Hepatitis B Treatment Overview
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Questions and Answers

What is the primary mechanism of action for integrase inhibitors?

  • They block viral protein synthesis.
  • They inhibit the incorporation of viral DNA with host DNA. (correct)
  • They enhance host immune response.
  • They prevent viral entry into host cells.

    • Which of the following adverse effects is associated with Amantadine?

  • Ataxia (correct)
  • Renal failure
  • Prolonged QT interval
  • Hepatotoxicity

    • Which drug is classified as a CYP450 inhibitor?

  • Dolutegravir
  • Ritonavir (correct)
  • Raltegravir
  • Amantadine

    • How is Rimantadine primarily metabolized and excreted?

    <p>Metabolized by the liver and extensively excreted.</p> Signup and view all the answers

    What is a common side effect of drugs like Nelfinavir and Saquinavir?

    <p>Rhabdomyolysis</p> Signup and view all the answers

    What type of drug is Lamivudine categorized as?

    <p>Nucleoside reverse transcriptase inhibitor</p> Signup and view all the answers

    Which side effect is commonly associated with Lamivudine?

    <p>Nausea</p> Signup and view all the answers

    What is the metabolism route for Adefovir dipivoxil?

    <p>Phosphorylation</p> Signup and view all the answers

    How does Lamivudine disrupt viral replication?

    <p>By terminating chain elongation</p> Signup and view all the answers

    What is the primary way Adefovir is excreted?

    <p>Urine</p> Signup and view all the answers

    What is the half-life of Lamivudine?

    <p>7 hours</p> Signup and view all the answers

    What is the mechanism of action of Lamivudine in treating HBV?

    <p>Inhibition of DNA polymerase</p> Signup and view all the answers

    Which additional virus can Lamivudine be used to treat aside from HBV?

    <p>HIV</p> Signup and view all the answers

    What is the primary function of NRTIs in treating viral infections?

    <p>Inhibit reverse transcriptase</p> Signup and view all the answers

    Which of the following side effects is most commonly associated with the use of Zidovudine?

    <p>Myopathy</p> Signup and view all the answers

    Which NRTI is known to cause nephrotoxicity?

    <p>Tenofovir</p> Signup and view all the answers

    What is the mechanism of action for NNRTIs in viral treatment?

    <p>Allosteric inhibition of reverse transcriptase</p> Signup and view all the answers

    Which of the following is a common side effect of Efavirenz?

    <p>CNS toxicity including mood changes</p> Signup and view all the answers

    What is an effect of using Protease Inhibitors?

    <p>Cleavage of polyproteins</p> Signup and view all the answers

    Which drug is known for causing a teratogenic effect?

    <p>Efavirenz</p> Signup and view all the answers

    Which side effect is associated with Maraviroc?

    <p>Hypersensitivity reactions</p> Signup and view all the answers

    What effect does Abacavir have on the body?

    <p>Can lead to hepatic steatosis</p> Signup and view all the answers

    Which of the following best describes the effect of antiretroviral therapy on DNA synthesis?

    <p>Terminates DNA formation from RNA</p> Signup and view all the answers

    What is the function of Velpatasvir in the treatment of HCV?

    <p>Inhibits the NS5A protein</p> Signup and view all the answers

    In which patient population is weight-based ribavirin dosing recommended?

    <p>Patients with decompensated cirrhosis</p> Signup and view all the answers

    Which enzyme is primarily involved in the metabolism of Velpatasvir?

    <p>CYP2B6</p> Signup and view all the answers

    What is a common adverse reaction associated with the use of HIV viral fusion inhibitors?

    <p>Headache</p> Signup and view all the answers

    Sofosbuvir is primarily excreted through which route?

    <p>Urine</p> Signup and view all the answers

    What mechanism of action does Maraviroc utilize in HIV treatment?

    <p>Inhibits CCR5 binding</p> Signup and view all the answers

    What is true about Sofosbuvir as a prodrug?

    <p>It is converted to an active metabolite</p> Signup and view all the answers

    What is the primary mechanism of action for Entecavir?

    <p>Inhibiting reverse transcriptase</p> Signup and view all the answers

    Which drug is classified as a fixed-dose combination product for treating chronic HCV?

    <p>Mavyret</p> Signup and view all the answers

    In HAART therapy, which combination is standard?

    <p>2 NRTIs + 1 Integrase Inhibitor</p> Signup and view all the answers

    Which of the following represents a potential adverse reaction of NS5B polymerase inhibitors?

    <p>Angioedema</p> Signup and view all the answers

    Which side effect is associated with the use of Mavyret?

    <p>Angioedema</p> Signup and view all the answers

    What distinguishes Velpatasvir from Sofosbuvir in terms of excretion?

    <p>Sofosbuvir is predominantly excreted in urine</p> Signup and view all the answers

    What is a significant contraindication for patients treated with Mavyret?

    <p>Past HBV infection</p> Signup and view all the answers

    What is the excretion pathway for Glecaprevir?

    <p>In feces</p> Signup and view all the answers

    Which statement about Pibrentasivir is true?

    <p>It has no significant hepatic metabolism.</p> Signup and view all the answers

    What is one of the mechanisms of action of Sofosbuvir in treating HCV?

    <p>Preventing RNA replication</p> Signup and view all the answers

    Which of the following side effects is not commonly associated with Entecavir?

    <p>Diarrhea</p> Signup and view all the answers

    How is Entecavir mainly metabolized in the body?

    <p>Minimal metabolism</p> Signup and view all the answers

    What is a primary characteristic of Epclusa?

