Infectious Disease - Antivirals/Hepatitis B and C/Antiparasitics

Question 1

Zanamavir

Brand
MOA
Indication
Dose for treatment vs prevention

Answer 1

Relena

Neuroaminidase inhibitor

Influenza A/B

TX: 2 puffs BID x 5days
PPX: 2 puffs QD x 7D

Question 2

Peramivir

Brand
Indication
Dose

Answer 2

Rapivab

Acute uncomplicated influenza >18y.o

600mg IV x 1

Question 3

Baloxavir

Brand
MOA
Indication
Dose

Answer 3

Xofluza

Endonuclease inhibitor

Influenza >5y.o prophylaxis AND treatment

50-80mg PO x 1

Question 4

Ganciclovir

Brand/ROA
Excretion
Compounding consideration
ADE

Answer 4

Cytovene - injection
Xirgan - Opthalmic gel

Renal

Must be made in vertical hood

Seizures , BMS

Question 5

Valganciclovir

Brand
ROA
Excretion
ADE

Answer 5

Valcyte

PO with food

Renal

Seizures, BMS

Question 6

Cidofovir

Brand
ROA
Excretion
ADE

Answer 6

Vistide

IV

Renal

Major nephrotox that you give probenacid prior and after administration l intraocular pressure

Question 7

Foscarnet

Brand
ROA
Renal
ADE
Storage

Answer 7

Foscavir

IV

Renal

Seizures, anemia

Glass bottles or IV bag

Question 8

Describe the 3 categories of a hepatitis B serologic panel and what a postive result means

Answer 8

HBsAg - Hep B surface antigen - postive = patient is infected

Anti-Hbs or HBsAb - Hep B surface antibody - positive = patient is immune

Anti-Hbc or HBcAb - Hep B core antibody - positive = patient has been infected either in past or present

Question 9

Hepatitis B oral options

MOA
Frequency
List all 5 with brand name

Answer 9

Nucleoside/tide analogs

All given PO QD

Entecavir - baraclude
Adefovir - hepsera
Lamivudine - Epivir
Tenofovir - Viread
Tenofovir alafenamide - Vemlidy

Question 10

Hepatitis B injections

List brand name and generic and dose

Answer 10

Interferon alfa 2b - Intron A - 3x/week SC/IM x 16 weeks

Pegylated interferon alfa 2a - Pegasys - weekly SC x 48 weeks

Question 11

Treatment naive hepatitis B DOC

Answer 11

Tenofovir or entecavir

Question 12

Pegasys ADE

Answer 12

Flu-like Sx
Depression
Thyroid issue
Hepatotox
Pulm/CV issues
Retinal damage
BMS

Question 13

How do you diagnose hepatitis C?

Who do you test?

Answer 13

The first antibody test will show if they have ever had it (past or present)

If positive, the a 2nd HCV RNA test will be done to see if they are currently positive

Any 18-79 y.o or blood product use before 1987/ HIV/ HD/ IVD

Question 14

What 4 classess of medications do we use to treat hep C?

Answer 14

PI
NPI
NNPI
NS5A inhibitors

Question 15

How long do you treat hepatitis C? Which is the exception?

Answer 15

12 weeks

Mavyret (glecaprevir + pibrentasvir) - 8 weeks

Question 16

Avoid sofosbuvir with…

Answer 16

Amiodarone because it can cause significant bradycardia

It can also increase statin concentrations

Question 17

Is peginterferon recommended for hepatitis C?

Answer 17

No

Question 18

Ribavirin

Brand
MOA
ROA
Indication
Caution

Answer 18

Rabetrol

inhibit RNA and DNA replication

PO

HCV

Must use 2 reliable contraceptions and for 6 months after DSC because it is pregnancy category X

Question 19

Sofosbuvir

Brand
Dose
Indication

Answer 19

Sovaldi

400mg QD

Hepatitis C treatment

Question 20

Harvoni

Generic
Dose
Interactions
Indication

Answer 20

Ledipasvir + sofosnuvir

1 tab PO QD

PGP inducers , amiodarone, statins

Hepatitis C

Question 21

Epclusa

Generic
Dose
Caution
BBW
Indication

Answer 21

Velpatasvir + sofosbuvir

1 T PO QD x12 weeks

Amiodarone, statin

Hep B reactiviation

Pan-genotypic hepatitis C

Question 22

Vosevi

Generic
Dose
Interactions
Indication
Separate from..

