Hepatitis medications

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Hepatitis medications


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Hepatitis medications

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A 65-year-old woman comes to the office for a general physical examination. The patient describes frequent experiences of fatigue and dull abdominal pain. Past medical history is significant for hypertension and type II diabetes mellitus. Current medications include lisinopril, metformin, glyburide, and aspirin. The patient received a blood transfusion during her 20s following complicated childbirth. She does not consume tobacco or alcohol, and she uses marijuana recreationally. Temperature is 37.0°C (98.6°F), pulse is 95/min, respirations are 18/min, and blood pressure is 130/85 mmHg. Physical examination is unremarkable. Laboratory results are shown below. The patient is started on an NS5A inhibitor and pibrentasvir. The latter drug clears the infection through modification of the following processes?  

Laboratory value
12.5 g/dL  
Leukocyte count  
8000 mm3   
Platelet count  
230,000 mm3   
Viral profile  

100,000,000 IU/ml  

External References

First Aid









contraindicated in pregnancy p. 201

hepatitis p. 723

hepatitis C p. 201

purine synthesis p. 34

Teratogens p. 638

ribavirin p. 201


Anti-hepatitis medications are a group of antiviral agents used to treat viral hepatitis, which is the inflammation of the liver caused by some sort of virus that targets and damages liver cells.

Now, viral hepatitis can be acute or chronic.

Acute hepatitis lasts for six months or less, and usually resolves on its own without any antiviral treatment.

Chronic hepatitis lasts for more than six months, sometimes even for decades.

Anti-hepatitis medications are mainly used to treat chronic hepatitis and the two main viruses are hepatitis B virus, or HBV, and hepatitis C virus, or HCV.

Alright, so, HCV is a single stranded RNA virus.

What this means is that HCV inject its RNA into the host’s cell and it can immediately use its host’s ribosomes and translate the proteins needed to make more viruses, like capsomere proteins and enzymes like RNA-dependent RNA polymerase.

This RNA-dependent RNA polymerase uses the viral RNA as a template, and uses the hepatocyte’s nucleotides to transcribe a complementary strand of RNA, which is then used to form new baby viruses!

HBV on the other hand is a double stranded DNA virus.

Once the DNA gets injected into a new cell, it enters the cell’s nucleus and is replicated by the host cell’s machinery.

It’s also transcribed into several messenger RNAs and a pregenomic RNA, and then the messenger RNAs are used to make capsomere proteins and enzymes like DNA polymerase.

DNA polymerase uses the pregenomic RNA to synthesize new copies of the viral DNA, which is combined with the capsomere proteins to assemble new viruses.

With each type of virus, whether it’s RNA or DNA, it’s turning your own cells into virus making factories and pumping out new viruses.

This process strains, damages and potentially kills the infected hepatocytes.

When these liver cells die, the liver gets inflamed and that’s called hepatitis.

The anti-hepatitis medications can be divided into two groups based on their mechanism of action; nucleoside or nucleotide analogues and interferons.


The medications for hepatitis can be divided into two broad categories: those that clear the virus from the body (i.e. antivirals) and those that work to protect the liver from further damage (i.e. hepatoprotectives).

Antiviral medications for hepatitis include pegylated interferon, ribavirin, and telbivudine. These medications are typically used in combination with each other and are very effective at clearing the virus from the body.

Hepatoprotective medications for hepatitis include milk thistle, ursodeoxycholic acid, and vitamin E. These medications protect the liver from further damage and can be quite effective at preventing or slowing the progression of liver disease.


  1. "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
  2. "Rang and Dale's Pharmacology" Elsevier (2019)
  3. "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
  4. "Is Tenofovir Alafenamide Safer than Tenofovir Disoproxil Fumarate for the Kidneys?" AIDS Rev (2016)
  5. "Sofosbuvir and Ribavirin Liver Pharmacokinetics in Patients Infected with Hepatitis C Virus" Antimicrobial Agents and Chemotherapy (2018)
  6. "Review article: long-term safety of oral anti-viral treatment for chronic hepatitis B" Alimentary Pharmacology & Therapeutics (2018)
  7. "Oral Direct-Acting Agent Therapy for Hepatitis C Virus Infection" Annals of Internal Medicine (2017)

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