HIV from mother to fetus.
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Zidovudine resembles _______ in structure.
Zidovudine resembles thymidine in structure.
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The combination product Combivir contains zidovudine and _______.
The combination product Combivir contains zidovudine and lamivudine.
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The reverse transcriptase enzyme mistakenly uses zidovudine, creating a _______.
The reverse transcriptase enzyme mistakenly uses zidovudine, creating a defective DNA strand.
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Resistance to zidovudine has become common since its widespread use since _______.
Resistance to zidovudine has become common since its widespread use since 1987.
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Zidovudine is often abbreviated as _______ after its chemical name _______.
Zidovudine is often abbreviated as AZT after its chemical name azidothymidine.
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What type of capsule is zidovudine available in?

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What is the prototype drug for HIV treatment?
Zidovudine (Retrovir, AZT)
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What is the onset time for Zidovudine?
1-2 hours
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What is the peak time for Zidovudine?
1-2 hours
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What is the duration of Zidovudine's effect?
Unknown
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How should Zidovudine be administered?
On an empty stomach with a full glass of water (no fruit juice).
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Is breastfeeding recommended while on Zidovudine?
No, due to the possibility of transmitting HIV to the nursing infant.
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What are common adverse effects of Zidovudine?
Fatigue, generalized weakness, anorexia, nausea, and diarrhea.
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What bone marrow suppression adverse effects can occur with Zidovudine?
Neutropenia, leukopenia, and anemia.
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What is a black box warning for Zidovudine?
Rare cases of fatal lactic acidosis with hepatomegaly and steatosis have been reported with zidovudine use.
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What may occur with long-term use of Zidovudine?
Myopathy may occur with long-term use.
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What is the only contraindication for Zidovudine?
Hypersensitivity to the drug is the only contraindication.
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What should be monitored frequently during therapy with Zidovudine?
Blood counts and other laboratory blood tests should be monitored frequently to prevent hematologic toxicity.
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What should be done for patients with significant CKD or hepatic impairment taking Zidovudine?
A reduction in dosage is required because zidovudine may accumulate to toxic levels in these patients.
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What is steatosis?
Steatosis refers to the accumulation of fat in the liver.
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What adverse effect can result from bone marrow suppression due to Zidovudine?
Bone marrow suppression may result in neutropenia or severe anemia.
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What is the prototype drug mentioned?
Zidovudine (Retrovir, AZT)
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What should be avoided when using Zidovudine?
Concurrent administration with drugs that depress bone marrow function.
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Which drugs may increase the risk of ZDV toxicity?
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What serious conditions can arise from using Zidovudine with other antiretroviral agents?
Lactic acidosis and severe hepatomegaly with steatosis.
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Which herbal supplement should be used with caution with Zidovudine?
St. John's wort.
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Is there a specific treatment for Zidovudine overdose?
No specific treatment for overdose.
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What is the therapeutic class of Efavirenz?
Antiretroviral
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What is the pharmacologic class of Efavirenz?
Nonnucleoside reverse transcriptase inhibitor (NNRTI)
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How is Efavirenz administered?
Orally (PO)
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What condition is Efavirenz used to treat?
HIV infection
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What is one major action of Efavirenz?
Inhibits reverse transcriptase
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What is a significant advantage of Efavirenz?
Once-daily dosing
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What can high-fat meals do to Efavirenz absorption?
Increase absorption by up to 50%
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What is Atripla?
A fixed-dose combination of efavirenz, emtricitabine, and tenofovir
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When should Efavirenz be administered to limit CNS effects?
At bedtime
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What risk does Efavirenz pose if taken during pregnancy?
May cause neural defects in the fetus
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What should patients of childbearing potential do during therapy with Efavirenz?
Use birth control
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How long should birth control be used after discontinuing Efavirenz?
For 12 weeks
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What type of resistance can develop with NNRTIs like Efavirenz?
Resistance can develop rapidly
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What are the CNS adverse effects of Efavirenz?
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How long do CNS symptoms of Efavirenz typically last after therapy initiation?
Symptoms gradually diminish after 3-4 weeks of therapy.
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What rash condition must be monitored when using Efavirenz?
Rash must be monitored to prevent severe blistering or desquamation.
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What is a significant contraindication for Efavirenz?
Efavirenz is a known teratogen causing neural tube defects; it must not be given to patients who may become pregnant.
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What should patients in their childbearing years do while taking Efavirenz?
They should use reliable methods of birth control to avoid pregnancy.
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What is the onset time for Efavirenz?
The onset of Efavirenz is rapid.
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What is the peak time for Efavirenz?
The peak time for Efavirenz is 3-5 hours.
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What is the duration of Efavirenz's effect?
The duration of Efavirenz is 24 hours.
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What is the prototype drug discussed?
Efavirenz (Sustiva)
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What enzyme does efavirenz induce?
CYP3A4
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Which medications require monitoring when taken with efavirenz?
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What effect does efavirenz have on serum levels of certain drugs?
It can decrease serum levels of statins, methadone, sertraline, and calcium channel blockers.
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What worsens the CNS adverse effects of efavirenz?
Taking psychotropic drugs or consuming alcohol.
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What herbal supplement may decrease antiretroviral activity?
St. John's wort
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Is there a specific treatment for efavirenz overdose?
No specific treatment exists for overdose.
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What do protease inhibitors (PIs) block?
The viral enzyme protease responsible for the final assembly of HIV virions.
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What is the prototype drug for protease inhibitors?
Lopinavir with ritonavir (Kaletra).
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What is the mechanism of action of protease inhibitors?
To inhibit HIV protease.
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What is the primary use of protease inhibitors?
In combination with other antiretrovirals for initial treatment of HIV-infected patients.
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What can protease inhibitors lower to an undetectable level?
Plasma levels of HIV RNA.
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What are Integrase Strand Inhibitors (INSTIs)?
They are medications that inhibit the integrase enzyme required for HIV to insert its viral DNA into human chromosomes.
