Viral Hepatitis Pharmacology

Question 1

What is Entecavir indicated for?

Answer 1

Tx of chronic HBV in adults and children at least 2 years old

Question 2

What are the black box warnings for Entecavir?

Answer 2

1) Severe acute exacerbations of hepatitis B
2) Patients co-infected with HIV and HBV
3) Lactic acidosis
4) Hepatomegaly

Question 3

What is Tenofovir Disoproxil indicated for?

Answer 3

1) Tx of chronic HBV in adults and pediatric patients 12 years of age and older
2) Tx of HIV-1 infection in adults and pediatric patients 2 yo and older

Question 4

What are the black box warnings for Tenofovir Disoproxil?

Answer 4

1) Lactic acidosis
2) Severe hepatomegaly with steatosis
3) Post treatment exacerbation of hepatitis

Question 5

What are some warnings and precautions associated with Tenofovir Disoproxil?

Answer 5

Acute renal failure and Fanconi syndrome

Question 6

What is Adefovir Dipivoxil indicated for?

Answer 6

Tx chronic HBV in patients 12 yo and up

Question 7

What are some warnings and precautions associated with Adefovir Dipivoxil?

Answer 7

Nephrotoxicity

Question 8

What adverse reaction is seen with Adefovir Dipivoxil in pre and post transplantation lamivudine-resistant liver disease patients?

Answer 8

Increased creatinine

Question 9

Coadministration of Adefovir Dipivoxil with what other types of drugs may increase serum concentrations of adefovir or the coadministered drug?

Answer 9

Drugs that reduce renal function or compete for active tubular secretion

Question 10

What is lamivudine indicated for?

Answer 10

Tx of HIV-1/HBV co-infection

Question 11

What are the black box warnings for Lamivudine?

Answer 11

1) Lactic acidosis
2) Severe hepatomegaly
3) Exacerbations of hepatitis B

Question 12

What are some warnings and precautions associated with Lamivudine?

Answer 12

1) HBV resistant variants

2) Pancreatitis

Question 13

What is Telbivudine indicated for?

Answer 13

Tx chronic HBV in adults

Question 14

What are the black box warnings for Telbivudine?

Answer 14

1) Lactic acidosis
2) Severe hepatomegaly with steatosis
3) Exacerbations of hepatitis B

Question 15

What contraindication does Telbivudine have?

What does it increase the risk of?

Answer 15

1) Combination therapy with PEG interferon alfa-2a

2) Peripheral neuropathy

Question 16

What is PEG interferon alfa-2a indicated for?

Answer 16

Tx of chronic HCV and HBV

Question 17

What are the black box warnings for PEG interferon alfa-2a?

Answer 17

Ribavirin associated effects

Question 18

What is PEG interferon alfa-2a contraindicated for?

Answer 18

1) Autoimmune hepatitis
2) Patients with cirrhosis
3) Use in neonates/infant

Question 19

What drug causes adverse effects such as headache, nausea, malaise and fatigue, nasal symptoms, diarrhea, and cough?

Answer 19

Lamivudine

Question 20

What drug causes adverse effects such as fatigue, increased creatine kinase, headache, cough, diarrhea, abdominal pain, and nausea?

Answer 20

Telbivudine

Question 21

What drug causes adverse effects such as nephrotoxicity, headache, nausea, malaise and fatigue, nasal symptoms, diarrhea, and cough?

Answer 21

Tenofovir Disoproxil

Question 22

What drug causes adverse effects such as “flu-like” symptoms, fever, headache, chills, myalgia, and fatigue?

Answer 22

PEG-Interferon Alfa-2a

Question 23

What drug causes common adverse reactions (≥3%, all severity grades) such as headache, fatigue, dizziness, and nausea?

Answer 23

Entecavir

Question 24

What drug causes adverse effects such as nephrotoxicity, asthenia and increased creatinine?

Answer 24

Adefovir Dipivoxil

Question 25

What is PEG-Interferon Alfa-2b indicated for?

Answer 25

Tx chronic HCV in patients 18yo or up with compensated liver disease

Question 26

What are the contraindications for PEG-Interferon Alfa-2b?

Answer 26

1) Autoimmune hepatitis | 2) Decompensated liver disease

Question 27

What is Elbasvir/Grazoprevir indicated for?

Answer 27

Tx of chronic HCV

Question 28

Of the Elbasvir/Grazoprevir combo, which is the NS5A inhibitor? Whis is the NS3/4A protease inhibitor?

Answer 28

1) Elbasvir | 2) Grazoprevir

Question 29

Co-administration of Elbasvir/Grazoprevir with what other drugs is not recommended as they may decrease their plasma concentration?

Answer 29

CYP3A inducers

Question 30

What is Ledipasvir/Sofosbuvir indicated for?

Answer 30

Tx of chronic HCV in adults

Question 31

Of the Ledipasvir/Sofosbuvir combo, which is the NS5B polymerase inhibitor? Which is the NS5A inhibitor?

Answer 31

1) Sofosbuvir | 2) Ledipasvir

Question 32

Ledipasvir/Sofosbuvir is only recommended under what condition?

Answer 32

Combined with other drugs such as ribavirin and peginterferon-alfa

Question 33

Co-administration of Ledipasvir/Sofosbuvir with what other drugs is not recommended as they may decrease their plasma concentration?

Answer 33

CYP3A inducers such as rifampin and St. John's wort

Question 34

What is Velpatasvir/Sofosbuvir indicated for?

Answer 34

Tx of chronic HCV in adults without cirrhosis

Question 35

Of the Velpatasvir/Sofosbuvir combo, which is NS5B polymerase inhibitor? Which is the NS5A inhibitor?

Answer 35

1) Sofosbuvir | 2) Velpatasvir

Question 36

What is Velpatasvir/Sofosbuvir combined with?

Answer 36

Ribavirin

Question 37

What can Velpatasvir/Sofosbuvir potentiate with amiodarone co-administration? You should caution using this combo in patients receiving what drugs?

Answer 37

1) Bradycardia | 2) Beta blockers

Question 38

Co-administration of Velpatasvir/Sofosbuvir with what other drugs is not recommended as they may decrease their plasma concentration?

Answer 38

PGP inducers and/or potent CYP inducers

Question 39

What is Ribavirin indicated for?

Answer 39

Tx of chronic HCV in patients 5yo and up and adult patients with HCV and HIV

Question 40

What black box warning does ribavirin have?

Answer 40

Birth defects and fetal death

Question 41

What contraindication does ribavirin have?

Answer 41

1) Pregnant women and men whose partner is pregnant | 2) Hemoglobinopathies

Question 42

What is Boceprevir indicated for?

Answer 42

Tx of chronic HCV in adult patients with compensated liver disease

Question 43

Boceprevir is used when what treatments have failed?

Answer 43

Interferon and ribavirin therapy

Question 44

Boceprevir and Grazoprevir make up what class of drug?

Answer 44

NS3/4A protease inhibitors (-previr)

Question 45

Ledipasvir, Velpatasvir, and Elbasvir make up what class of drug?

Answer 45

NS5A inhibitors (-asvir)

Question 46

Sofosbuvir makes up what class of drug?

Answer 46

NS5B polymerase inhibitor (-buvir)