Pharmacological Aspects of Hepatitis C: Interventions and Management

Desklib provides past papers and solved assignments for students. This presentation explores the pharmacology of Hepatitis C and Sofosbuvir.

HEPATITIS C
PHARMACOLOGY

INTRODUCTION
 This presentation is aiming to discuss
the pharmacological aspects of hepatitis
C including interventions and
management of the disease.
 Hepatitis c is a infectious disease which
affects human liver.
 Hepacivirus C (HCV) is the virus which
causes this infection.
 This disease does not spread by
superficial contact

HEPATIC SYSTEM
 Hepatic system consist of liver, gall
bladder and hepatic portal system which
collectively responsible for absorption of
nutrients and its distribution.
 Liver detoxify metabolites, produces bio
chemicals and synthesizes protein which
helps in digestion and absorption.
 Gall bladder is a small pouch like organ
which stores bile produced by liver and
releases to small intestine as needed to
emulsify and digest fat.

HEPATITIS C
 Hepatitis C primarily affects liver.
 Chronic and mild infections usually go
undetected for years.
 People who initially infected, 75 to 85
percent still have viruses in dormant state
in their liver.
 It mainly spreads through transfusion of
blood, needle sharing, mother to child and
poorly sterilized medical equipments.
 Light fever, abdominal pain, dark urine and
yellowness in skin are symptoms which are
observed in patients occassionally.

VIROLOGY
 HCV is a RNA virus which is single stranded
and it has an enveloped structure.
 It has total 7 genotypes but 70 % of cases
are caused by genotype 1.
 These viruses usually replicates inside the
liver and lymphatic system.
 Intravenous drug use and blood transfusion
infection are the two main reason of
Hepatitis C spreading.
 There are no vaccines against hepatitis C.
 Antiviral drugs are primarily used for
management post infection.

MANAGEMENT
 95 % of the infection can be cured by
antiviral drugs like
sofosbuvir or simeprevir.
 Medication management also include
reducing stress on liver by inhibiting
alcohol consumption, avoiding drugs
with toxic impact on liver etc.
 Patient is also screened for other
associated complications like liver
cirrhosis and hepatocellular carcinoma.
 Hepatitis A and B vaccination are also
given to reduce their risk

SOFOSBUVIR
 Sofosbuvir is always sold in combination
with velpatasvir.
 It is a advanced generation anti viral drug
fixed combination usually given for chronic
hepatitis C cases.
 It was approved to be used for treatment in
2016 in USA and WHO also included it in
list of essential medicines.
 Sofosbuvir is a NS5B polymerase inhibitor
and Velpatasir is a NS5A inhibitor.
 Single tablet regimen is used for adults for
chronic infection of genotype 1 to 6.

SOFOSBUVIR

PHARMACOLOGY
 This drug is administered through oral
route.
 Estimated half life .4 hrs
 It is a direct acting antiviral medication.
 Bioavailability after first pass:- 92 %
 Protein binding 65 %
 Metabolism:- on administration it is
quickly activated to triphosphate
 80 percent of drug is eliminated through
urine and 14 percent by fecal route.

INDICATION AND
CONTRAINDICATION
 Indicated in combination for chronic
hepatitis C infection and other hepatitis
infection which belong to genotype 1-6
category as a first line of therapy
treatment.
 It is also indicated in previously failed
treatment cases and in patients who are
not HIV positive.
 Usual regime of treatment is 12 week.
 It is not contraindicated in any case
however in pregnant human females the
tests are still on going.

SIDE EFFECTS AND
COMPLICATIONS
 No significant side effects when used as
a single dose form. Toxicity level in
humans is also low.
 In combination the side effects and
complication of combining drugs are to
be considered.
 Headache and fatigue are reported in
some overdose cases.
 Symptomatic bradycardia is observed in
case of combination with amiodarone.

PHARMACODYNAMICS
 Sofosbuvir is categorized as a (DAA)
antivrial agent.
 90 percent it is used in combination
therapy.
 Recommended dosage is 400 mg/OD-BD
 Maximum plasma concentration is
reached in .5 to 2 hrs.
 Cmax is 567ng/ml
 No known food interaction or drug
interaction till date.