    <p>Contains Sofosbuvir and Velpatasvir</p> Signup and view all the answers

    Study Notes

    Hepatitis B (HBV) Treatment

    • Lamivudine (DOC):
      • Classification: Cytosine analogue, Nucleoside reverse transcriptase and polymerase inhibitor
      • MOA: Turns into active metabolite (phosphorylation by host cell), incorporated into viral DNA, disrupting replication process.
      • Metabolism & Excretion: Minimal metabolism (intracellular by sulfotransferase). Excretion is primarily through urine (mainly unchanged). Half-life: 7 hours. CYP450 minimal.
      • Side Effects: Nausea, Vomiting, Nephrotoxicity.
    • Adefovir dipivoil:
      • Classification: Adenosine nucleotide analog.
      • MOA: Leads to termination of HBV DNA. Active form is incorporated into viral DNA, which disrupts the process of replication.
      • Metabolism & Excretion: Phosphorylation (prodrug), converted to active form. Excretion primarily through urine (45% unchanged). Half-life: 7 hours. CYP450 none.
      • Side Effects: HA
    • Entecavir (Baraclude):
      • Classification: Deoxyguanosine analog.
      • MOA: Inhibits reverse transcriptase, DNA replication, and transcription, Effective in Lamivudine-resistant HBV.
      • Metabolism & Excretion: Minimal metabolism. Excreted by glomerular filtration and tubular secretion.
      • Side Effects: HA, Fatigue, Nausea, Dizziness

    Hepatitis C (HCV) Treatment

    • Mavyret (Pibrentasivir/Glecaprevir):
      • Classification: Fixed-dose combination, HCV NS3/4A protease inhibitor and HCV NS5A inhibitor.
      • MOA: Inhibits HCV NS3/4A protease (cleavage of HCV-encoded polyprotein) and HCV NS5A (essential for viral RNA replication and virion assembly).
      • Metabolism & Excretion: Glecaprevir: liver, partially CYP3A4. Pibrentasivir: none. Glecaprevir excretion is in feces. Pibrentasivir excretion is in urine.
      • Side Effects: Liver failure, Angioedema, HBV reactivation, HA, Nausea, Diarrhea
    • Epclusa:
      • Classification: Combination of Sofosbuvir (HCV NS5B inhibitor) and Velpatasvir (HCV NS5A inhibitor).
      • MOA: Sofosbuvir inhibits the HCV NS5B polymerase. Velpatasvir inhibits the HCV NS5A protein. NS5A polymerase inhibitors interact with viral and host proteins. NS5B polymerase inhibitors interferes with the viral RNA polymerase.
      • Metabolism & Excretion: Sofosbuvir: liver extensively, CYP450 none. Prodrug converted to active form. Velpatasvir: liver CTYP 2B6, 2C8, 3A4. Sofosbuvir excretion is in urine (80%). Velpatasvir excretion is in feces/bile (94%).
      • Side Effects: HA, Diarrhea, Rash, Bradycardia, HBV reactivation, Angioedema, Nausea, Vomiting.

    HIV Treatment

    • Viral Fusion Inhibitors:
      • MOA: Inhibits entry of viral RNA into host cell.
      • Drugs: Enfuvirtide
    • Attachment Co-receptor Inhibitors:
      • MOA: Inhibits entry of viral RNA into host cell by blocking interaction of viral proteins with co-receptors.
      • Drug: Maraviroc
    • NRTIs (Nucleoside Reverse Transcriptase Inhibitors):
      • MOA: Inhibit reverse transcriptase, stopping viral DNA production.
      • Drugs: Zidovudine, Abacavir, Emtricitabine, Stavudine, Didanosine, Lamivudine, Tenofovir.
    • NNRTIs (Non-Nucleoside Reverse Transcriptase Inhibitors):
      • MOA: Bind to and alter reverse transcriptase enzyme, stopping viral DNA production.
      • Drugs: Nevirapine, Efavirenz, Etravirine, Delavirdine, Rilpivirine

    Protease Inhibitors

    • MOA: Inhibit protease, stopping the cleavage of polyproteins.
      • Drugs: Atazanavir, Darunavir, Indinavir, Lopinavir, Nelfinavir, Saquinavir, Tipranavir, Ritonavir.

    Integrase Inhibitors

    • MOA: Inhibit integrase, preventing the incorporation of viral DNA with the human DNA.
      • Drugs: Dolutegravir, Raltegravir, Elvitegravir.

    Respiratory Syncytial Virus (RSV)

    • Amantadine:
      • MOA: Dopamine drugs.
      • Admin: 100mg PO BID x 3-5 days
      • Side Effects: Ataxia, Seizures, Dizziness
    • Rimantadine:
      • MOA: Inhibits Inosine 5-phosphate dehydrogenase, preventing the formation of guanine nucleotides and RNA synthesis.
      • Admin: Same dose as Amantadine.
      • Side Effects: GI intolerance, Prolonged QT interval, seizures. etc.
    • Ribavirin:
      • MOA: Inhibits Inosine 5-phosphate dehydrogenase.
      • Admin: Aerosol
      • Side Effects: Teratogenic, Hemolytic Anemia

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    Hepatitis + HIV Treatment PDF

    Description

    This quiz covers the treatment options for Hepatitis B, focusing on the mechanisms of action, classifications, and side effects of key medications like Lamivudine, Adefovir, and Entecavir. Test your knowledge on the pharmacology and clinical implications of these antiviral therapies.

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