Drug Topics - April 14, 2008 - (Page 54)

54 DRUG TOPICS APRIL 14 , 2008 www.drugtopics.com CONTINUING EDUCATION An ongoing CE program of The University of Florida College of Pharmacy and DRUG TOPICS Recent advancements in HIV/AIDS treatment CE The University of Florida College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education ACPE # 012-99907-248-H02-P ACPE # 012-99907-248-H02-T Dolores Kutzer, B.S. Pharm., Pharm.D., Assistant Professor, Lake Erie College of Osteopathic Medicine, Director of Student Promotion and Retention Megan Hicks, Pharm.D. Candidate, Lake Erie College of Osteopathic Medicine Erin Hlebik, Pharm.D. Candidate, Lake Erie College of Osteopathic Medicine Jeremy Infantino, B.S., Pharm.D. Candidate, Lake Erie College of Osteopathic Medicine This lesson is no longer valid for CE credit after 4/30/10. To obtain immediate CE credit, take the test online at www.drugtopics.com. Just click on the “Continuing Education” box on the Drug Topics home page, which will take you to the CE site. Log in, find and click on this lesson, and follow the three simple steps. Test results will be displayed immediately and you can print the certificate showing your earned CE credits. his article titled “Recent advancements in HIV/AIDS treatment” includes review of the pathogenesis and clinical presentation of an HIV infection, review of methods of detection and diagnosis, and latest medications approved for the treatment of HIV/AIDS such as: tipranavir, fosamprenavir, darunavir, atazanavir, enfuvirtide, raltegravir, emtricitabine, and maraviroc. Discussion includes indications, pharmacokinetics, precautions, adverse effects, drug interactions, dosage and availability, and patient counseling. Since the first reported case in 1982, HIV infections have been noted in staggering numbers. There are an estimated one million individuals currently living with HIV/AIDS in the United States, with approximately 40,000 new infections occurring each year. Most new infections are attributed to men who have sex with men (MSM). However, the numbers of heterosexual transmission and those occurring in young adults and adolescents are also on the rise. The most common methods of transmission is through contact between infected bodily fluids and the mucosal surfaces lining the intestinal tract and the genitalia and the sharing of needles for intravenous drug abuse. Factors that increase the risk of transmission include having a high viral load or an advanced infection (AIDS), if vaginal or rectal bleeding occurs during sexual intercourse, if a male is uncircumcised, co-infection with other sexually transmitted infections (STIs), menstruation, and hormonal imbalances. T Pathogenesis: HIV is a positive sense, single stranded RNA retrovirus. It possesses an indolent and complicated infectious cycle. Infections result in a destruction of CD4 lymphocytes and cell-mediated immunity. After the virus gains entry into the body, it binds to host CD4 cells and chemokine co-receptors by utilizing a glycoprotein located on its outer surface (gp160). The gp160 is comprised of two smaller units (gp41 and gp120). Gp120 has a higher affinity for the CD4 cell receptors, playing a significant role in the initial internalization of the virus. Chemokines (CCR5 and CXCR4) help to further promote internalization. Since HIV is a RNA virus, it must convert its RNA into viral DNA. To do this, the virus carries an essential RNA-dependent DNA polymerase enzyme called reverse transcriptase (RT). RT is rather inaccurate, creating many errors which promote viral mutation. The new viral DNA enters the nucleus to incorporate into the host DNA using the enzyme DNA integrase. Integration is random, creating cell abnormalities that lead to apoptosis. After integration is complete, the virus utilizes the host cell to duplicate its newly formed DNA and produce viral proteins, RNA, and surface glycoproteins. Viral RNA, proteins, and other necessities are packaged together under the host cell membrane. This package then buds off from the host cell, using the membrane to form its own and take on host characteristics. Once free from the host cell, the new viron uses HIV protease to create mature proteins and an infectious virus. Clinical Presentation: Most patients present with acute mononucleosis-like signs and symptoms two For questions concerning PRINT CEs, call (352) 273-6275. For questions concerning ON-LINE CEs, call (866) 261-3558. http://www.drugtopics.com http://www.drugtopics.com

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Drug Topics - March 14, 2008 Contents Latebreakers Letters: Students Need Grounding in Chemistry Pharmacy Directors Wary of Heparin Shortages Some E-prescribing Standards are Ready to Go, Others are Not News Briefs Nanotechnology: Big Stakes in a Small World Pay for Performance is Coming to Pharmacy Patient Safety Organizations Still Very Much in Planning Stage Reconciling Medications in Specialty Patients Poses More Challenges Pharmacy Outsourcing Still Much in Use by Hospitals Studied Extensively, New Drug-Eluting Stent Said to be Very Safe Prevention is Key in Treating C. Difficile Infections E-prescribing Grows in Massachusetts, but Other States Lag Behind Active Metabolite Gives New Life to Antidepressant NSAIDS not Recommended for Long-term Use in Osteoarthritis This Time R.Ph.s and States Are Ready for Tamper-Resistant Rx Pads Cardinal Caught Between DEA and Pharmacies over Diversion Control Medicating Kids: Still More Questions than Answers Schnucks Pharmacy: Drug Topics' Chain of the Year Panel Will Ask for a System for R.Ph. Practice Across State Lines FDA Safety Page: How to use Fentora Safely The Shining OTC/HBC Stars of 2007 Take a Look at These OTCs for Eye Health Technology Update: Google Offers a Sneak Peak at its Electronic Records Initiative Recent Advancements in HIV/AIDS Treatment New Products Advertisers Index Classified Viewpoint: Are State Boards of Pharmacy Abusing Their Power?

Drug Topics - April 14, 2008

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