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What is the mechanism of action of INSTIs?
To inhibit HIV integrase transfer.
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What is the primary use of Integrase Strand Inhibitors?
Used as a replacement therapy for HIV infections resistant to other retrovirals.
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What is the therapeutic class of Dolutegravir (DTG)?
Antiretroviral
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What is the pharmacologic class of Dolutegravir (DTG)?
Integrase strand transfer inhibitor
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What year was Dolutegravir (DTG) approved?
2013
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What does Dolutegravir inhibit in HIV treatment?
HIV integrase
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What is the onset time for Dolutegravir?
Rapid
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What is the peak time for Dolutegravir?
2-3 hours
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What is the duration of action for Dolutegravir?
14 hours
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What fixed-dose combination includes Dolutegravir and rilpivirine?
Juluca
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What is the fixed-dose combination of Dolutegravir, abacavir, and lamivudine?
Triumeq
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Who can use Dolutegravir?
Both adults and pediatric patients
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Is Dolutegravir preferred for treatment naive or treatment experienced patients?
Both
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What is the primary action of Dolutegravir in HIV treatment?
Blocks the strand transfer of retroviral DNA
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Why is Dolutegravir preferred over other INSTIs?
Fewer drug interactions and greater barriers to resistance
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Can Dolutegravir be taken with food?
Yes, it may be taken with or without food.
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What risk does Dolutegravir pose if taken during the first trimester of pregnancy?
It may cause neural defects in the fetus.
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When should Dolutegravir be used in pregnancy?
Only if the benefits to the patient justify the risks to the fetus.
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Is Dolutegravir recommended during lactation?
No, it should not be used during lactation.
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What are the most common adverse effects of Dolutegravir?
Insomnia, fatigue, and headache.
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What less frequent reactions can occur with Dolutegravir?
Hypersensitivity and hepatotoxicity.
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What can Dolutegravir significantly increase in patients?
Blood cholesterol and triglycerides.
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What neuropsychiatric events may some patients experience with Dolutegravir?
Depression, suicidal ideation, and anxiety.
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Who should not use Dolutegravir?
Patients with severe CKD or hepatic impairment.
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Which drugs should be used with caution when taking dolutegravir?
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What effect do efavirenz, carbamazepine, and phenobarbital have on dolutegravir?
They increase its metabolism and reduce its effect.
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Which drug may increase blood levels of dolutegravir?
Nevirapine
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Is concurrent therapy with dofetilide allowed when taking dolutegravir?
No, it is contraindicated.
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When should dolutegravir be administered in relation to calcium-containing supplements?
2 hours before or 6 hours after.
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Is there a specific treatment for dolutegravir overdose?
No, there is no specific treatment for overdose.
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What should be included in a complete health and drug history for HIV patients?
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What signs and symptoms should be assessed for current infection in HIV patients?
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What laboratory findings are important to evaluate in HIV patients?
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What should be done to ensure proper medication administration for HIV patients?
Instruct the patient or caregiver in proper self-administration techniques followed by teach-back.
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How can HIV transmission be prevented in pregnant and breastfeeding patients?
ART therapy and lifestyle modifications can prevent transmission during pregnancy, childbirth, or breastfeeding.
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What should breastfeeding women with HIV be counseled about?
Counsel on the risks of transmission during breastfeeding and discuss alternate feeding options.
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What should HIV-positive patients do regarding their status?
Disclose their HIV status to any sexual partners and provide access to preexposure prophylaxis.
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What type of approach is required for HIV treatment?
A multidisciplinary approach is required for effective treatment.
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What resources should be provided to HIV patients and caregivers?
Advise about community resources, support groups, and assist with respite care as needed.
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What laboratory work should be monitored for patients receiving HIV pharmacotherapy?
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What are the adverse effects of drugs used for HIV treatment?
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Why is it important to monitor lipid levels and serum amylase in HIV patients?
To assess for pancreatitis and monitor for hyperglycemia.
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What age-related risk factors affect older adults receiving HIV treatment?
Older adults may be at greater risk for hepatotoxicity or nephrotoxicity due to age-related physiologic changes.
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Why should ethnically diverse patients be monitored closely when taking zidovudine?
Zidovudine is metabolized through the CYP450 system, requiring close monitoring for optimal effects and minimizing adverse effects.
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What can be done to prevent drug accumulation in the kidneys for HIV patients?
Increasing fluid intake.
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What should be immediately reported to the healthcare provider?
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What may increasing fever indicate in HIV medication patients?
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What dermatologic effects should be monitored in patients?
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What severe condition may result from medication effects in HIV patients?
Stevens-Johnson syndrome
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Patients should report increasing fever, diarrhea, or vomiting, dyspnea, tachycardia, dizziness, syncope, and changes in behavior, lethargy, or level of consciousness to the healthcare provider. Increasing fever may indicate _______, _______, or _______.
Patients should report increasing fever, diarrhea, or vomiting, dyspnea, tachycardia, dizziness, syncope, and changes in behavior, lethargy, or level of consciousness to the healthcare provider. Increasing fever may indicate worsening infection, adverse drug effects, or drug resistance.
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Monitor for dermatologic effects, such as _______, _______, or _______ in HIV patients.
Monitor for dermatologic effects, such as red or purplish skin rash, blisters, or peeling skin in HIV patients.
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Severe rashes, especially those associated with _______, should be reported immediately as they may indicate serious drug reactions.
Severe rashes, especially those associated with blistering, should be reported immediately as they may indicate serious drug reactions.
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What should a patient with HIV infection do daily regarding their oral health?
Inspect the oral cavity daily and maintain regular dental exams.
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What is a recommended practice for oral hygiene after eating?
Rinse the mouth with plain water or solution as prescribed by the healthcare provider.
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What should patients report related to headaches or dizziness?
Immediately report increasing headache; dizziness; drowsiness; worsening insomnia; numbness of hands, feet, or extremities; and changes in behavior or level of consciousness.
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What symptoms should be reported that indicate potential liver issues?
