Viral Hepatitis Pharmacology Flashcards
What is Entecavir indicated for?
Tx of chronic HBV in adults and children at least 2 years old
What are the black box warnings for Entecavir?
1) Severe acute exacerbations of hepatitis B
2) Patients co-infected with hiv and hbv
3) Lactic acidosis
4) Hepatomegaly
What is Tenofovir Disoproxil indicated for?
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
What are the black box warnings for Tenofovir Disoproxil?
1) Lactic acidosis
2) Severe hepatomegaly with steatosis
3) Post treatment exacerbation of hepatitis
What are some warnings and precautions associated with Tenofovir Disoproxil?
Acute renal failure and Fanconi syndrome
What is Adefovir Dipivoxil indicated for?
Tx chronic HBV in patients 12 yo and up
What are some warnings and precautions associated with Adefovir Dipivoxil?
Nephrotoxicity
What adverse reaction is seen with Adefovir Dipivoxil in pre and post transplantation lamivudine-resistant liver disease patients?
Increased creatinine
Coadministration of Adefovir Dipivoxil with what other types of drugs may increase serum concentrations of adefovir or the coadministered drug?
Drugs that reduce renal function or compete for active tubular secretion
What is lamivudine indicated for?
Tx of HIV-1/HBV co-infection
What are the black box warnings for Lamivudine?
1) Lactic acidosis
2) Severe hepatomegaly
3) Exacerbations of hepatitis B
What are some warnings and precautions associated with Lamivudine?
1) HBV resistant variants
2) Pancreatitis
What is Telbivudine indicated for?
Tx chronic HBV in adults
What are the black box warnings for Telbivudine?
1) Lactic acidosis
2) Severe hepatomegaly with steatosis
3) Exacerbations of hepatitis B
What contraindication does Telbivudine have?
What does it increase the risk of?
1) Combination therapy with PEG interferon alfa-2a
2) Peripheral neuropathy
What is PEG interferon alfa-2a indicated for?
Tx of chronic HCV and HBV
What are the black box warnings for PEG interferon alfa-2a?
Ribavirin associated effects
What is PEG interferon alfa-2a contraindicated for?
1) Autoimmune hepatitis
2) Patients with cirrhosis
3) Use in neonates/infant
What drug causes adverse effects such as headache, nausea, malaise and fatigue, nasal symptoms, diarrhea, and cough?
Lamivudine
What drug causes adverse effects such as fatigue, increased creatine kinase, headache, cough, diarrhea, abdominal pain, and nausea?
Telbivudine
What drug causes adverse effects such as nephrotoxicity, headache, nausea, malaise and fatigue, nasal symptoms, diarrhea, and cough?
Tenofovir Disoproxil
What drug causes adverse effects such as “flu-like” symptoms, fever, headache, chills, myalgia, and fatigue?
PEG-Interferon Alfa-2a
What drug causes common adverse reactions (≥3%, all severity grades) such as headache, fatigue, dizziness, and nausea?
Entecavir
What drug causes adverse effects such as nephrotoxicity, asthenia and increased creatinine?
Adefovir Dipivoxil
What is PEG-Interferon Alfa-2b indicated for?
Tx chronic HCV in patients 18yo or up with compensated liver disease
What are the contraindications for PEG-Interferon Alfa-2b?
1) Autoimmune hepatitis
2) Decompensated liver disease
What is Elbasvir/Grazoprevir indicated for?
Tx of chronic HCV
Of the Elbasvir/Grazoprevir combo, which is the NS5A inhibitor?
Whis is the NS3/4A protease inhibitor?
1) Elbasvir
2) Grazoprevir
Co-administration of Elbasvir/Grazoprevir with what other drugs is not recommended as they may decrease their plasma concentration?
CYP3A inducers
What is Ledipasvir/Sofosbuvir indicated for?
Tx of chronic HCV in adults
Of the Ledipasvir/Sofosbuvir combo, which is the NS5B polymerase inhibitor?
Which is the NS5A inhibitor?
1) Sofosbuvir
2) Ledipasvir
Ledipasvir/Sofosbuvir is only recommended under what condition?
Combined with other drugs such as ribavirin and peginterferon-alfa
Co-administration of Ledipasvir/Sofosbuvir with what other drugs is not recommended as they may decrease their plasma concentration?
CYP3A inducers such as rifampin and St. John’s wort
What is Velpatasvir/Sofosbuvir indicated for?
Tx of chronic HCV in adults without cirrhosis
Of the Velpatasvir/Sofosbuvir combo, which is NS5B polymerase inhibitor?
Which is the NS5A inhibitor?
1) Sofosbuvir
2) Velpatasvir
What is Velpatasvir/Sofosbuvir combined with?
Ribavirin
What can Velpatasvir/Sofosbuvir potentiate with amiodarone co-administration?
You should caution using this combo in patients receiving what drugs?
1) Bradycardia
2) Beta blockers
Co-administration of Velpatasvir/Sofosbuvir with what other drugs is not recommended as they may decrease their plasma concentration?
PGP inducers and/or potent CYP inducers
What is Ribavirin indicated for?
Tx of chronic HCV in patients 5yo and up and adult patients with HCV and HIV
What black box warning does ribavirin have?
Birth defects and fetal death
What contraindication does ribavirin have?
1) Pregnant women and men whose partner is pregnant
2) Hemoglobinopathies
What is Boceprevir indicated for?
Tx of chronic HCV in adult patients with compensated liver disease
Boceprevir is used when what treatments have failed?
Interferon and ribavirin therapy
Boceprevir and Grazoprevir make up what class of drug?
NS3/4A protease inhibitors (-previr)
Ledipasvir, Velpatasvir, and Elbasvir make up what class of drug?
NS5A inhibitors (-asvir)
Sofosbuvir makes up what class of drug?
NS5B polymerase inhibitor (-buvir)
