Anti-HEP Agents (mostly HBV)

Question 1

Treatment of HBV and HCV is…

Answer 1

suppressive not curative

Question 2

Treatment of HBV Agents:

Answer 2

1) INF-a
2) Lamivudine
3) Adefovir
4) Entacavir
5) Telbivudine
6) Tenofovir

Question 3

Treatment of HCV

Answer 3

1) Ribavirin

2) INF-a

Question 4

INF-a & INF-B expression is induced by…

Answer 4

double stranded RNA

Question 5

INF’s are…

Answer 5

paracrine agents that diffuse out of virus infected cells to neighboring cells, and bind respective receptors to cause cell signaling, in these cells signal certain INF-inducible genes get turned on

Question 6

The unique INF-inducible gene that gets turned on from INF and what it does?

Answer 6

2-5’ oligonucleotide synthase that produces 2-5’ oligoadenylates, which stimulate a specific nuclease (RNase L) that breaks down viral and host mRNAs

Question 7

What inhibits protein synthesis in INFs and how?

Answer 7

dsRNA-dependent protein kinase phosphorylates ribosomal protein eIF-2, which inhibits prot. synth

Question 8

What inhibits peptide chain elongation?

Answer 8

phosphodiesterase

Question 9

Basically, INF does what?

Answer 9

signals all unaffected cells to be synthetically inactive so the virus gets quarantined and then the host immune processes can eliminate the virus.

Question 10

INF-a treats…

Answer 10

HBV and HCV- via IV

Question 11

What INF can only be given SC?

Answer 11

INF-alfacon-1

Question 12

PEG forms of INF-a have…

Answer 12

slower clearance

Question 13

Dosage adjustments in INF-a made for…

Answer 13

renal patients

Question 14

INF-a typical SE:

Answer 14

flu-like syndrom- fever and chills- bc your body is producing INF’s

Question 15

INF-a CI’d in

Answer 15

pregnancy, hepatic insuff, autoimmunity, cardiac arrythmia

Question 16

INF-a caution in case of…

Answer 16

psychiatric disorders, epilepsy, thyroid disease, ischemic cardia disease, severe renal insuff, and cytopenia.

Question 17

Lamivudine MOA

Answer 17

cytosine analog that inhibits HBV DNA polymerase (& HIV RT) and causes chain termination

Question 18

Lamivudine is effective by…

Answer 18

reducing viral copy #’s and causing seroconversion (development of Abs) of HBeAg from positive to negative (sero-reversion)

Question 19

Lamivudine benefits:

Answer 19

improves liver fxn, reduces cirrhosis, and incidedence of hepatocellular carcinoma

Question 20

Adefovir dipivoxil is a…

Answer 20

diester prodrug of adefovir

Question 21

Adefovir is a what analog?

Answer 21

an acyclic phosphonated adenine nucleotide analog that causes DNA chain termination

Question 22

Entecavir MOA:

Answer 22

guanasine analog that inhibits HBV DNA polymerase including reverse transcription of the negative strand and synthesis of the positive strand of DNA strand (unique feature!)

Question 23

Entecavir has what % oral absorption?

Answer 23

100%, food reduces

Question 24

Entecavir is similar to lamivudine bc…

Answer 24

it has seroconversion HBeAg, but higher suppression of HBV DNA

Question 25

Telbivudine MOA

Answer 25

thymidine analog phosphorylated by cellular kinases and inhibits HBV DNA polymerase, causes chain termination

Question 26

Telbivudine AE:

Answer 26

lactic acidosis, severe hepatomegaly and steatosis