Viral Hepatitis Pharmacology Flashcards

(34 cards)

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
what is the MOA of velpatasvir/sofosbuvir?
sofosbuvir: nucleotide analogue NS5B polymerase inhibitor + velpatasvir: NS5A inhibitor
26
when is V/S contraindicated?
in patients for whom ribavirin is contraindicated
27
what are adverse reactions of V/S?
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
what drug interactions need to be considered before giving V/S?
poly-glycoprotein inducers (St. Johns wort and rifampin) may alter concentrations
29
what is the black box warning of ribivarin?
birth defects and fetal death if used for pregnant woman
30
what is the MOA of ribivarin?
nucleoside analogue *used in combination with interferon alfa-2A
31
when is ribivarin contraindicated?
pregnant women AND men whose female partners are pregnant hemoglobinopathies
32
what is the MOA of boceprevir?
NS3/4A protease inhibitor *used in combination with ribavarin and interferon alfa-2A
33
when is boceprevir contraindicated?
since used with ribivarin - pregnancy and hemoglobinopathies
34
what are common adverse reactions associated with all HBV/HCV drugs?
headache nausea fatigue