viral hepatitis treatment Flashcards
tenofovir disoproxil moa
pro-drug for tenofovir; nucleotide analog of adenosine-5-monophosphate, causes inhibition of HBV polymerase and produces chain termination
entecavir moa
guanosine nucleoside analog that inhibits HBV viral polymerase
tenofovir and entecavir metabolism and excretion
eliminated unchanged in the urine, no CYP interactions
tenofovir bioavailability
taken with high fat meal increases bioavailability
entecavir bioavailability
food delays absorption
tenofovir adverse effects
acute renal failure (rare), osteoporosis, bone pain, and fractures- give Ca and Vit D supplements
hepatotoxicity due to inhibition of mitochondrial DNA polymerase gamma
treatment of confection of HBV and HIV
tenofovir and emtricitabine
interferon moa
bind to the cell surface and activate tyrosine kinases that leads to the production of IFN-stimulated enzymes, causing an anti proliferative and immunomodulatory effect
interferon toxicity
dose-limiting neuropsychiatric issues: depression, somnolence, confusion, behavioral changes, and seizures;
anemia, myelosuppression with granulocytopenia and thrombocytopenia
hepatic enzyme elevation and triglyceride elevation
treatment of HCV-1
PEG-interferon and ribavirin for 24-48 weeks + telaprevir, boceprevir, or simeprevir
ribavirin moa
enhances hot t-cell immune clearance of HCV, inhibition of host IMPDH which depletes pools of GTP, and directly inhibits HCV replication;
minimal effect on decreasing HCV RNA but works synergistically with interferon
ribavirin tox
primary toxicity is hemolytic anemia
can cause MI and difficulty breathing secondary to anemia
teratogen (male and female)
telaprevir and boceprevir moa
NS3/4 serine protease inhibitors
protease inhibitor adverse effects
potential interactions via CYP 3A4/5
exacerbation of anemia
teratogenicity due to the co-administration with ribavirin
