Review of Pharmacology - 9E (2015)

Review of Pharmacology
Chemotherapy B: Antimicrobials for Specific Conditions
DOC for chronic HBV is
entecavir whereas for HCV (both
acute and chronic), DOC is Peg-
IFN-a plus riibavirin.
DOC for chronic HBV is entecavir whereas for HCV (both acute and chronic), DOC is Peg-
IFN-α plus riibavirin.
Entecavir
It is the newer HBV viral DNA polymerase inhibitor. It is effective against HBV resistant to
lamivudine and has become first line drug for chronic HBV infection. It should be given in
empty stomach.
Adefovir
It acts as an antimetabolite for HBV but nephrotoxicity is dose limiting adverse effect. It can
also cause lactic acidosis with hepatomegaly and steatosis.
New Drugs for Hepatitis C Virus
• Boceprevir and Telaprevir are protease inhibitors of HCV. These act by binding
to NS-3 active site and inhibit NS3/4A serine protease of HCV. These are used
along with Peg-interferon and ribavirin and are approved for HCV genotype
1 only. These are administered orally with food. Anemia and rash are common
adverse effects. These are also inhibitors of CYP 3A4.
• Sofosbuvir is a nucleotide analog that act by inhibiting RNA polymerae (NS-
5B protein). It can be given without interferons. Combination with ribavirin is
approved for HCV genotypes 2 and 3.
• Ledipasvir (NS 5A inhibitor) is approved in combination with sofosbuvir for
HCV.
Anti Hiv Drugs
586
Fig. 14.2: Pathogenesis of HIV
and target of various drugs
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