Report nausea, vomiting, yellowing of skin or sclera, abdominal pain, light or clay-colored stools, and diminished urine output or darkening of urine.
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What precautions should a patient take regarding temperature sensitivity?
Be careful when in contact with heat or cold due to numbness from peripheral neuropathy.
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What sleep hygiene measures should be encouraged for patients?
Encourage restful routines before bed and avoiding large meals within 1 or 2 hours of sleep.
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When should a patient consult with a healthcare provider regarding insomnia?
Consult if insomnia causes daytime sleepiness or continues.
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What are the key infection control measures for HIV patients?
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What should patients practice during sexual activity to prevent HIV transmission?
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What should patients with HIV not do regarding needles?
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What should a patient do if they become pregnant while on HIV medication?
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What is the target maternal viral load to reduce HIV transmission to the baby?
Less than 50 copies/mL
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What is the risk of HIV transmission to the baby if the maternal viral load is below 50 copies/mL?
Less than 1%
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What should patients not taking ART do during pregnancy?
Start ART
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What are the recommended regimens for ART during pregnancy?
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Is ART recommended for newborns?
Yes, regimen depends on circumstances
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What type of viruses cause repeated blister-like lesions on the skin and mucosal surfaces?
Herpesviruses (Family of DNA viruses)
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What is the primary effect of antiviral drugs on herpesvirus infections?
Lower frequency of acute episodes and diminish intensity of acute disease
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Do antiviral drugs cure herpesvirus infections?
No, they do not provide a cure
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What symptoms do antiviral drugs relieve in herpesvirus infections?
Acute symptoms and prevent recurrences
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Which type of herpes simplex virus primarily affects the upper body?
HSV-2
Both HSV-1 and HSV-2
HSV-1
None of the above
Which type of herpes simplex virus primarily affects the upper body?
HSV-2
Both HSV-1 and HSV-2
HSV-1
None of the above
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Which type of herpes simplex virus primarily affects the genitals?
HSV-1
Both HSV-1 and HSV-2
HSV-2
None of the above
Which type of herpes simplex virus primarily affects the genitals?
HSV-1
Both HSV-1 and HSV-2
HSV-2
None of the above
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The diagram illustrates the effects of _______ types 1 and 2 on different parts of the body.
The diagram illustrates the effects of Herpes Simplex Virus types 1 and 2 on different parts of the body.
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What is the therapeutic class of Acyclovir?
Antiviral for herpesviruses
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What is the pharmacologic class of Acyclovir?
Nucleoside analog
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What is Acyclovir primarily used for?
Treatment of herpesviruses
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Which herpes simplex viruses is Acyclovir most effective against?
HSV-1 and HSV-2
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What is one action of Acyclovir?
Prevents viral DNA synthesis
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Does Acyclovir cure herpes?
No, it does not cure the patient.
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How is Acyclovir administered for severe episodes?
As an IV
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What dosage form of Acyclovir is available for application to active lesions?
5% ointment
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How often is Acyclovir sometimes administered orally?
Up to five times a day
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What is the primary action of Acyclovir?
Stimulates viral replication
Increases immune response
Inhibits protein synthesis
Prevents viral DNA synthesis
What is the primary action of Acyclovir?
Stimulates viral replication
Increases immune response
Inhibits protein synthesis
Prevents viral DNA synthesis
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What should be monitored when Acyclovir is given IV?
Painful inflammation of vessels at the site of infusion
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When should Acyclovir be administered?
Around the clock, even if sleep is interrupted
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Should Acyclovir be taken with food?
Yes, it should be administered with food
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What did studies show about Acyclovir's effects during pregnancy?
No evidence of fetal harm
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What is the onset time for Acyclovir when taken orally?
1–2 hours
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What is the peak time for Acyclovir when taken orally?
1.5–2 hours
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What is the duration of action for Acyclovir when taken orally?
4–8 hours
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What is the prototype drug discussed?
Acyclovir (Zovirax)
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What are the potential adverse effects of acyclovir when given IV?
Nephrotoxicity and neurotoxicity
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In which patients is acyclovir contraindicated?
Patients with hypersensitivity to drugs in this class
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What should be avoided when using acyclovir?
Concurrent use with nephrotoxic agents
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What effect does probenecid have on acyclovir?
It decreases acyclovir elimination
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What effect may zidovudine have when used with acyclovir?
Increased drowsiness and lethargy
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Is there a specific treatment for acyclovir overdose?
No specific treatment for overdose
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What is the best approach for influenza prevention?
Vaccination
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What are the antivirals used for influenza?
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What is the purpose of antivirals in influenza treatment?
To prevent and decrease severity of acute symptoms
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What are the primary types of viral hepatitis?
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What is the effect of viral hepatitis on the liver?
Causes inflammation and necrosis of liver cells.
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Which types of viral hepatitis have vaccination available?
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Is there a vaccine for Hepatitis C?
No, there is no vaccine for Hepatitis C.
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What are the immunoglobulins used for prophylaxis or post-exposure treatment?
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What type of treatment is used for chronic hepatitis?
Symptomatic treatment.
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Which medications are used for Hepatitis C?
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What should be monitored in patients on IV acyclovir?
Signs of neurotoxicity: - Drowsiness - Dizziness - Tremors - Headache - Confusion - Changes in LOC - Seizures
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What is a safety measure for patients on IV acyclovir?
Ensure patient safety by having them rise slowly from lying or sitting to standing.
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What should be monitored in patients on amantadine?
Changes in behavior, psychiatric symptoms, or suicidal thoughts.
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What risk is increased with amantadine?
Increased risk of CNS or psychiatric symptoms, especially in patients with preexisting disorders.
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What signs indicate blood dyscrasias?
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What may occur due to bone marrow suppression?
Decreases in red blood cells, white blood cells, or platelets.
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What periodic monitoring is required for patients at risk of blood dyscrasias?
Periodic monitoring of CBC (Complete Blood Count).
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What hygiene measures should be taught to patients with non-HIV viral infections?
