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Saturday 10 May 2014

HIV Pharmacology

To Understand HIV let first understand HIV path.

Step 1: HIV fuses with T cell/monocyte via CCR5 receptor and GP 120.

MARAviroc prevents this fusion. (Itna MARA kay attach hi nahi hosaka)

Step 2: HIV enters the cell

ENfuviritide inhibits this entry (INfuviritide prevents HIV to go INside the cell)

Step 3: HIV integrate its genome into host cell chromosome

RalteGravir inhibits this by inhibiting InteGrase. Luckily RalteGravir is the only HIV drug that as G in it so does inteGrase.

Step 4: It replicates it DNA via reverse transcriptase.

NRTIS: They competitively inhibits reverse transcriptase. Zidovudine can be used in pregnancy. Important side effects are bone marrow suppression, anemia (ZDV), pancreatitis (didanosine)

NNRTIS: They bind to reverse transcriptase at different site than NRTIs. Unlike NRTIS they don't need phosphorylation. efaVIRenz, neVIRapine, delaVIRadine. Even thou maraviroc, enfuviritide, raltegravir all have VIR in it but you can differentiate them apart by the already mentioned ways.

Their side effects include rash and hepatotoxicity. Delaviradine and efavirenz are contraindication in pregnancy.

Step 5: After it has replicated its DNA, assembly of virion takes place that cleaves polypeptide of HIV mRNA into their functional parts. Protease (pol gene) do this part.

Protease inhibitor, (all end in NAVIR).

RitoNAVIR inhibits cytochrome p-450
Side effvects include hyperglycemia, lipodystrophy
indiNAVIR is nephrotoxic 

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