Viral Hepatitis Pharm Flashcards
(24 cards)
Entecavir:
List the class.
List the indication(s).
Evidence of what is needed before prescribing?
Hepatitis B virus nucleoside analogue reverse transcriptase.
Chronic Hep B virus infection in adults and children >2 years old.
Need evidence of active viral replication and elevations of ALT or AST.
Entecavir:
List the BB warnings. (4)
List the adverse reactions.
List the contraindications.
Severe acute exacerbations of Hep B.
Patients coinfected with HIV and HBV.
Lactic Acidosis.
Heptaomegaly
Tenofovir Disoproxil:
List the Class.
List the Indications for HIV and CBV.
Nucleotide analog HIV-1 RT inhibitor + HBV RT inhibitor
Used in combination with other antiretroviral agents for the treatement of HIV-1 infection in adults and pediatric patients >2 y.o.
Used to treat CBV in adults and pediatric patients >12 y.o.
Tenofovir Disoproxil:
List the BB warnings (3).
List the warnings and precautions.
Lactic acidosis
Severe hepatomegaly with steatosis
Post treatment exacerbation of hepatitis.
Renal impairment
Adefovir:
List the Class.
List the indications.
Nucleotide analog
Treatment of chronic Hep B in patients >12 y.o.
Adefovir:
List the contraindications
List the warnings/precautions
List the adverse rxns.
List the drug interactions.
Hypersensitivity to any of the components of the product.
Nephrotoxicity.
Compensated disease = asthenia
Pre and post transplantation lamivudine-resistant liver = increased creatinine.
Any drugs that reduce renal fx or compete for active tubular secretion (increase concentrations of one of the two compounds).
Lamivudine:
List the class.
List the indications.
List the contraindications.
Nucleoside analogue RT inhibitor
Used in combination with other antiretroviral agents to treat HIV-1.
Previous hypersensitivity to lamivudine.
Lamivudine:
List the BB warnings (4)
List the warnings and precautions. (3)
Lactic acidosis
Severe hepatomegaly
Exacerbations of Hep B
Different formulations
Co-infected HIV-1/HBV patients - lamivudine-resistant HBV variants that are resistant
Pancreatitis
Telbivudine:
List the class.
List the indications.
List the contraindications
Nucleoside analogue RT inhibitor
Chronic hep B in adults. Must have proof of active disease.
Telbivudine + PEGylated interferon alpha-2a = increased risk of peripheral neuropathy
Telbivudine:
List the BB warnings (3)
Lactic acidosis
Severe hepatomegaly with steatosis
Severe acute exacerbations of HEP B
PEG Interferon alpha-2a:
List the indications. (2)
List the contraindications (3)
Hep C with compensated liver disease not previously treated with interferon alpha.
Hep B infection who have compensated liver disease and liver inflammation
Autoimmune hepatitis
Hepatic decompensation in patients with cirrhoisis
Use in neonates/infants.
PEG interferon alpha-2a:
List the BB warning.
Risk of serious disorders and ribavirin-associated affects
PEG Interferon Alpha-2b:
List the indications.
List the contraindications. (3)
HEP C >18 years old with compensated liver disease.
Hypersensitivity to inferon alpha
Autoimmune hepatitis
Decompensated liver disease
PEG Interferon Alpha-2b
List the BB warning
Fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders.
Elbasvir/Grazoprevir:
List the classes in this combination.
List the treatment
List the contraidications.
Elbasvir (NS5a inhibitor), Grazoprevir (NS3/4A protease inhibitor).
HEP C
Moderate or severe hepatic impairment
Elbsavir/Grazoprevir:
List the Warnings/precautions
List the drug interactions
ALT elevation
Co-administration with CYP3a inducers is not recommended. They decrease plasma concentration.
Ledipasvir/Sofosbuvir:
List the combination.
List the treatment.
List the warnings/precautions.
Ledipasvir ( NS5a inhibitor), Sofosbuvir (NS5B polymerase inhibitor)
Hep C in adults
Only recommended with some combination of ribavirin, PEG interferon-alfa, simprevir, ledipasvir, daclatasvir, or velpatasvir
Ledipasvir/Sofosbuvir:
List the drug interactions
Poly glycoprotein inducers (rifampin, St. John’s wort). May alter drug concentrations.
Velpatasvir/Sofosbuvir:
List the combination
List the indication (2)
List the contraindication
List the warnings/precautions (2)
Sofsbuvir ( NS5B polymerase inhibitor), Velpatasvir (NS5A inhibitor)
adults with HCV without cirrhosis or with compensated cirrhosis
If they have decompensated cirrhosis use with ribavirin.
Patients that cant take ribavirin.
Can potentiate bradycardia with amiodarone co-administration.
Caution in patients receiving beta-blockers/ Cardiac comorbidities/Liver disease
Velpatasvir/Sofosbuvir:
List the drug interactions.
PGP inducers, CYP inducers… decrease concentration of V/S.
Ribivarin:
List the class.
List the indication. (2)
List the contraindications (2)
Nucleoside analogue
Given in combination with interferon alfa-2a in patients >5 with compensated liver disease not previously treated with interferon alpha
used in adult CHC patients co-infected with HIV.
Pregnant women and men whose partners are pregnant.
Hemoglobinopathies
Ribivarin:
List the BB warnings (2)
Birth defects and fetal death
Boceprevir:
List the class.
List the combination.
List the Indication
List the contraindication
NS3/4A protease inhibitor
PEG interferon alfa and ribavirin
CHC in adult patients with compensated liver disease, who are previously untreated or who have failed previous interferon and ribavirin therapy.
PEG interferon alfa and ribavirin contraindications.
Boceprevir:
List the warnings/precautions (2)
Ribavirin may cause birth defects and fetal death. Avoid in pregnancy in female patients and female partners of male patients.
