Hepatitis Tx Flashcards Preview

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Flashcards in Hepatitis Tx Deck (29):
1

What are the preferred antivirals?

Tenofovir and Entacavir

2

HBV resistance occurs when?

WHen mutations occur in the HBV polymerase.
Tends to be structure specific.

3

Which drug does not inhibit HBV polymerase

Adefovir

4

All of the antivirals are Triphosphates except

Adefovir and Tenofovir

5

Why are the oral antiviral drugs first line therapy over Interferon?

Because they are better tolerated and suppres the virus better

6

Lamivudine is what type of drug?

Nucleoside/tide structural analog

7

Lamivudine MOA

Prodrug adenosine analog

8

Lamivudine AE

GFR and RTS

9

Adefovir is what type of structural analog

Acyclic phosphate

10

Adefovir MOA

Adenosine analog (not a prodrug like lamivudine)

11

Adefovir AE

GFR and RTS, Also may cause lactic acidosis and steatorrhea (hepatotoxic)

12

Tenofovir os what type of structural analog

Acyclic phosphate.

13

Tenofovir moa

cytosine analog

14

What can yo do to increase the bioavailability of tenofovir?

Take with a high fat meal

15

Important AE of TENOFOVIR

Renal toxicity in pts with renal dz. Make sure t test serum creatinine and BUN.

- MAKE SURE to ask pts about bone pain or muscle pain as this may be a sign of renal tubolopathy

- Tenofovir ( a retroviral) Has also been shown to cause osteoporosis. Give with calcium and Vit d

16

Avoid taking Tenofovir with other nephrotoxic agents like

Tylenol

17

Emtricitabine

can be used for co-infections....its a cytosine analog

18

Interferon 2a used against

HBV

19

IFN 2b used for

HCV

20

AE of IFN

flu like, neuropsych (depression and seizures), myelosuppresion, high LFTs, Transient thyroid disturbance

21

How the fuck do IFNs work

They agonize IFN receptors (JAK/STAT) that upregulate enzymes like adenosine deaminase, PKR, and oligoadenylate cyclase----all of which are endonucleases which cleave viral DNA , Inh dsRNA, Inh Viral penetration, uncoating, and release

22

HCV genotype 1

Pegylated IFN 2B + Ribavirin + Telaprevir

23

What does Ribavirin do?

Increases immune clearance, lowers GTP, Mutates RNA. transiently decreases HCV RNA but normalizes ALT

24

Ribavirin absorption increased with

high fat meal

25

AE of Ribavirin

Hemolytic anemia, MI, difficulty breathing

26

Telepravir and Boceprevir mech

Inhibit NS3

27

When are telepravir and boceprevir added?

after four weeks of Interferon + Ribavirin

28

Rash?

Telapravir

29

Male teratogen

Ribavirin