Hepatitis Antivirals (Quiz4) Flashcards
structure of Hep A
+ssRNA
structure of Hep C
+ssRNA
structure of Hep B
dsDNA with reverse transcriptase
which drugs are used to treat Hep B
- Lamivudine
- Entecavir
- Tenofovir
which drugs are used to treat Hep C
- Sofosbuvir
- Glecaprevir
- Ledipasvir
- Ribavirin
- PEG-IFN alpha
MOA of Tenofovir
- Reverse transcriptase inhibitor
- analog of adenosine
- incorporate into growing DNA strands and cause chain termination
MOA of Entecavir
- reverse transcriptase inhibitor
- analog of guanosine
- incorporate into growing DNA strands and cause chain termination
MOA of Lamivudine
- reverse transcriptase inhibitor
- analog of cytidine
- incorporate into growing DNA strands and cause chain termination
which Hep B drug has high rates of resistance
- lamivudine
which Hep B drug has low rates of resistance
- tenofovir
- entecavir
toxicity of Entecavir, Tenofovir
- Acute tubular necrosis
- acute kidney injury in PCT
toxicity of tenofovir only
mechanism
- osteoporosis
- reduced reabsorption of PO4 in PCT
which are the first line monotherapies for both acute and chronic Hep B infections
- Tenofovir
- Entecavir
which hep B drug is not used as a monotherpay due to resistance
- Lamivudine
NS5B is what
inhibitors end with which suffix
- RNA polymerase
- buvir
FLIP THE P UPSIDE DOWN TO MAKE A b
NS3A/4 is what
inhibitors end with which suffix
- protease
- previr
protease - previr
NS5A is what
inhibitors end with which suffix
- viral assembly
- asvir
assembly - asvir
MOA of sofosbuvir
- NS5B RNA polymerase inhibitor
MOA of Gleprevir
- NS3/4A protease inhibitor
MOA of Ledipasvir
- NS5A assembly inhibitor
drug interaction with sofosbuvir
mechanism
- Amiodarone
- compete with binding to albumin
- increased free amiodarone
- bradycardia, heart block
Don’t use NS3/4 protease inhibitors (Glecaprevir) with which condition
- decompensated cirrhosis
drug interaction with NS5A inhibitors (Ledapasvir)
- PPIs may reduce effectiveness
MOA of ribavirin
- guanosine analog
- interferes with Hep C RNA synthesis and induces mutations
MOA of monophosphate of ribavirin
- inhibits GTP synthesis
MOA of triphosphate of ribavirin
- inhibits RNA replication
- incorporates producing a defective genome
ribavirin for Hep C is administered how
- orally
distribution of ribavirin for Hep C
- concentrates in RBCs
use caution with ribavirin for Hep C in patients with
- renal insufficiency
toxicities of ribavirin
- hemolytic anemia
- teratogenic, embryotoxic
can pregnant women care for someone on aerosolized ribavirin
what happens if a women does
- no
- birth control for 7 months
why do you add polyethylene glycol to IFN
- stabilize it
- make it more effective in the body
how do we give PEG-IFN alpha
- subcutaneously
toxicity of PEG-IFNalpha
- depression, anxiety, other neuropsychiatric effects
how do we give Hep C to avoid development of resistance
- give in combinations
Lepidasvir + sofosbuvir protects against what Hep C types
- 1, 4, 5, 6
Glecaprevir + pibrentasvir protects against what Hep C types
1, 2, 3, 4, 5, 6