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Why might a patient need to be isolated during treatment?
To prevent social isolation during peak transmission periods.
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What should patients with genital HSV infections be taught regarding sexual activity?
Practice abstinence or use barrier protection even if lesions are not present.
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What dietary recommendations are given to patients to avoid mouth irritation?
Avoid acidic foods, carbonated drinks, and excessively hot or cold foods.
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What eating strategy is encouraged for patients experiencing nausea or diarrhea?
Try small, frequent meals instead of fewer, larger meals.
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What additional dietary support may a patient need if maintaining intake is difficult?
Assist in obtaining a dietary consultation for high-caloric foods and supplements.
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What should be assessed for desired therapeutic effects in patients with herpesvirus infection?
Diminished or absence of signs and symptoms of herpesvirus infection without symptoms of concurrent infections.
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How should drug effects be observed in patients?
Drug effects may not be immediately observable; gradual improvement should be noted.
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What periodic monitoring should be continued in patients receiving pharmacotherapy?
Periodic monitoring of CBC and liver and kidney function.
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What are some adverse effects to assess in patients?
Nausea, vomiting, diarrhea, anorexia, fatigue, drowsiness, dizziness, headache.
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What symptoms should be reported immediately during pharmacotherapy?
Decreased urine output, darkened urine, increased bruising or bleeding, increasing fever, or symptoms of infections.
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What should the patient state about the drug prescribed?
The patient should state the reason for the drug, appropriate dose and scheduling, adverse effects to observe for, and the anticipated length of therapy.
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What should a patient do with their medication therapy?
Complete the entire course of therapy unless otherwise instructed.
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How should the patient take their medication?
Take the medication as evenly spaced throughout each day.
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What should the patient increase while on medication?
Increase overall fluid intake.
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What hygiene practice should be followed when using ointments or creams?
Wash hands well before applying and again after application.
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What should caregivers wear when administering medicine?
Caregivers should wear gloves when administering the medicine.
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This work is protected by United States copyright laws and is provided solely for the use of instructors in teaching their courses and assessing student learning. Dissemination or sale of any part of this work will destroy the integrity of the work and is not permitted. All recipients of this work are expected to abide by these _______.
This work is protected by United States copyright laws and is provided solely for the use of instructors in teaching their courses and assessing student learning. Dissemination or sale of any part of this work will destroy the integrity of the work and is not permitted. All recipients of this work are expected to abide by these restrictions.
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Who holds the copyright for the work mentioned?
Pearson Education, Inc.
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What year was the copyright established?
2024, 2020, 2017
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What are the defining characteristics of viruses?
What are the steps of HIV replication inside a host cell?
What are the general therapeutic goals for treatment of HIV infection?
What are the recommended HIV medications for treatment as prevention?
What is the mechanism of action of reverse transcriptase inhibitors?
What are examples of reverse transcriptase inhibitors?
What is the mechanism of action of protease inhibitors?
What are examples of protease inhibitors?
What are the mechanisms of action of integrase strand inhibitors?
What are examples of integrase strand inhibitors?
What are the mechanisms of action of entry inhibitors and attachment inhibitors?
What are examples of entry inhibitors?
How can perinatal transmission of HIV be prevented through pharmacotherapy?
What are the procedures for achieving postexposure prophylaxis after occupational HIV exposure?
What are viruses considered to be?
Nonliving agents that infect bacteria, plants, and animals.
What type of parasite are viruses?
Intracellular parasite.
Where must viruses be to replicate?
In a host cell.
What surrounds a virus?
A capsid (protein coat).
What genetic material do viruses contain?
Either RNA or DNA.
What may viruses have that triggers an immune response?
Lipid envelope with protein spikes.
Viruses are considered nonliving agents that infect bacteria, plants, and animals.
Viruses are intracellular parasites that must be in a host cell to replicate.
The structure of viruses includes a capsid and may contain RNA or DNA.
What do many viruses infect?
Bacteria only
Animals only
Specific host cells
Plants only
What can trigger an immune response in viruses?
Capsid
RNA
DNA
Protein spikes
What do viruses need from host cells?
To produce energy
To grow larger
To replicate
To survive indefinitely
What information is contained in the DNA of viruses?
Information needed for replication.
What image illustrates the components of a virus?

What image shows bacteriophages attacking bacteria?

What are mature virus particles called?
Virions
Do most viruses require pharmacotherapy?
No, most viruses are self-limiting.
What is an example of a virus that causes the common cold?
Rhinovirus
Which virus is fatal if left untreated?
HIV
What can herpesviruses cause if left untreated?
Significant pain and disability
What is a challenge of antiviral therapy?
Viruses mutate rapidly, making drugs ineffective.
Why is it difficult for drugs to find viruses?
Drugs may injure normal cells while targeting viruses.
Are antiviral drugs specific to one virus?
Yes, each antiviral drug is specific to one particular virus.
What does HIV stand for?
Human Immunodeficiency Virus
What receptor does HIV target?
CD4 receptor on T4 lymphocyte
What enzyme does HIV use to make viral DNA from RNA?
Reverse transcriptase
What happens to virions after they bud from the host cell?
They can infect other T4 lymphocytes
What is the role of protease in HIV replication?
Enables virion to infect other T4 lymphocytes
What is the result of HIV infection on the immune system?
Gradual destruction of the immune system
Why is HIV called a retrovirus?
Because of the reverse synthesis process
What syndrome is caused by HIV?
Acquired immunodeficiency syndrome (AIDS)
What characterizes AIDS?
Profound immunosuppression leading to opportunistic infections
What types of infections are commonly associated with AIDS?
Opportunistic infections and malignancies
How has HIV changed in terms of its fatality?
HIV has gone from being rapidly fatal to a manageable chronic disease.
What is required to remain symptom free from HIV?
Pharmacotherapy is required to remain symptom free.
When should pharmacotherapy for HIV begin?
Pharmacotherapy should begin immediately after diagnosis.
