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Pharmacology > Hep A and B > Flashcards

Hep A and B Flashcards

1
Q

At what age should children be vaccinated for Hep A?

A

age 1

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2
Q

who should be vaccinated against Hep A?

A 
IVDU
travelers
MSM
Health workers/Occupation
anyone who wants immunity
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3
Q

what is route of transmission for Hep A? what type of virus is it DNA or RNA?

A

fecal oral route

RNA virus

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4
Q

What is dx of Hep A?

A

IgM against to HAV (anti-HAV)

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5
Q

What is tx for HepA?

A

supportive IgG anti-HAV: passive
limit acetominophen to 2g/day
NO ANTIVIRALS!

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6
Q

Which vaccine is given to children for Hep A? What is dosing schedule?

A

Harvrix
2 doses,
at age 1, and the 6- 12 months later

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7
Q

What is benefit for using VAQTA?What is dosing schedule for VAQTA?

A

preservative free
2 doses
0, 6-18 months

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8
Q

What is application of Twinrix? What is the dosing schedule?

A

adults only
3 doses= 0,1,6 months
combo A and B vaccine 4 doses= 0,7 days, 21-30 days, +12 mo

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9
Q

What are ADE of Hep vaccine?

A

injection site rxn soreness
HA
malaise

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10
Q

T/F There is a decrease in the efficacy of Hep A vaccine in people with HIV or immunocompromised or HepC

A

True

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11
Q

T/F There is a high seroconversion (94%) in Hep A first dose vaccine

A

True

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12
Q

What is pre exposure prophylaxis for pt <40 y/o? for >40y/o or immunocompromised?

A
  1. Can give vaccine 1 day before travel

2. give 2 weeks before and give IgG and Hep vaccine

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13
Q

What is post exposure prophylaxis protocol?

A

If no prior HAV vaccine given: vaccinate within 2 weeks after exposure to HAV

a) if ages 1-40 give HAV vaccine
b) if age <1 and >40 give HAV vaccine and IVIG

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14
Q

T/F IVIG to HAV alone is given only when vaccine cannot be used

A

TRUE

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15
Q

What is clinical use of IVIG?

A
  • short term pre exposure coverage <3 months
  • long term pre exposure prophlyaxis <5 months but requires a double dose
  • post exposure prophylaxis
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16
Q

What are the administration sites of IVIG?

A

> 24 months: deltoid and butt

<24 months anterolateral thigh

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17
Q

What type of immunity if IVIG?

A

passive

18
Q

what is route of transmission for hep b?

A

sexually transmitted

19
Q

What determines chronic Hep B infection?

A

HBsAg present for > 6mo

20
Q

What does loss of HBsAg mean?

A

immunity and clearance with anti-HBsAb

-patient got vaccine or developed ab to virus

21
Q

What does loss of HBeAg mean?

A
  • cleared infection with anti-HBeAg

- you only get this antibody from having had the virus

22
Q

What is dosing schedule for adults for Hep B?

A

1mL : 3 doses
0, 1, 6 months
Engerix-B
Recombivax HB

23
Q

What us dosing schedule for infants for Hep B?

A

.5 mL , 3 doses
0,1, 6
Engerix-B
Recombivax HB

24
Q

T/F You cannot use combination vaccines like DTaP and HIB for infants at birth

A

TRUE

25
Q

When can you use combo Hep B vaccines for infants?

A

after 6 weeks (2 months)

26
Q

What is protocol for vaccine if infants mother is HBsAg neg?

A

give vaccine before discharge

27
Q

What is protocol for vaccine if infants mother is HBsAg pos?

A

give vaccine within 12 hrs of birth and IVIG at same time but different site

28
Q

What is protocol for vaccine if infants mother is HBsAg unknown?

A

give vaccine within 12 hrs of birth do more testing and then determine of IVIG is necessary

29
Q

When do you vaccinate for pts with renal impairment?

A
  • if AB concentration is less than 10, give 3 doses again
  • check serology for ab 1-2 months after last primary dose series
  • check annually for booster vaccines
30
Q

What are ADE of Hep B vaccine?

A

hypersensitivity-yeast
syncope,
angioedema
immunosuppressants may decrease vaccine efficacy

31
Q

What is post exposure tx for Hep B?

A

HBIG within 7 days

32
Q

What is tx for chronic Hep B infection?

A

interferon
PEG
Antivirals : tenofovir, entecovir
vaccine against HAV

33
Q

T/ F Hep B may requite long term therapy which can lead to resistance

A

TRUE

34
Q

Which drugs have high resistance rates?

A

Lamivudine

Telbivudine

35
Q

Which drugs has low resistance rates?

A

Tenofovir

36
Q

What should a pt with Hep B avoid?

A

Alcohol

milk thistle- believe it can help but don’t use with vaccine used only when pt doe snot want to use Hep B treatment

37
Q

What are ADE of Entecavir, Tenofovir?

A

HA, nausea, abdominal pain, fatigue, lactic acidosis
Entecavir: upper abdominal pain, HA
Tenofovir: dizziness, nephropathy, diarrhea

38
Q

What are ADE PEG-Interferon?

A

flu like symptoms, cytopenias, mood disturbance,

39
Q

What do you monitor?

A

ALT
HbsAg and HbeAg levels
HBV DNA

40
Q

Review slides 12, 13, 21, 25, 26 before test

A

=)

Pharmacology (47 decks)

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