Pharmacology of Anti-Hepatitis Drugs

Question 1

What antivirals are NS3/4A protease inhibitors?

Answer 1

Grazoprevir, Paritaprevir

Question 2

What is the only HCV antiviral given in prodrug form (requires phosphorylation for activation)?

Answer 2

Sofosbuvir (NS5B inhibtor)

Question 3

What NRTIs are used to treat HBV?

Answer 3

Lamivudine, Entecavir, Adefovir, Tenofovir

Question 4

In what populations is TNF-alpha for HBV treatment contraindicated?

Answer 4

Patients with decompensated cirrhosis, pregnant women

Question 5

What is the function of NS3/4A in HCV?

Answer 5

Post-translational processing and replication of HCV

Question 6

This NRTI is effective against Lamivudine-resistant HBV, but poses a risk for nephrotoxicity, lactic acidosis, and hepatomegaly.

Answer 6

Adefovir

Question 7

What HCV antivirals are NS5A inhibitors?

Answer 7

Declatasvir, ledispavir

Question 8

True/False. Ribavirin is commonly given as a monotherapy.

Answer 8

False. Must be combined with another drug

Question 9

What ADRs are associated with Ribavirin?

Answer 9

Hemolytic anemia, absolute contraindication in pregnancy

Question 10

NS3/4A inhibitors interact highly with other drugs and are contraindicated in these patients.

Answer 10

Grazoprevir, Paritaprevir - Patients with hepatic impairment

Question 11

This NRTI is considered a first-line drug for HBV, but has high resistance rates in patients who failed Lamivudine treatment.

Answer 11

Entecavir

Question 12

This NRTI is first-line for HBV with low resistance, but is contraindicated in pregnancy.

Answer 12

Tenofovir

Question 13

What is the function of NS5A in HCV?

Answer 13

Regulates HCV viral assembly and replication

Question 14

This drug is nontoxic, but not recommended as first-line treatment for HBV due to high resistance.

Answer 14

Lamivudine

Question 15

What ADRs are associated with Tenofovir?

Answer 15

Renal failure, Fanconi syndrome, decreased bone density

Question 16

What ADRs are associated with IFN-alpha?

Answer 16

Flu-like symptoms, bone marrow suppression, psychiatric disturbances

Question 17

Absorption of this HCV antiviral is reduced at high gastric pH and should be taken during a fasted state and without PPIs.

Answer 17

Ledispavir (NS5A inhibitor)

Question 18

What is the MOA of IFN-alpha to treat HBV?

Answer 18

Activates JAK/STAT signaling to degrade viral RNA and inhibit viral DNA synthesis

Question 19

What HCV antivirals are NS5B inhibitors?

Answer 19

Sofosbuvir, dasabuvir

Question 20

What is the function of NS5B in HCV?

Answer 20

RNA-dependent RNA polymerase

Question 21

What is the primary target for HBV antivirals?

Answer 21

Interrupt replication via the reverse transcriptase.

Question 22

What is the MOA of NRTIs?

Answer 22

Nucleotide analogs that require phosphorylation for activation. They competitively inhibit the reverse transcriptase to terminate the DNA chain.