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GI > HCV drugs > Flashcards

HCV drugs Flashcards

1
Q

protease inhibitors end in ___

A

previr

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2
Q

replication complex inhibitors end in

A

asvir

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3
Q

polymerase inhibitors end in

A

buvir

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4
Q

what are the protease inhibitors

A

glecaprevir, voxilaprevir, grazoprevir

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5
Q

what are the replication inhibitors

A

velpatasvir, ledipasvir, pibrentasvir, elbasvir

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6
Q

what is the polymerase inhibitor

A

sofosbuvir

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7
Q

what is sovaldi

A

sofosbuvir

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8
Q

what is harvoni

A

ledipasvir/sofosbuvir

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9
Q

what is epclusa

A

sofosbuvir/velpatasvir

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10
Q

what is vosevi

A

sofosbuvir/velpatasvir/voxilaprevir

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11
Q

what is mavyret

A

glecaprevir/pibrentasvir

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12
Q

what is zepatier

A

elbasvir/grazoprevir

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13
Q

ribavirin side effect

A

hemolytic anemia (BW)

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14
Q

ribavirin counseling

A

pregnancy category x: counsel both males and females to avoid pregnancy during treatment and for 6 months after

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15
Q

sofosbuvir contraindication/drug interaction

A

amiodarone: severe bradycardia

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16
Q

recommended treatments for treatment naive WITHOUT cirrhosis

A

mavyret x 8 weeks, epclusa x 12 weeks

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17
Q

recommended treatments for treatment naive WITH cirrhosis (compensated, child pugh class A)

A

mavyret x 8 weeks for genotype 1-6. epclusa x 12 weeks for all genotypes except 3

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18
Q

first line for treatment failure if sofosbuvir based?

A

vosevi x 12 weeks (+ ribavirin if genotype 3)

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19
Q

first line for treatment failure if mavyret?

A

mavyret PLUS ribavirin x 16 weeks

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20
Q

alternate treatment for sofosbuvir based failure

A

mavyret x 16 weeks

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21
Q

alternate treatment for mavyret failure

A

vosevi x 12 weeks (+ ribavirin if compensated)

22
Q

describe the drug interaction with acid lowering therapy

A

velpatasvir and ledipasvir solubility requires acidic pH, acid lowering therapy reduces concentrations

23
Q

which medications should you be careful with antacids

A

harvoni, epclusa, vosevi

24
Q

counseling for antacid

A

separate by 4 hr

25
Q

counseling for H2RA

A

simultaneous or sep by 12 hr

26
Q

counseling for PPI

A

max omeprazole 20 mg QD, take simultaneously for harvoni and vosevi. For epclusa, only if necessary and take it 4 hours before PPI.

27
Q

describe the drug interactions with cholesterol lowering agents

A

DAA inhibit OATP and P-gp which inhibits statin metabolism. increases AUC, myalgia, and rhabdomyolysis risk

28
Q

which drugs should you avoid certain statins for

A

mavyret, harvoni, and vosevi

29
Q

what is the drug interaction with anticonvulsants/inducers

A

strong CYP3A4 and P-gp inducers decrease DCC AUC

30
Q

which anticonvulsants and inducers should you stop

A

carbamazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, st johns wort

31
Q

which antimicrobials should you avoid

A

rifampin, rifabutin

32
Q

what is the interaction with immunosuppressants

A

cyclosporine is OATP inhibitor, leads to AUC increase grazoprevir and voxilaprevir

33
Q

which drugs do you take with food

A

mavyret and vosevi, ribavirin

34
Q

which drugs are not pangeotypic

A

harvoni, zepatier

35
Q

____ is contraindicated with rifampin

A

vosevi

36
Q

the drug that is never monotherapy

A

ribavirin

37
Q

adverse effects of most DAAs

A

fatigue, headache, nausea

38
Q

what are the treatment recommendations for kids over 3

A

mavyret x 8 weeks with food, harvoni x 12 weeks, epclusa x 12 weeks

39
Q

foods you can recommend the kiddos to take with mavyret

A

peanut butter, cream cheese, hazelnut spread, greek yogurt

40
Q

what foods can kids take with epclusa and harvoni

A

nonacidic soft foods, chocolate syrup, ice cream

41
Q

which therapies for kids are all genotypes

A

mavyret and epclusa

42
Q

harvoni for kids: what genotypes

A

all but 2 and 3

43
Q

if mixing with food, must take within __ minutes of mixing

A

15

44
Q

which statin is the safest

A

pravastatin

45
Q

which drug has renal dose adjustments

A

ribavirin

46
Q

which drugs increase LFT with ethinyl estradiol

A

mavyret, vosevi

47
Q

____ is contraindicated in Child Pugh Class C

A

mavyret

48
Q

_____is contraindicated in child pugh class B or C

A

zepatier

49
Q

which genotypes does zepatier cover

A

1a, 1b, 4

50
Q

which statins do you avoid for mavyret

A

atorvastatin, lovastatin, simvastatin

51
Q

which statins do you avoid for harvoni

A

rosuvastatin

52
Q

which statins do you avoid for vosevi

A

fluvastatin, lovastatin, pitavastatin, rosuvastatin, simvastatin

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