HBV and HCV Pharm Flashcards
What are the goals of chronic HBV therapy?
- supression of HBV DNA to undetectable levels
- seroconversion of HBeAg from positive to negative
- Reduction in elevated serum aminotransferase levels
What are the endpoints of HBV supression?
improved necro-inflammatory disease
decreased risk for hepatocellular carcinoma and cirrhosis
decreased need for liver transplant
What is the MOA for Entecavir?
HBV nucleoside analogue reverse transcriptase
What is the BB warning for Entecavir?
severe acute exacerbation of Hep B
Coinfection with HIV and HBV
lactic acidosis
hepatomegaly
What are the indications for Entecavir?
Tx chronic HBV in adults and kids ages 2+ with persistent elevated ALT/AST or histologically active disease and evidence of active viral replication
What are the contraindications for Entecavir?
None
What are the AE of Entecavir?
Adults and kids-HA, dizziness, nausea
What is the MOA for Tenofovir Disoproxil?
HBV reverse transcriptase inhibitor (also for HIV-1)
What is the BB warning for Tenofovir Disoproxil?
Lactic acidosis
severe hepatomegaly with steatosis
post-treatment exacerbation of hepatitis
What are the indications for Tenofovir Disoproxil?
Use in combo for HIV-1 in adults and kids 2+
Use for HBV in adults and kids 12+
What are the contraindications for Tenofovir Disoproxil?
New onset or worsening renal impairment (ARF or Fanconi)
What are the AE for Tenofovir Disoproxil?
Pt’s with compensated liver disease most commonly experience is Nausea
What is the MOA and indication for Adefovir?
Nucleotide analogue for HBV in pt’s ages 12+
What are the contraindications for Adefovir?
Don’t use in any pt with a hx of hypersensitivity to any of the ingredients
What is the main warning/precaution of Adefovir?
nephrotoxicity
monitor renal fxn!!
What are the adverse effects of Adefovir?
asthenia and increased creatinine
What are the drug interactions for Adefovir?
coadministration with drugs that reduce renal function may increase concentrations of adefovir or the coadministered drug
What is the MOA for Lamivudine?
nucleoside analogue RT inhibitor for HBV
What is the BB warning for Lamivudine?
Lactic Acidosis
Severe Hepatomegaly
Exaceration of Hep B
Different formulations
What are the indications of Lamivudine?
What are the contraindications for Lamivudine?
Used in combination with other antiretroviral agents for the treatment of HIV1
Don’t use in pt’s with previous hypersensitivity rxn to any ingredient
What are the warnings/precautions for Lamivudine?
In co-infected pt’s with HBV/HIV-1: Lamivudine resistant HBV strains
Pancreatitis
What are the AE for Lamivudine?
HA, nausea, malaise, fatigue
What is the MOA for Telbivudine?
nucleoside analogue RT inhibitor for HBV
What are the BB warnings for Telbivudine?
Lactic Acidosis
Severe Hepatomegaly with steatosis
severe acute exacerbations of Hep B
What are the indications for Telbivudine?
Used for chronic HBV with evidence of viral replication, and either elevated ALT/AST or histological evidence