Answer 22

Velpatasvir + sofosbuvir + voxilaprevir

1 T PO with food x 12 weeks

Potent inducers, rifampin, statins, amiodarone

Hepatitis C

Antacids and limit H2RA use (PPI safer)

Question 23

Viekira pak

Generic
Dose
Indication

Answer 23

Ombitasvir + paritaprevir + ritonavir + dasabuvir

2 pink tabs in AM and 1 tan tab BID with food

Hepatitis C

Question 24

Zepatier

Generic
Dose
Interactions
Indication

Answer 24

Elbasvir + Grazoprevir

1 tab QD PO x 12 weeks

Contraindicated with 3A4 inducers and not recommended with 3A4 inhibitors

Hepatitis C

Question 25

Mavyret Generic Dose Indication

Answer 25

Glecaprevir + pibrentasvir 2 tabs QD with food x 8 weeks Hepatitis C

Question 26

What hepatitis C medications do you use for HCV genotype 1 infection? (brand name only)

Answer 26

Harvoni Epclusa Mavyret Zepatier Viekiera pak

Question 27

What hepatitis C medications do you use for HCV genotype 3 infection? (brand name only)

Answer 27

Epclusa Mavyret Vosevi

Question 28

What hepatitis C medications do you use for HCV genotype 4 infection? (brand name only)

Answer 28

Epclusa, harvoni, mavyret, zepatier

Question 29

What vaccines are recommended to protect the liver? What two substances harm the liver?

Answer 29

Hepatitis A/B Influenza Pneumonia TDaP Alcohol and kava kava (OTC)

Question 30

Mebendazole Brand Dose Indication

Answer 30

Emverm 100mg single dose Pinworm

Question 31

Albendazole Brand Dose / age Indication

Answer 31

Albenza 400mg singe dose for >1y.o PinwormP

Question 32

Pyrantel Brand Dose/age Indication

Answer 32

Pin-X, Pin-RID Singel dose >2y.o Pinworm, hookwork, roundworm

Question 33

Does everyone need to be treated for pinworm infections?

Answer 33

Yes And cut fingernails short

Question 34

Miltefosine Brand Indication Pregnancy

Answer 34

Impavido Leishmaniasis (flesh eating parasite) Category D - must continue contraception 5 months after DSC

Question 35

What 5 options for available for malaria prevention if resistance?

Answer 35

Mefloquine (lariam) Doxycycline Atovaquone & proguanil (Malarone) Hydrochloroquine Primaquine

Question 36

Which malaria treatments are the best tolerated? Which are most associated with neuro symptoms?

Answer 36

Doxycycline and malarone Mefloquine

Question 37

When do you start prophylactic malaria therapy?

Answer 37

Start 1-2 weeks before travel and 4 weeks after leaving

Question 38

Which antimalarials are safe for pregnancy?

Answer 38

Chloroquine (Aralen) Mefloquine

Question 39

What is DOC for malaria prevention + brand?

Answer 39

Chloroquine (Aralen)

Question 40

Which antimalarials are given weekly? Which are PO?

Answer 40

WEEKLY Chloroquine Mefloquine Hydrochloroquine Tafenoquine (Arakoda) DAILY Doxycycline Atovaquonoe + Proguanil

Question 41

What is VSL#3 approved for? Where is it stored?

Answer 41

UC Ileal pouch IBS Refrigerator

Question 42

Tafenoquine Brand (2) Indication Dose

Answer 42

Arakoda - Prevention of malaria : 200mg QD x 3 days before travel then once weekly Krintafel - Prevention of malaria relapse : 300mg single dose

Question 43

Artesunate Brand Indication ROA

Answer 43

Amivas Treatment of severe malaria IV