University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

200

Pages:

1
Author:

Leilani Contreras

6.3 – “Lady G Guinevere uinevere and the Sword in the Sto Stone”: ne”: Protease inhibitors • Protease inhibitors often end in -navir suffix (Guinevere) including ritonavir, atazanavir, indinavir. Do not need Ⓟ by intracellular enzymes (knight running away with Ⓟ scroll). • HIV proteases serve to cleave the single long poly-protein product of the HIV gene products, which must be cleaved into proteins needed to construct virion particles (sword to cleave things). With proteases inactivated, the virion remains immature (immature page boy). • HIV pol gene encodes enzymes including RTs & proteases (Paul the blacksmith crafting protease blades). o Pol gene mutations → resistance. Never used as monotherapy, as may rapidly develop resistance to the entire class. • Adverse effects – many are metabolic o Hyperglycemia d/t insulin resistance, which may lead to diabetes eventually (elevated candy) o Dyslipidemias, with ↑TG & LDL (elevated butter) o Lipodystrophy (silly steed) o Inhibition of CYP450 (chrome bumper on inoperable wagon) causing numerous drug-drug interactions. Ritonavir especially (Right on! High fives) ▪ Can be used to advantage by boosting levels of other protease inhibitors ▪ Rifampin contraindicated when taking protease inhibitors d/t CYP450 activation → ↓protease inhibitor levels (rifampin crossbow utilized by wizardly henchman). May use rifabutin. • Indinavir (indigo princess) o May cause nephrolithiasis d/t urinary crystallization (stones in kidney fountain). May occur within days of beginning therapy. Adequate hydration is critical (drinking kid)