Fitz - Antiviral Pharm for HBV & HCV

Question 1

NRTIs

Answer 1

• Adefovir
• entecavir
• tenofovir
• lamivudine
• telbivudine

Question 2

interferons are dagerous for use in what kind of pts?

Answer 2

pts with decompensated cirrhosis

Question 3

AEs: interferon-alpha

Answer 3

• flu-like s/s after injection
• fatigue & mental depression
• bone marrow suppression
• neurotoxicity

Question 4

how to monitor efficacy of interferon tx

Answer 4

• dec in HBV DNA

- dec in HBeAg (envelope protein that allows for transmisssion)

Question 5

2 modes of HBV resistance to NRTIs

Answer 5

• impared purine/pyrimidine kinase activity

- mutation of DNA polymerase/reverse transcriptase

Question 6

nuceloside NRTIs

Answer 6

• lamivudine
• telbivudine
• entecavir

Question 7

nucleotide monophosphate NRTIs

Answer 7

• adefovir

- tenofovir

Question 8

first line oral anti-HBV agents

Answer 8

• tenofovir

- entecavir

Question 9

second line oral anti-HBV agents

Answer 9

• lamivudine

- telbivudine

Question 10

first line tx for wild-type HBV

Answer 10

tenofovir

Question 11

AE with high dose of tenofovir

Answer 11

nephrotoxicity

Question 12

drug of choice for HBV in pts with renal insufficiency

Answer 12

entecavir

Question 13

LT use of lamivude is limited by what?

Answer 13

frequent emergence of drug-resistant HBV

Question 14

standard of care for HCV inf

Answer 14

PEG-inf plus ribavirin for 24-48 wk

Question 15

MOA: ribavirin-monoP

Answer 15

IMP dehydrogenase > stops pruine synthesis and salvage ptwys

Question 16

MOA: ribavirin-triP

Answer 16

• RNA-dependent RNA polymerase > stops RNA replication

- encorporation into viral DNA > lethal mutagenesis

Question 17

metabolism of RBV

Answer 17

• hepatic > T1/2 = 1 d

- RBCs > T1/2 = 40 d

Question 18

CI: RBV

Answer 18

pregnancy, category X

-need to have monthly preg test during and 6 mo post tx

Question 19

MOA: simeprevir

Answer 19

NS3/4A protease inhibitor

Question 20

MOA: ledipsavir

Answer 20

NS5A inhibitor

Question 21

MOA: sobosuvir

Answer 21

NS5B polyerase inhibitor > RNA-dependent RNA polymerase blocker

Question 22

high potency HCV drugs

Answer 22

NS3/4A PIs and NS5A inhibitors

Question 23

drug regimen using 2nd generation drug for HCV infection

Answer 23

-simeprevir
-PEG-interfereon
-RBV
OR
-sofosobuvir
-RBV

Question 24

HCV drug that is effective across all genotypes

Answer 24

ledipasvir - potent NS5A inhibitor