Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX > Chapter 19: Hepatitis and Liver Disease > Flashcards

Chapter 19: Hepatitis and Liver Disease Flashcards

1
Q

Hepatitis A

A
  • Acute
  • Fecal-Oral transmission
  • Yes vaccine
  • 1st line tx is supportive care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hepatitis B

A
  • Acute and Chronic
  • Blood and body fluid transmission
  • Yes vaccine
  • 1st line tx PEG-INF or NRTI (tenofovir or entacavir)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hepatitis C

A

-Acute and Chronic
-Blood and body fluid transmission
-No vaccine
-1st line tx for tx naïve: DAA combination
Other tx: DAA combo + RBV or
DAA combo + RBV + PEG-INF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DAA mechanisms: NS3/4A Protease Inhibitors

A

-previr
P for PI

Glecaprevir
Grazoprevir
Paritaprevir
Voxilaprevir

*PIG
protease inhibitors and grub (take with food)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DAA Mechanisms: NS5A Replication Complex Inhibitors

A

-asvir
A for NS5A

Elbasvir
Ledipasvir
Ombitasvir
Pibrentasvir
Velpatasvir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DAA Mechanism: NS5B Polymerase Inhibitors

A

-buvir
B for NS5B

Dasabuvir
Sofosbuvir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

All DAAs boxed warning, warnings, side-effects

A

Boxed: Risk of reactivation of HBV; test all patients prior to starting DAA
Warning: for sofosbuvir containing regimes do not use amiodarone serious symptomatic bradycardia
SE: well-tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Epclusa

A

sofosbuvir/velpatasvir

sofosbuvir monotherapy not recommended
administer in original container
avoid or minimize acid-suppressive therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mavyret

A

Glecaprevir/pibrentasvir

Take with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tx for pan-genotypic (all 6 genotypes) for tx naïve pts

A
  • Epclusa

- Mavyret

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx for salvage therapy

A
  • Mavyret

- Vosevi (sofosbuvir/velpatasvir/voxilaprevir)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx for 8 week therapy (select patients)

A

-Mavyret

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tx for HCV/HIV co-infection

A
  • Epclusa
  • Harvoni (sofosbuvir/ledipasvir)
  • Mavyret
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for children with certain genotypes

A
  • Solvadi (sofosbuvir) and Harvoni (age >=3 years)
  • Epclusa (age >=6 years)
  • Mavyret (age >=12 years)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Viekira Pak Dose and CI

A

Paritaprevir/ritonavir/ombitasvir qam
and
Dasabuvir bid with meals

CI: use with cyp3A4 substrates or inducers and use with ethinyl estradiol products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Viekir Pak Warnings

A

Hepatic decompensation/failure in patients with cirrhosis, increased LFTs, significant drug interaction potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Zepatier CI, Warnings

A

Elbasvir/grazoprevir

CI: Strong inducers of cyp3A4
Warnings: increased LFTs, significant drug interaction potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

All DAA CI

A

Strong inducers of CYP3A4: carbamazepine, oxcarbezapine, phenobarbitol, phenytoin, rifampin, rifabutin, and St. John’s Wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Harvoni, Epclusa, and Vosevi DI

A

Antacids, H2RAs, and PPIs can decrease concentrations of ledipasvir and velpatasvir

PPIs are not recommended with Epclusa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Viekira Pak DI

A

Strong inducers of CYP3A4 (carbamazepine, oxcarbezapine, phenobarbitol, phenytoin, rifampin, rifabutin, and St. John’s Wort)
ethinyl estradiol containing products, lovastatin, simvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ribavirin MOA

A

Oral antiviral that inhibits replications of RNA and DNA viruses
Never used as monotherapy

22
Q

Ribavirin CI, Boxed Warnings

A

CI: Pregnancy

Boxed Warning: significant teratogenic effects, not effective as monotherapy for HCV, hemolytic anemia

23
Q

Ribavirin SE, Notes

A

SE: Hemolytic anemia

Notes: avoid pregnancy in female patients (including in female partners of male patients) during therapy, and 6 months after completion; use at least 2 reliable forms of contraception during and for 6 months after

