3.1 Only Bolded Stuff on Slides

For pegylated interferon alfa-2a what is the treatment duration?

48 weeks

For pegylated interferon alfa-2a which are the ADRs (a lot)?

- fatigue

- fever

- headache

- nausea

- arthralgia

- insomnia

- depression

- anxiety

- alopecia

- injection site reactions

For pegylated interferon alfa-2a what is the frequency of dosing?

every week

For pegylated interferon alfa-2a which are the patient counseling points?

- take at the same time each week

- take within 2 days of missed dose

An advantage of Nucleotide Analogs is that

all oral meds are taken once daily

Nucleotide Analogs all have

Black box warning

Which are the Black box warnings for Nucleotide Analogs?

- Lactic acidosis

- Severe hepatomegaly with steatosis

Why can't patients discontinue Nucleotide Analogs?

Risk of rebound hepatitis upon discontinuation

What should patients be monitored for when using Nucleotide Analogs?

- liver function

- renal function

- GI effects

- baseline bone density if fracture or osteoporosis

Which meds are used for FIRST LINE in the Nucleotide Analogs class?

- Tenofovir (TDF & TAF)

- Entecavir

What does TDF stand for?

Tenofovir Disoproxil Fumarate

Which TDF (Viread) ADRs are considered as SERIOUS?

- nephrotoxicity

- ostoeomalacia

- Fanconi syndrome

Which TDF (Viread) ADRs are considered as COMMON?

- nausea

- headache

- diarrhea

- dizziness

Which are IMPORTANT drug interactions with TDF (Viread)?

- Atazanavir

- Ledipasvir/sofosbuvir

Which TAF(Vemlidy) ADRs are mentioned?

- headache

- abdominal pain

- fatigue

- nausea

Which are IMPORTANT drug interactions with TAF(Vemlidy)?

P-gp inducers

IMPORTANT DOSE TO KNOW: Entecavir (Baraclude) dose for Nucleoside naive patients

0.5 mg PO daily

IMPORTANT DOSE TO KNOW: Entecavir (Baraclude) dose for Lamivudine resistance/refractory

1 mg PO daily

Which Entecavir (Baraclude) ADRs are mentioned?

Overall well tolerated (headache, fatigue, dizziness)

Which Lamivudine (Epivir-HBV) ADRs are mentioned?

Overall well tolerated (diarrhea, upper respiratory infections)

Which Emtricitabine (Emtriva) ADRs are mentioned?

Overall well tolerated (headache, diarrhea, nausea, fatigue)

Which Adefovir (Hepsera) ADR is mentioned as RARE?

Nephrotoxicity

Which other Adefovir (Hepsera) ADRs are mentioned?

- headache

- abdominal pain

- diarrhea

- nausea

Which Hep B antiviral is most likely to cause nephrotoxicity?

Tenofovir disoproxil fumarate

What is the mechanism of action of NS3/4A agents?

Protease inhibition

What name suffix is associated with NS3/4A inhibitors?

-previr

What is the mechanism of action of NS5A agents?

Replication complex inhibition

What name suffix is associated with NS5A inhibitors?

-asvir

What is the mechanism of action of NS5B nucleos(t)ide analogs?

Polymerase inhibition

What name suffix is associated with NS5B nucleos(t)ide analogs?

-buvir

What is the mechanism of action of NS5B non-nucleotide analogs?

Polymerase inhibition

What name suffix is associated with NS5B non-nucleotide analogs?

-buvir

Which is the Sofosbuvir/Velpatasvir (Epclusa) dosing frequency?

daily x12 weeks

Which are the ADEs associated with the use of Sofosbuvir/Velpatasvir (Epclusa)?

- fatigue

- headache

Which Drugs should be AVOIDED with Sofosbuvir/Velpatasvir (Epclusa)?

- P-gp inducers: rifampin, St. johns wort, carbamazepine, phenytoin

- Amiodarone

- Efavirenz

Which Drugs should be MONITORED with Sofosbuvir/Velpatasvir (Epclusa)?

- Acid reducing agents

- Tenofovir (TDF)

- Rosuvastatin, atorvastatin

Which are the dosing requirements for Glecaprevir/Pibrentasvir (Mavyret)?

daily with food

Which patient population require an 8 week tx duration with Glecaprevir/Pibrentasvir (Mavyret)?

- Genotypes 1-6 w/o cirrhosis

- Genotype 1,2,4,5,6 + PRS regimen + NO cirrhosis

Which are the ADRs for Glecaprevir/Pibrentasvir (Mavyret)?

- headache

- fatigue

Which Drugs should be AVOIDED with Glecaprevir/Pibrentasvir (Mavyret)?

- carbamazepine, St. Johns wort, rifampin

- HIV drugs: atazanavir, darunavir, lopinavir, efavirenz

- Ethinyl-estradiol containing oral contraceptives

- Atorvastatin, lovastatin, simvastatin

Which Drugs should be MONITORED with Glecaprevir/Pibrentasvir (Mavyret)?

- digoxin

- dabigatran

- pravastatin, rosuvastatin

Which is the Sofosbuvir/Ledipasvir (Harvoni) dosing frequency?

daily

Which is the Sofosbuvir/Ledipasvir (Harvoni) duration of treatment?

12-24 weeks

Which are the side effects mentioned with Sofosbuvir/Ledipasvir (Harvoni)?

- fatigue

- headache

- nausea

- insomnia

Which is the Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi) treatment duration?

12 weeks

Which are the ADEs mentioned for Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi)?

- headaches

- fatigue

Which Drugs should be AVOIDED with Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi)?

- P-gp inducers: rifampin, St. John's wort, carbamazepin, phenytoin

- amiodarone

- HIV drugs: atazanavir, lopinavir, efavirenz

- rosuvastatin

- cyclosporine

Which Drugs should be MONITORED with Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi)?

- acid-reducing agents

- digoxin

- tenofovir (DF)

- other statins

Which HCV regimens are considered safe to use with HIV therapy?

- Sofosbuvir

- Ledipasvir/sofosbuvir

- Velpatasvir/sofosbuvir

Which HCV regimens require caution when used with HIV therapy?

- Sofosbuvir/velpatasvir/voxilaprevir

- Glecaprevir/pibrentasvir

- Ribavirin

Which HCV regimen should be avoided (stop) with HIV therapy?

Elbasvir/grazoprevir

Which HIV drugs are least likely to cause interactions?

Bictegravir, Raltegravir, Dolutegravir, Lamivudine, Abacavir, Emtricitabine

Which are the ADEs mentioned for Ribavirin?

- teratogenicity

- anemia

- nausea

- vomiting

- diarrhea

- rash

Which are the Drug interactions mentioned for Ribavirin?

other anemia-causing drugs

Which Hep C antiviral works by inhibiting the protease enzyme?

Voxilaprevir

Which drug is most likely to interact with all combination Hep C DAA's?

Carbamazepine

What are the #1 ADRs present in Direct Acting Antiviral drugs used in HCV?

Fatigue and Headache