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GI II Exam 2 > Viral Hepatitis Pharmacology > Flashcards

Viral Hepatitis Pharmacology Flashcards

1
Q

what drugs are used to treat chronic HBV?

A

“IT TALE” (think Pennywise the clown has HBV)

Interferon Alfa-2A
Telbivudine

Tenofovir Disproxil
Adenofir Pipivoxil
Lamivudine
Entecavir

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2
Q

what is the MOA of entecavir?

A

HBV nucleoside analogue reverse transcriptase

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3
Q

what are the black box warnings of entecavir?

A

severe acute exacerbation of HBV
patients co-infected with HBV and HIV
lactic acidosis
hepatomegaly

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4
Q

what is the MOA of tenofovir disoproxil?

A

nucleotide analog HIV-1 reverse transcriptase inhibitor and an HBV reverse transcriptase inhibitor

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5
Q

what are the black box warnings of tenofovir disoproxil?

A

lactic acidosis
severe hepatomegaly with steatosis
post treatment exacerbation of hepatitis

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6
Q

what are some adverse reactions of tenofovir disoproxil?

A

acute or worsening renal impairment or Fanconi syndrome

nausea

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7
Q

what is the MOA of adefovir dipivoxil?

A

nucleotide analogue

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8
Q

what are some adverse reactions of adefovir dipivoxil?

A

nephrotoxicity
severe acute exacerbation of hepatitis
asthenia
increased creatinine

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9
Q

what drug interactions should be considered when giving adefovir dipivoxil?

A

drugs that reduce renal function or compete for activ tubular secretions

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10
Q

what is the MOA of lamivudine?

A

nucleoside analogue reverse transcriptase inhibitor

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11
Q

what are the black box warnings of lamivudine?

A

lactic acidosis
severe hepatomegaly
exacerbation of HBV

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12
Q

what should be considered prior to giving lamivudine to a HIV/HBV co-infected patient?

A

lamivudine-resistant HBV variants have been reported after giving lamivudine containing regimens

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13
Q

what is the MOA of telbivudine?

A

nucleoside analogue reverse transcriptase inhibitor?

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14
Q

what are the block box warnings of telbivudine?

A

lactic acidosis
severe hepatomegaly with steatosis
severe acute exacerbation of HBV

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15
Q

when is telbivudine contraindicated?

A

combination of telbivudine with PEGylated interferon alfa-2a

risk of peripheral neuropathy

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16
Q

what is the black box warning of interferon alfa-2A?

A

risk of serious disorders and ribavarin-associated effects

17
Q

when is interferon alfa-2A contraindictated?

A

autoimmune hepatitis
hepatic decompensation in patients with cirrhosis
use in neonates/infants

18
Q

what drugs are used to treat HCV?

A

“VEILS B”

Velpatasvir/sofosbuvir
Elbasvir/grazoprevir
Interferon alfa-2A
Ledipasvir/sofosbuvir
Sofosbuvir/ribavirin
Boceprevir
19
Q

what drug can treat HBV or HCV?

A

interferon alfa-2A

20
Q

what is the MOA of elbasvir/grazoprevir?

A

Elbasvir: NS5A inhibitor
+
Grazoprevir: NS3/4A protease inhibitor

21
Q

what is a possible warning associated with E/G?

A

ALT elevation

22
Q

what drug interactions need to be considered before giving E/G?

A

do not give with moderate CYP3A inducers

*may decreased the concentration of E/G

23
Q

what is the MOA of ledipasvir/sofosbuvir?

A

ledipasvir: NS5A inhibitor
+
sofosbuvir: nucleotide analogue NS5B polymerase inhibitor

24
Q

what drug interactions need to be considered before giving L/S?

A

poly-glycoprotein inducers (St. Johns wort and rifampin) may alter concentrations

25
Q

what is the MOA of velpatasvir/sofosbuvir?

A

sofosbuvir: nucleotide analogue NS5B polymerase inhibitor
+
velpatasvir: NS5A inhibitor

26
Q

when is V/S contraindicated?

A

in patients for whom ribavirin is contraindicated

27
Q

what are adverse reactions of V/S?

A

can potentiate bradycardia with amiodarone co-administration

do not give to patients on beta-blockers

do not give to patients with cardiac comorbidities

do not give to patients with advanced liver disease

28
Q

what drug interactions need to be considered before giving V/S?

A

poly-glycoprotein inducers (St. Johns wort and rifampin) may alter concentrations

29
Q

what is the black box warning of ribivarin?

A

birth defects and fetal death if used for pregnant woman

30
Q

what is the MOA of ribivarin?

A

nucleoside analogue

*used in combination with interferon alfa-2A

31
Q

when is ribivarin contraindicated?

A

pregnant women AND men whose female partners are pregnant

hemoglobinopathies

32
Q

what is the MOA of boceprevir?

A

NS3/4A protease inhibitor

*used in combination with ribavarin and interferon alfa-2A

33
Q

when is boceprevir contraindicated?

A

since used with ribivarin - pregnancy and hemoglobinopathies

34
Q

what are common adverse reactions associated with all HBV/HCV drugs?

A

headache
nausea
fatigue

GI II Exam 2 (16 decks)

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