What is one goal of HIV pharmacotherapy?
To reduce HIV RNA load in the blood to an undetectable level or less than 50 copies/mL.
What is another therapeutic goal of HIV treatment?
Restore and preserve the immune system.
What should be suppressed to an undetectable level in HIV treatment?
Plasma HIV RNA level should be suppressed to undetectable.
What is a key benefit of effective HIV treatment for mothers?
Decreased risk of transmission from mother to child.
What is the goal of antiretroviral therapy (ART)?
To achieve undetectable levels of HIV RNA or less than 200 copies/ml in the blood.
What does the CD4 T-lymphocyte count estimate?
The degree of immune system damage caused by the HIV virus.
What is the purpose of the viral load test in HIV treatment?
To estimate how rapidly the virus is replicating in the body.
How many drugs are typically required for antiretroviral therapy (ART)?
At least 2 drugs, usually more.
What are common adverse effects of antiretroviral therapy (ART)?
Nausea, diarrhea, rash, lipid abnormalities, hepatotoxicity, neuropathy, increased cardiovascular events.
What is a critical requirement for the success of antiretroviral therapy (ART)?
Strict adherence to the medication regimen, often 3 or 4 times a day, indefinitely.
What is the most common mechanism of action (MOA) of antiretroviral therapies (ARTs)?
To inhibit viral replication.
What are the main classes of drugs for HIV and AIDS?
What is an example of a nucleoside reverse transcriptase inhibitor?
Zidovudine (AZT, Retrovir)
What is an example of a nonnucleoside reverse transcriptase inhibitor?
Efavirenz (Sustiva)
What is an example of an integrase strand transfer inhibitor?
Dolutegravir (DTG, Tivicay)
What is an example of a drug for herpesviruses?
Acyclovir (Zovirax)
What is an example of a drug for influenza viruses?
(specific drug not provided in the text)
What is an example of a drug for hepatitis viruses?
(specific drug not provided in the text)
What is an example of a drug for coronavirus-19?
(specific drug not provided in the text)
Which class of drugs includes zidovudine?
Protease inhibitors
Nucleotide reverse transcriptase inhibitors
Integrase inhibitors
Entry inhibitors
Which class of drugs does efavirenz belong to?
Attachment inhibitors
Protease inhibitors
Entry inhibitors
Nonnucleoside reverse transcriptase inhibitors
What is the prototype drug for integrase inhibitors?
Dolutegravir (DTG, Tivicay)
Acyclovir (Zovirax)
Efavirenz (Sustiva)
Zidovudine (AZT, Retrovir)
The main classes of drugs for HIV and AIDS include: - Nucleotide reverse transcriptase inhibitors (NtRTIs) - Nonnucleoside reverse transcriptase inhibitors (NNRTIs) - Protease inhibitors (PIs) - Entry inhibitors - Attachment inhibitors - Integrase inhibitors/miscellaneous antivirals
An example of a drug for herpesviruses is Acyclovir (Zovirax).
An example of a drug for influenza viruses is (specific drug not provided in the text).
An example of a drug for hepatitis viruses is (specific drug not provided in the text).
An example of a drug for coronavirus-19 is (specific drug not provided in the text).
What is the goal of medication recommendations for HIV and AIDS?
Based on comorbid conditions and to improve adherence.
How can sexual transmission of HIV be prevented?
By maintaining a viral load below 200 copies/mL of blood.
What is Preexposure prophylaxis (PrEP)?
A method for preventing HIV transmission for HIV-negative individuals with HIV-positive partners or unknown status partners.
How effective is PrEP in reducing HIV transmission to uninfected partners?
99% effective for uninfected sexual partners.
What is the effectiveness of PrEP in reducing transmission among people who inject drugs?
74% effective.
How often must PrEP be taken?
Daily.
When should PrEP be started after potential exposure?
Within 72 hours of exposure.
What should individuals still practice while taking PrEP?
Safe sex practices.
Name three medications used for PrEP.
Truvada, Descovy, and Cabotegravir (Apretude).
What are the three types of reverse transcriptase inhibitors?
What is the mechanism of action of reverse transcriptase inhibitors?
The virus mistakenly uses zidovudine as nucleoside, creating a defective DNA strand.
What is the primary use of reverse transcriptase inhibitors?
Used with other antiretrovirals for symptomatic and asymptomatic HIV-infected patients.
What is another use of reverse transcriptase inhibitors in healthcare?
Post-exposure prophylaxis in HIV-exposed healthcare workers.
How do reverse transcriptase inhibitors help in mother-to-fetus transmission?
They reduce the transmission rate from HIV-positive mother to fetus.
What is the prototype drug for HIV infection?
Zidovudine (AZT)
What is the therapeutic class of zidovudine?
Antiretroviral
What is the pharmacologic class of zidovudine?
Nucleoside reverse transcriptase inhibitor (NRTI)
What does zidovudine resemble in its structure?
Thymidine
What enzyme mistakenly uses zidovudine during viral DNA synthesis?
Reverse transcriptase
What is a common indication for zidovudine?
Prevent transmission of HIV from mother to fetus
What are the combination products containing zidovudine?
Combivir and Trizivir
What is the chemical name for AZT?
Azidothymidine
Why is zidovudine not often used as a first-line drug?
Due to potential for resistance
What is the action of zidovudine in HIV treatment?
It inhibits protein synthesis.
It creates a defective DNA strand.
It boosts the immune system.
It prevents viral entry into cells.
Zidovudine is also known as AZT.
Zidovudine is a nucleoside reverse transcriptase inhibitor (NRTI).
The most frequent indication for zidovudine is to prevent the transmission of HIV from mother to fetus.
Zidovudine resembles thymidine in structure.
The combination product Combivir contains zidovudine and lamivudine.
The reverse transcriptase enzyme mistakenly uses zidovudine, creating a defective DNA strand.
Resistance to zidovudine has become common since its widespread use since 1987.
Zidovudine is often abbreviated as AZT after its chemical name azidothymidine.
