[PHARM] Viral Hepatitis Pharmacology Flashcards Preview

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Flashcards in [PHARM] Viral Hepatitis Pharmacology Deck (44)
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1

What is the goal for treatment of HBV?

Slow the development of liver disease

 

Can prevent from progressing to hepatocellular carcinoma

2

Define: 

 

Chronic active hepatitis

Acute hepatitis state that continues without normal recovery (longer than 6-12 months)

3

What do interferons do within the body?

Interferons are host cytokines that exert complex 

 

 

antiviral, immunomodulatory and antiproliferative actions

4

What are the (technically 3) types of interferons used to treat hepatitis?

Inferferon alpha-2b

 

PEGylated interferon alpha-2b

PEGylated interferon alpha-2a

 

*The PEGylated interferons are basically the same for our purposes

5

When would you give an interferon drug?

Treatment of patients with well compensated liver disease

6

You should NOT give interferons if your patient....

Is planning to be pregnant within 2-3 years

 

 

***DANGEROUS to give to patients in decompensated cirrhosis

7

What are the differnces in duration of action of inferferon alpha 2-b VERSUS PEGylated interferons alpha2a/2b?

Inferferon alpha 2b doesn't last as long as PEGylated interferons

8

What are the 3 primary functions of interferons in surrmounting an immune response?

1. Protect nearby healthy cells

 

2. Signal macrophages and NK cells to clear infection

 

3. Lysosome lysis, lysis of infected cell

9

What is the MOA of interferon alpha?

Interferon alpha binds to JAK1 and TYK2 which activates them

 

This causes STAT1 and STAT2 to become active (phosphorylated) and induce the activation of transciption of interferon stimulated genes (ISGs)

10

What are the adverse effects that occur with interferon alpha/PEGylated interferons?

80-90% of patients experience SOME kind of adverse effect

 

FLU LIKE SYNDROME

Fatigue and mental depression

11

What are the dose limiting toxicities associated with interferon alpha/PEGylated interferon?

Bone marrow suppression

 

Neurotoxicity-behavioral changes

12

What is the MOA of nucleosides/nucleotides treatment for HBV?

HBV DNA reverse transciptase/DNA polymerase inhibitors

13

How do you take nucleosides/nucleotides for treatment of HBV?

ORALLY

 

 

*much easier to take than the interferon drugs

14

What drugs would you use for a patient that has decompensated cirrhosis?

Nucleoside/nucleotides 

15

What are the (3) nucleoSIDE drugs?

Lamivudine

 

Telbivudine

 

Entecavir

16

What is are the two nucleoTIDE drugs?

Tenofovir

 

Adefovir

17

Which one has the monophosphate attached?

 

Nucleosides?

Nucleotides?

NucleoTIDES!!! have the monophosphate group

18

What is the first line treatment for wild-type HBV?

Tenofovir

 

 

19

What is the unique AE of tenofovir?

Nephrotoxicity

20

What category drug is tenofovir in?

Nucleotide analog of adenosine

21

What is the first line treatment of HBV in patients that have renal insufficiency?

Entecavir

22

What are the TAKE HOME MESSAGES for HBV treatment?

-Therapies for HBV fail to fully eradicate the virus

 

-RELAPSE of hepatitis induced by HBV is always possible

 

 

23

What are the interferon drugs?

Interferon alpha2b

 

PEGylated interferon alpha 2b

PEGylated interferon alpha 2a

24

What category is lamivudine in?

Nucleoside

25

What category is telbivudine in?

Nucleoside

26

What category is entecavir in?

Nucleoside

27

What category is tenofovir in?

Nucleotide

28

What cateogory is adefovir in?

Nucleotide

29

Which can be cured?

 

HBV or HCV?

HCV

 

*remember: HCV has a C in it, so it can be CURED

30

What is the primary drug used for HCV (historically)?

Ribavirin