Hepatitis Antivirals (Quiz4)

Question 1

structure of Hep A

Answer 1

+ssRNA

Question 2

structure of Hep C

Answer 2

+ssRNA

Question 3

structure of Hep B

Answer 3

dsDNA with reverse transcriptase

Question 4

which drugs are used to treat Hep B

Answer 4

• Lamivudine
• Entecavir
• Tenofovir

Question 5

which drugs are used to treat Hep C

Answer 5

• Sofosbuvir
• Glecaprevir
• Ledipasvir
• Ribavirin
• PEG-IFN alpha

Question 6

MOA of Tenofovir

Answer 6

• Reverse transcriptase inhibitor
• analog of adenosine
• incorporate into growing DNA strands and cause chain termination

Question 7

MOA of Entecavir

Answer 7

• reverse transcriptase inhibitor
• analog of guanosine
• incorporate into growing DNA strands and cause chain termination

Question 8

MOA of Lamivudine

Answer 8

• reverse transcriptase inhibitor
• analog of cytidine
• incorporate into growing DNA strands and cause chain termination

Question 9

which Hep B drug has high rates of resistance

Answer 9

• lamivudine

Question 10

which Hep B drug has low rates of resistance

Answer 10

• tenofovir

- entecavir

Question 11

toxicity of Entecavir, Tenofovir

Answer 11

• Acute tubular necrosis

- acute kidney injury in PCT

Question 12

toxicity of tenofovir only

mechanism

Answer 12

• osteoporosis

- reduced reabsorption of PO4 in PCT

Question 13

which are the first line monotherapies for both acute and chronic Hep B infections

Answer 13

• Tenofovir

- Entecavir

Question 14

which hep B drug is not used as a monotherpay due to resistance

Answer 14

• Lamivudine

Question 15

NS5B is what

inhibitors end with which suffix

Answer 15

• RNA polymerase
• buvir

FLIP THE P UPSIDE DOWN TO MAKE A b

Question 16

NS3A/4 is what

inhibitors end with which suffix

Answer 16

• protease
• previr

protease - previr

Question 17

NS5A is what

inhibitors end with which suffix

Answer 17

• viral assembly
• asvir

assembly - asvir

Question 18

MOA of sofosbuvir

Answer 18

• NS5B RNA polymerase inhibitor

Question 19

MOA of Gleprevir

Answer 19

• NS3/4A protease inhibitor

Question 20

MOA of Ledipasvir

Answer 20

• NS5A assembly inhibitor

Question 21

drug interaction with sofosbuvir

mechanism

Answer 21

• Amiodarone
• compete with binding to albumin
• increased free amiodarone
• bradycardia, heart block

Question 22

Don’t use NS3/4 protease inhibitors (Glecaprevir) with which condition

Answer 22

• decompensated cirrhosis

Question 23

drug interaction with NS5A inhibitors (Ledapasvir)

Answer 23

• PPIs may reduce effectiveness

Question 24

MOA of ribavirin

Answer 24

• guanosine analog

- interferes with Hep C RNA synthesis and induces mutations

Question 25

MOA of monophosphate of ribavirin

Answer 25

• inhibits GTP synthesis

Question 26

MOA of triphosphate of ribavirin

Answer 26

• inhibits RNA replication

- incorporates producing a defective genome

Question 27

ribavirin for Hep C is administered how

Answer 27

• orally

Question 28

distribution of ribavirin for Hep C

Answer 28

• concentrates in RBCs

Question 29

use caution with ribavirin for Hep C in patients with

Answer 29

• renal insufficiency

Question 30

toxicities of ribavirin

Answer 30

• hemolytic anemia

- teratogenic, embryotoxic

Question 31

can pregnant women care for someone on aerosolized ribavirin

what happens if a women does

Answer 31

• no

- birth control for 7 months

Question 32

why do you add polyethylene glycol to IFN

Answer 32

• stabilize it

- make it more effective in the body

Question 33

how do we give PEG-IFN alpha

Answer 33

• subcutaneously

Question 34

toxicity of PEG-IFNalpha

Answer 34

• depression, anxiety, other neuropsychiatric effects

Question 35

how do we give Hep C to avoid development of resistance

Answer 35

• give in combinations

Question 36

Lepidasvir + sofosbuvir protects against what Hep C types

Answer 36

• 1, 4, 5, 6

Question 37

Glecaprevir + pibrentasvir protects against what Hep C types

Answer 37

1, 2, 3, 4, 5, 6