What type of capsule is zidovudine available in?

What is the prototype drug for HIV treatment?
Zidovudine (Retrovir, AZT)
What is the onset time for Zidovudine?
1-2 hours
What is the peak time for Zidovudine?
1-2 hours
What is the duration of Zidovudine's effect?
Unknown
How should Zidovudine be administered?
On an empty stomach with a full glass of water (no fruit juice).
Is breastfeeding recommended while on Zidovudine?
No, due to the possibility of transmitting HIV to the nursing infant.
What are common adverse effects of Zidovudine?
Fatigue, generalized weakness, anorexia, nausea, and diarrhea.
What bone marrow suppression adverse effects can occur with Zidovudine?
Neutropenia, leukopenia, and anemia.
What is a black box warning for Zidovudine?
Rare cases of fatal lactic acidosis with hepatomegaly and steatosis have been reported with zidovudine use.
What may occur with long-term use of Zidovudine?
Myopathy may occur with long-term use.
What is the only contraindication for Zidovudine?
Hypersensitivity to the drug is the only contraindication.
What should be monitored frequently during therapy with Zidovudine?
Blood counts and other laboratory blood tests should be monitored frequently to prevent hematologic toxicity.
What should be done for patients with significant CKD or hepatic impairment taking Zidovudine?
A reduction in dosage is required because zidovudine may accumulate to toxic levels in these patients.
What is steatosis?
Steatosis refers to the accumulation of fat in the liver.
What adverse effect can result from bone marrow suppression due to Zidovudine?
Bone marrow suppression may result in neutropenia or severe anemia.
What is the prototype drug mentioned?
Zidovudine (Retrovir, AZT)
What should be avoided when using Zidovudine?
Concurrent administration with drugs that depress bone marrow function.
Which drugs may increase the risk of ZDV toxicity?
What serious conditions can arise from using Zidovudine with other antiretroviral agents?
Lactic acidosis and severe hepatomegaly with steatosis.
Which herbal supplement should be used with caution with Zidovudine?
St. John's wort.
Is there a specific treatment for Zidovudine overdose?
No specific treatment for overdose.
What is the therapeutic class of Efavirenz?
Antiretroviral
What is the pharmacologic class of Efavirenz?
Nonnucleoside reverse transcriptase inhibitor (NNRTI)
How is Efavirenz administered?
Orally (PO)
What condition is Efavirenz used to treat?
HIV infection
What is one major action of Efavirenz?
Inhibits reverse transcriptase
What is a significant advantage of Efavirenz?
Once-daily dosing
What can high-fat meals do to Efavirenz absorption?
Increase absorption by up to 50%
What is Atripla?
A fixed-dose combination of efavirenz, emtricitabine, and tenofovir
When should Efavirenz be administered to limit CNS effects?
At bedtime
What risk does Efavirenz pose if taken during pregnancy?
May cause neural defects in the fetus
What should patients of childbearing potential do during therapy with Efavirenz?
Use birth control
How long should birth control be used after discontinuing Efavirenz?
For 12 weeks
What type of resistance can develop with NNRTIs like Efavirenz?
Resistance can develop rapidly
What are the CNS adverse effects of Efavirenz?
How long do CNS symptoms of Efavirenz typically last after therapy initiation?
Symptoms gradually diminish after 3-4 weeks of therapy.
What rash condition must be monitored when using Efavirenz?
Rash must be monitored to prevent severe blistering or desquamation.
What is a significant contraindication for Efavirenz?
Efavirenz is a known teratogen causing neural tube defects; it must not be given to patients who may become pregnant.
What should patients in their childbearing years do while taking Efavirenz?
They should use reliable methods of birth control to avoid pregnancy.
What is the onset time for Efavirenz?
The onset of Efavirenz is rapid.
What is the peak time for Efavirenz?
The peak time for Efavirenz is 3-5 hours.
What is the duration of Efavirenz's effect?
The duration of Efavirenz is 24 hours.
What is the prototype drug discussed?
Efavirenz (Sustiva)
What enzyme does efavirenz induce?
CYP3A4
Which medications require monitoring when taken with efavirenz?
What effect does efavirenz have on serum levels of certain drugs?
It can decrease serum levels of statins, methadone, sertraline, and calcium channel blockers.
What worsens the CNS adverse effects of efavirenz?
Taking psychotropic drugs or consuming alcohol.
What herbal supplement may decrease antiretroviral activity?
St. John's wort
Is there a specific treatment for efavirenz overdose?
No specific treatment exists for overdose.
What do protease inhibitors (PIs) block?
The viral enzyme protease responsible for the final assembly of HIV virions.
What is the prototype drug for protease inhibitors?
Lopinavir with ritonavir (Kaletra).
What is the mechanism of action of protease inhibitors?
To inhibit HIV protease.
What is the primary use of protease inhibitors?
In combination with other antiretrovirals for initial treatment of HIV-infected patients.
What can protease inhibitors lower to an undetectable level?
Plasma levels of HIV RNA.
What are Integrase Strand Inhibitors (INSTIs)?
They are medications that inhibit the integrase enzyme required for HIV to insert its viral DNA into human chromosomes.
What is the mechanism of action of INSTIs?
To inhibit HIV integrase transfer.
What is the primary use of Integrase Strand Inhibitors?
Used as a replacement therapy for HIV infections resistant to other retrovirals.
What is the therapeutic class of Dolutegravir (DTG)?
Antiretroviral
What is the pharmacologic class of Dolutegravir (DTG)?
Integrase strand transfer inhibitor
What year was Dolutegravir (DTG) approved?
2013
What does Dolutegravir inhibit in HIV treatment?
HIV integrase
What is the onset time for Dolutegravir?
Rapid
What is the peak time for Dolutegravir?
2-3 hours
What is the duration of action for Dolutegravir?
14 hours
What fixed-dose combination includes Dolutegravir and rilpivirine?
Juluca
What is the fixed-dose combination of Dolutegravir, abacavir, and lamivudine?
