Fitz - Antiviral Pharm for HBV & HCV Flashcards
NRTIs
- Adefovir
- entecavir
- tenofovir
- lamivudine
- telbivudine
interferons are dagerous for use in what kind of pts?
pts with decompensated cirrhosis
AEs: interferon-alpha
- flu-like s/s after injection
- fatigue & mental depression
- bone marrow suppression
- neurotoxicity
how to monitor efficacy of interferon tx
- dec in HBV DNA
- dec in HBeAg (envelope protein that allows for transmisssion)
2 modes of HBV resistance to NRTIs
- impared purine/pyrimidine kinase activity
- mutation of DNA polymerase/reverse transcriptase
nuceloside NRTIs
- lamivudine
- telbivudine
- entecavir
nucleotide monophosphate NRTIs
- adefovir
- tenofovir
first line oral anti-HBV agents
- tenofovir
- entecavir
second line oral anti-HBV agents
- lamivudine
- telbivudine
first line tx for wild-type HBV
tenofovir
AE with high dose of tenofovir
nephrotoxicity
drug of choice for HBV in pts with renal insufficiency
entecavir
LT use of lamivude is limited by what?
frequent emergence of drug-resistant HBV
standard of care for HCV inf
PEG-inf plus ribavirin for 24-48 wk
MOA: ribavirin-monoP
IMP dehydrogenase > stops pruine synthesis and salvage ptwys
MOA: ribavirin-triP
- RNA-dependent RNA polymerase > stops RNA replication
- encorporation into viral DNA > lethal mutagenesis
metabolism of RBV
- hepatic > T1/2 = 1 d
- RBCs > T1/2 = 40 d
CI: RBV
pregnancy, category X
-need to have monthly preg test during and 6 mo post tx
MOA: simeprevir
NS3/4A protease inhibitor
MOA: ledipsavir
NS5A inhibitor
MOA: sobosuvir
NS5B polyerase inhibitor > RNA-dependent RNA polymerase blocker
high potency HCV drugs
NS3/4A PIs and NS5A inhibitors
drug regimen using 2nd generation drug for HCV infection
-simeprevir
-PEG-interfereon
-RBV
OR
-sofosobuvir
-RBV
HCV drug that is effective across all genotypes
ledipasvir - potent NS5A inhibitor
