HCV drugs Flashcards
protease inhibitors end in ___
previr
replication complex inhibitors end in
asvir
polymerase inhibitors end in
buvir
what are the protease inhibitors
glecaprevir, voxilaprevir, grazoprevir
what are the replication inhibitors
velpatasvir, ledipasvir, pibrentasvir, elbasvir
what is the polymerase inhibitor
sofosbuvir
what is sovaldi
sofosbuvir
what is harvoni
ledipasvir/sofosbuvir
what is epclusa
sofosbuvir/velpatasvir
what is vosevi
sofosbuvir/velpatasvir/voxilaprevir
what is mavyret
glecaprevir/pibrentasvir
what is zepatier
elbasvir/grazoprevir
ribavirin side effect
hemolytic anemia (BW)
ribavirin counseling
pregnancy category x: counsel both males and females to avoid pregnancy during treatment and for 6 months after
sofosbuvir contraindication/drug interaction
amiodarone: severe bradycardia
recommended treatments for treatment naive WITHOUT cirrhosis
mavyret x 8 weeks, epclusa x 12 weeks
recommended treatments for treatment naive WITH cirrhosis (compensated, child pugh class A)
mavyret x 8 weeks for genotype 1-6. epclusa x 12 weeks for all genotypes except 3
first line for treatment failure if sofosbuvir based?
vosevi x 12 weeks (+ ribavirin if genotype 3)
first line for treatment failure if mavyret?
mavyret PLUS ribavirin x 16 weeks
alternate treatment for sofosbuvir based failure
mavyret x 16 weeks
alternate treatment for mavyret failure
vosevi x 12 weeks (+ ribavirin if compensated)
describe the drug interaction with acid lowering therapy
velpatasvir and ledipasvir solubility requires acidic pH, acid lowering therapy reduces concentrations
which medications should you be careful with antacids
harvoni, epclusa, vosevi
counseling for antacid
separate by 4 hr
counseling for H2RA
simultaneous or sep by 12 hr
counseling for PPI
max omeprazole 20 mg QD, take simultaneously for harvoni and vosevi. For epclusa, only if necessary and take it 4 hours before PPI.
describe the drug interactions with cholesterol lowering agents
DAA inhibit OATP and P-gp which inhibits statin metabolism. increases AUC, myalgia, and rhabdomyolysis risk
which drugs should you avoid certain statins for
mavyret, harvoni, and vosevi
what is the drug interaction with anticonvulsants/inducers
strong CYP3A4 and P-gp inducers decrease DCC AUC
which anticonvulsants and inducers should you stop
carbamazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, st johns wort
which antimicrobials should you avoid
rifampin, rifabutin
what is the interaction with immunosuppressants
cyclosporine is OATP inhibitor, leads to AUC increase grazoprevir and voxilaprevir
which drugs do you take with food
mavyret and vosevi, ribavirin
which drugs are not pangeotypic
harvoni, zepatier
____ is contraindicated with rifampin
vosevi
the drug that is never monotherapy
ribavirin
adverse effects of most DAAs
fatigue, headache, nausea
what are the treatment recommendations for kids over 3
mavyret x 8 weeks with food, harvoni x 12 weeks, epclusa x 12 weeks
foods you can recommend the kiddos to take with mavyret
peanut butter, cream cheese, hazelnut spread, greek yogurt
what foods can kids take with epclusa and harvoni
nonacidic soft foods, chocolate syrup, ice cream
which therapies for kids are all genotypes
mavyret and epclusa
harvoni for kids: what genotypes
all but 2 and 3
if mixing with food, must take within __ minutes of mixing
15
which statin is the safest
pravastatin
which drug has renal dose adjustments
ribavirin
which drugs increase LFT with ethinyl estradiol
mavyret, vosevi
____ is contraindicated in Child Pugh Class C
mavyret
_____is contraindicated in child pugh class B or C
zepatier
which genotypes does zepatier cover
1a, 1b, 4
which statins do you avoid for mavyret
atorvastatin, lovastatin, simvastatin
which statins do you avoid for harvoni
rosuvastatin
which statins do you avoid for vosevi
fluvastatin, lovastatin, pitavastatin, rosuvastatin, simvastatin