Triumeq
Who can use Dolutegravir?
Both adults and pediatric patients
Is Dolutegravir preferred for treatment naive or treatment experienced patients?
Both
What is the primary action of Dolutegravir in HIV treatment?
Blocks the strand transfer of retroviral DNA
Why is Dolutegravir preferred over other INSTIs?
Fewer drug interactions and greater barriers to resistance
Can Dolutegravir be taken with food?
Yes, it may be taken with or without food.
What risk does Dolutegravir pose if taken during the first trimester of pregnancy?
It may cause neural defects in the fetus.
When should Dolutegravir be used in pregnancy?
Only if the benefits to the patient justify the risks to the fetus.
Is Dolutegravir recommended during lactation?
No, it should not be used during lactation.
What are the most common adverse effects of Dolutegravir?
Insomnia, fatigue, and headache.
What less frequent reactions can occur with Dolutegravir?
Hypersensitivity and hepatotoxicity.
What can Dolutegravir significantly increase in patients?
Blood cholesterol and triglycerides.
What neuropsychiatric events may some patients experience with Dolutegravir?
Depression, suicidal ideation, and anxiety.
Who should not use Dolutegravir?
Patients with severe CKD or hepatic impairment.
Which drugs should be used with caution when taking dolutegravir?
What effect do efavirenz, carbamazepine, and phenobarbital have on dolutegravir?
They increase its metabolism and reduce its effect.
Which drug may increase blood levels of dolutegravir?
Nevirapine
Is concurrent therapy with dofetilide allowed when taking dolutegravir?
No, it is contraindicated.
When should dolutegravir be administered in relation to calcium-containing supplements?
2 hours before or 6 hours after.
Is there a specific treatment for dolutegravir overdose?
No, there is no specific treatment for overdose.
What should be included in a complete health and drug history for HIV patients?
What signs and symptoms should be assessed for current infection in HIV patients?
What laboratory findings are important to evaluate in HIV patients?
What should be done to ensure proper medication administration for HIV patients?
Instruct the patient or caregiver in proper self-administration techniques followed by teach-back.
How can HIV transmission be prevented in pregnant and breastfeeding patients?
ART therapy and lifestyle modifications can prevent transmission during pregnancy, childbirth, or breastfeeding.
What should breastfeeding women with HIV be counseled about?
Counsel on the risks of transmission during breastfeeding and discuss alternate feeding options.
What should HIV-positive patients do regarding their status?
Disclose their HIV status to any sexual partners and provide access to preexposure prophylaxis.
What type of approach is required for HIV treatment?
A multidisciplinary approach is required for effective treatment.
What resources should be provided to HIV patients and caregivers?
Advise about community resources, support groups, and assist with respite care as needed.
What laboratory work should be monitored for patients receiving HIV pharmacotherapy?
What are the adverse effects of drugs used for HIV treatment?
Why is it important to monitor lipid levels and serum amylase in HIV patients?
To assess for pancreatitis and monitor for hyperglycemia.
What age-related risk factors affect older adults receiving HIV treatment?
Older adults may be at greater risk for hepatotoxicity or nephrotoxicity due to age-related physiologic changes.
Why should ethnically diverse patients be monitored closely when taking zidovudine?
Zidovudine is metabolized through the CYP450 system, requiring close monitoring for optimal effects and minimizing adverse effects.
What can be done to prevent drug accumulation in the kidneys for HIV patients?
Increasing fluid intake.
What should be immediately reported to the healthcare provider?
What may increasing fever indicate in HIV medication patients?
What dermatologic effects should be monitored in patients?
What severe condition may result from medication effects in HIV patients?
Stevens-Johnson syndrome
Patients should report increasing fever, diarrhea, or vomiting, dyspnea, tachycardia, dizziness, syncope, and changes in behavior, lethargy, or level of consciousness to the healthcare provider. Increasing fever may indicate worsening infection, adverse drug effects, or drug resistance.
Monitor for dermatologic effects, such as red or purplish skin rash, blisters, or peeling skin in HIV patients.
Severe rashes, especially those associated with blistering, should be reported immediately as they may indicate serious drug reactions.
What should a patient with HIV infection do daily regarding their oral health?
Inspect the oral cavity daily and maintain regular dental exams.
What is a recommended practice for oral hygiene after eating?
Rinse the mouth with plain water or solution as prescribed by the healthcare provider.
What should patients report related to headaches or dizziness?
Immediately report increasing headache; dizziness; drowsiness; worsening insomnia; numbness of hands, feet, or extremities; and changes in behavior or level of consciousness.
What symptoms should be reported that indicate potential liver issues?
Report nausea, vomiting, yellowing of skin or sclera, abdominal pain, light or clay-colored stools, and diminished urine output or darkening of urine.
What precautions should a patient take regarding temperature sensitivity?
Be careful when in contact with heat or cold due to numbness from peripheral neuropathy.
What sleep hygiene measures should be encouraged for patients?
Encourage restful routines before bed and avoiding large meals within 1 or 2 hours of sleep.
When should a patient consult with a healthcare provider regarding insomnia?
Consult if insomnia causes daytime sleepiness or continues.
What are the key infection control measures for HIV patients?
What should patients practice during sexual activity to prevent HIV transmission?
What should patients with HIV not do regarding needles?
What should a patient do if they become pregnant while on HIV medication?
What is the target maternal viral load to reduce HIV transmission to the baby?
Less than 50 copies/mL
What is the risk of HIV transmission to the baby if the maternal viral load is below 50 copies/mL?
Less than 1%
What should patients not taking ART do during pregnancy?
Start ART
What are the recommended regimens for ART during pregnancy?
Is ART recommended for newborns?
Yes, regimen depends on circumstances
What type of viruses cause repeated blister-like lesions on the skin and mucosal surfaces?
Herpesviruses (Family of DNA viruses)
What is the primary effect of antiviral drugs on herpesvirus infections?
Lower frequency of acute episodes and diminish intensity of acute disease
Do antiviral drugs cure herpesvirus infections?