24
Q

Interferon Alfa MOA

A

Interferons are naturally produced cytokines that have antiviral, antiproliferative, and immunodmodulatory effects.
Approved for tx of HBV and HCV
PEG-ING-alfa has polyethylene glycol which prolongs half-life

25
INF-alfa Boxed warnings
Can cause or worsen neuropsychiatric, autoimmune, ischemic or infectious disorders If used with ribavirin, teratogenic/anemia risk
26
INF-alfa Side Effects
-CNS effects (fatigue, depression) -GI upset -Increased LFTs (5-10x the ULN during tx) -myelosuppression Flu like syndrome (fever, chills, headache, malaise) pre-treat with apap and antihistamine
27
Nucleoside/Tide Reverse Transcriptase Inhibitors
NRTIs | Inhibit HBV replication by inhibiting HBV polymerase resulting in DNA chain termination
28
All HBV NRTIs Dosing, Boxed Warnings
Dosing: CrCl <50 decrease dose or frequency | Boxed Warnings: Lactic acidosis and severe hepatomegaly with steatosis which can be fatal. Exacerbations of HBV
29
Viread
Tenofovir disoproxil fumarate (TDF) Preferred therapy SE: renal impairment, decrease bone density Warnings Fanconi syndrome (NOF; nephrotoxicity, osteoporosis, Fanconi syndrome)
30
Vemlidy
Tenofovir alafenamide (TAF) Preferred therapy SE: nausea
31
Entecavir
Baraclude Preferred therapy Take on an empty stomach
32
Epivir HBV
Lamivudine Do not use Epivir HBV for tx of HIV SE: headache, n/v/d
33
Lab Test for Liver Disease: Acute Liver Toxicity
Increased AST/ALT
34
Lab Test for Liver Disease: Chronic Liver Disease
Increased AST/ALT, Alk Phos, Tbili, LDH, PT/INR | Decreased Albumin
35
Lab Test for Liver Disease: Alcoholic Liver Disease
Increased AST > increased ALT (AST will be about double ALT), increased GGT
36
Lab Test for Liver Disease: encephalopathy
Increased ammonia
37
Lab Test for Liver Disease: Jaundice
Increased Tbili
38
Child-Pugh Score
``` Class A (mild disease) >7 Class B (moderate disease) 7-9 Class C (severe disease) 10-15 ```
39
MELD Score
The higher the numbers indicate a greater risk of death within 3 months
40
Drugs With a Boxed Warning for Liver Damage
- Apap (high doses, acute or chronic) - Amiodarone - Isoniazid - Ketoconazole (oral) - Methotrexate - Nefazodone - NNRTIs - NRTIs - Propylthiouracil - Tipranavir - Valproic Acid
41
Octreotide
Sandostatin Selective for splanich vessels to stop bleeding SE: bradycardia, cholelithiasis, billiary sludge
42
Vasopressin
Vasostrict Non-selective Antidiuretic hormone analog
43
Non-selective Beta-Blockers for Portal Hypertension
Work by 2 mechanisms 1. decrease cardiac output via beta-1 blockade 2. decrease splanich blood flow due to vasoconstriction (via beta-2 blockade and alpha activity)
44
Beta-Blockers for Portal Hypertension
Nadolol (corgard) | Propranolol (inderal la, inderal XL
45
Beta-Blocker for Porta Hypertension Boxed warnings, warnings
Boxed warnings: do not withdraw beta-blocker abruptly | Warning: non-selective drugs are used to portal hypertension, use extreme caution in asthma, severe cop, PVD
46
Lactulose for Hepatic Encephalopathy MOA
Works by converting ammonia produced by intestinal bacteria to ammonium which is polar and therefore cannot readily diffuse into the blood
47
Lactulose SE
Flatulence, diarrhea, dyspepsia, abdominal discomfort
48
Rifaximin
Xifaxin
49
Neomycin
Neurotoxicity | GI upset
50
Ratio of furosemide to spironolactone
40mg furosemide to 100mg spironolactone to maintain potassium balance

NAPLEX (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions