GI: Hepatitis Pharm Flashcards
What is the contraindication of adefovir?
hypersensitivity
Would you prescribe Elbasvir/Grazoprevir in someone with cirrhosis?
No
-anyone with severe hepatic impairment, DO NOT prescribe
PEG IFN-a-2_ can treat HepB and C, while PEG IFN-a-2_ only treats HepC?
IFN-a-2a=HepB and C
IFN-a-2b=Hep C only
BB warning of tenofovir?
Acute exacerbations of HepB when discontinued
Lactic acidosis
Hepatomegaly and steatosis
What combo of drugs used to treat HepC are NS5A and NS3/4A inhibitors?
Elbasvir (NS5A)
and
Grazoprevir (NS3/4A)
What HepC drug can cause altered taste?
Boceprevir is associated with dysgeusia
What drug is a NS3/4A inhibitor used along with PEG-IFN-a and ribavirin?
Boceprevir
What drugs can cause flu like symptoms?
PEG IFN-a-2a and b
what combo of drugs to treat HepC is only used in junction with ribavirin?
Ledipasvir (NS5A)/Sofosbuvir (NS5B)
What combo of drugs causes an increase in ALT levels?
Elbasvir/Grazoprevir
What other drug is given along with ribivirin for HepC?
IFN-a-2a
What two drugs can cause renal toxicity?
Tenofovir and Adefovir
-so do not prescribe in those w renal issues!
What drugs can Elbasvir/Grazoprevir interact with?
Those that interfere with CYP3A
-can increase or decrease concentration
Would you prescribe entecavir in someone with HIV?
No, can make it a lot worse
What nucleoTide analog is used to treat HepB?
Adefovir
BB warning of entecavir?
Acute exacerbations of HepB when discontinued
Lactic acidosis
Hepatomegaly
What HepC drug is severely teratogenic?
Ribivirn
-so pregnant mothers and husbands of pregnant mothers beware
BB warning for Telbivudine?
Severe exacerbations of HepB when discontinued
Lactic acidosis
Hepatomegaly
Both forms of PEG IFN-a are contraindicated in someone with what condition?
Autoimmune hepatitis
What nucleoTide analog is used for treatment of HIV and HepB?
Tenofovir disoproxil
If a patient is taking amiodarone for their heart arrythmias, what HepC drugs should you not prescribe?
Velpatasvir/Sofosbuvir
-potentiates bradycardia!!
What fixed combo of HepC drugs inhibit both NS5A and NS5B?
Ledipasvir (NS5A)/Sofosbuvir (NS5B)
or
Velpatasvir (NS5A)/Sofosbuvir (NS5B)
What nucleoSide analogues are used to treat HepB?
Entecavir and Telbivudine
BB warning for lamivudine?
Acute exacerbations of HepB when discontinued
Lactic acidosis
Hepatomegaly
What nucleoSide is used to treat HepB and HIV?
Lamivudine
What can the combo of Telbivudine w PEG IFN-a-2a cuase?
Peripheral Neuropathy
What drug can cause pancreatitis?
lamivudine
Would you use PEG IFN-a-2a in neonates?
no
What drugs should you not prescribe with Velpatasvir/Sofosbuvir?
Amiodarone, B-blockers
-can worsen cardiac/liver comorbidities
What drug/drug interactions do you need to watch out for when prescribing Ledipasvir/Sofosbuvir and Velpatasvir/Sofosbuvir?
Poly Glycoprotein inducers (rifampin, St. Johns wart, carbamazepine)
-alter concentrations!
What is the goal of HBV therapy?
- Supress HBV DNA
- Convert HBeAg from positive to neg
- Reduce AST/ALT
What is the goal of HepC therapy?
Eradication of the virus
Sofosbuvir inhibit what enzyme?
it is a NS5B polymerase inhibitor
The NS3/4 drugs, boceprevir and grazoprevir, inhibit what enzyme?
They function as NS3/4 protease inhibitors