No, they do not provide a cure
What symptoms do antiviral drugs relieve in herpesvirus infections?
Acute symptoms and prevent recurrences
Which type of herpes simplex virus primarily affects the upper body?
HSV-2
Both HSV-1 and HSV-2
HSV-1
None of the above
Which type of herpes simplex virus primarily affects the genitals?
HSV-1
Both HSV-1 and HSV-2
HSV-2
None of the above
The diagram illustrates the effects of Herpes Simplex Virus types 1 and 2 on different parts of the body.
What is the therapeutic class of Acyclovir?
Antiviral for herpesviruses
What is the pharmacologic class of Acyclovir?
Nucleoside analog
What is Acyclovir primarily used for?
Treatment of herpesviruses
Which herpes simplex viruses is Acyclovir most effective against?
HSV-1 and HSV-2
What is one action of Acyclovir?
Prevents viral DNA synthesis
Does Acyclovir cure herpes?
No, it does not cure the patient.
How is Acyclovir administered for severe episodes?
As an IV
What dosage form of Acyclovir is available for application to active lesions?
5% ointment
How often is Acyclovir sometimes administered orally?
Up to five times a day
What is the primary action of Acyclovir?
Stimulates viral replication
Increases immune response
Inhibits protein synthesis
Prevents viral DNA synthesis
What should be monitored when Acyclovir is given IV?
Painful inflammation of vessels at the site of infusion
When should Acyclovir be administered?
Around the clock, even if sleep is interrupted
Should Acyclovir be taken with food?
Yes, it should be administered with food
What did studies show about Acyclovir's effects during pregnancy?
No evidence of fetal harm
What is the onset time for Acyclovir when taken orally?
1–2 hours
What is the peak time for Acyclovir when taken orally?
1.5–2 hours
What is the duration of action for Acyclovir when taken orally?
4–8 hours
What is the prototype drug discussed?
Acyclovir (Zovirax)
What are the potential adverse effects of acyclovir when given IV?
Nephrotoxicity and neurotoxicity
In which patients is acyclovir contraindicated?
Patients with hypersensitivity to drugs in this class
What should be avoided when using acyclovir?
Concurrent use with nephrotoxic agents
What effect does probenecid have on acyclovir?
It decreases acyclovir elimination
What effect may zidovudine have when used with acyclovir?
Increased drowsiness and lethargy
Is there a specific treatment for acyclovir overdose?
No specific treatment for overdose
What is the best approach for influenza prevention?
Vaccination
What are the antivirals used for influenza?
What is the purpose of antivirals in influenza treatment?
To prevent and decrease severity of acute symptoms
What are the primary types of viral hepatitis?
What is the effect of viral hepatitis on the liver?
Causes inflammation and necrosis of liver cells.
Which types of viral hepatitis have vaccination available?
Is there a vaccine for Hepatitis C?
No, there is no vaccine for Hepatitis C.
What are the immunoglobulins used for prophylaxis or post-exposure treatment?
What type of treatment is used for chronic hepatitis?
Symptomatic treatment.
Which medications are used for Hepatitis C?
What should be monitored in patients on IV acyclovir?
Signs of neurotoxicity: - Drowsiness - Dizziness - Tremors - Headache - Confusion - Changes in LOC - Seizures
What is a safety measure for patients on IV acyclovir?
Ensure patient safety by having them rise slowly from lying or sitting to standing.
What should be monitored in patients on amantadine?
Changes in behavior, psychiatric symptoms, or suicidal thoughts.
What risk is increased with amantadine?
Increased risk of CNS or psychiatric symptoms, especially in patients with preexisting disorders.
What signs indicate blood dyscrasias?
What may occur due to bone marrow suppression?
Decreases in red blood cells, white blood cells, or platelets.
What periodic monitoring is required for patients at risk of blood dyscrasias?
Periodic monitoring of CBC (Complete Blood Count).
What hygiene measures should be taught to patients with non-HIV viral infections?
Why might a patient need to be isolated during treatment?
To prevent social isolation during peak transmission periods.
What should patients with genital HSV infections be taught regarding sexual activity?
Practice abstinence or use barrier protection even if lesions are not present.
What dietary recommendations are given to patients to avoid mouth irritation?
Avoid acidic foods, carbonated drinks, and excessively hot or cold foods.
What eating strategy is encouraged for patients experiencing nausea or diarrhea?
Try small, frequent meals instead of fewer, larger meals.
What additional dietary support may a patient need if maintaining intake is difficult?
Assist in obtaining a dietary consultation for high-caloric foods and supplements.
What should be assessed for desired therapeutic effects in patients with herpesvirus infection?
Diminished or absence of signs and symptoms of herpesvirus infection without symptoms of concurrent infections.
How should drug effects be observed in patients?
Drug effects may not be immediately observable; gradual improvement should be noted.
What periodic monitoring should be continued in patients receiving pharmacotherapy?
Periodic monitoring of CBC and liver and kidney function.
What are some adverse effects to assess in patients?
Nausea, vomiting, diarrhea, anorexia, fatigue, drowsiness, dizziness, headache.
What symptoms should be reported immediately during pharmacotherapy?
Decreased urine output, darkened urine, increased bruising or bleeding, increasing fever, or symptoms of infections.
What should the patient state about the drug prescribed?
The patient should state the reason for the drug, appropriate dose and scheduling, adverse effects to observe for, and the anticipated length of therapy.
What should a patient do with their medication therapy?
Complete the entire course of therapy unless otherwise instructed.
How should the patient take their medication?
Take the medication as evenly spaced throughout each day.
What should the patient increase while on medication?
Increase overall fluid intake.
What hygiene practice should be followed when using ointments or creams?
Wash hands well before applying and again after application.
What should caregivers wear when administering medicine?
Caregivers should wear gloves when administering the medicine.
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Who holds the copyright for the work mentioned?
Pearson Education, Inc.
What year was the copyright established?
2024, 2020, 2017
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