Hepatic

Question 1

Interferon Alpha Treats…

Answer 1

HBV/HCV

Question 2

Interferon Beta Treats…

Answer 2

Multiple Sclerosis

Question 3

Boxed Warning Interferon Alpha

Answer 3

Exacerbate autoimmune disorders, aggrivate/cause infectious disorders, aggrivate/cause ischemic and hemorrhagic cerebrovascular events, combination with ribavirin may cause birth defects and/or fetal mortality and/or hemolytic anemia

Question 4

Hep A

Answer 4

Self-limiting, vaccine preventable, fecal-oral

Question 5

Hep B

Answer 5

Vaccine preventable, body fluid contact, may lead to chronic infection and can be reactivated when taking immunosupressants, Tx: NRTIs and Interferons

Question 6

Hep C

Answer 6

No vaccine, blood transmission, acute or chronic (mostly latter) disease, 6 different genotypes with various subtypes, Tx: Peg-Interferons, Ribavirin, Sofosbuvir, Simeprevir, Ledipasvir/Sofosbuvir combo

Question 7

Natural product used to treat liver dz

Answer 7

Milk Thistle

Question 8

Naltrexone

Answer 8

Revia

Question 9

Acamprosate

Answer 9

Campral

Question 10

Disulfiram

Answer 10

Antabuse

Question 11

Drugs used to prevent alcohol relapse

Answer 11

Revia, Campral, Antabuse

Question 12

Tx of acute alcohol withdrawal

Answer 12

Benzos

Question 13

Wernicke-Korsakoff syndrome caused by lack of ______

Answer 13

Vitamin B1 (Thiamine)

Question 14

Used to help prevent portal HTN and variceal bleeds

Answer 14

Non-selective BBs (Nadolol, Propranolol)

Question 15

Drugs to manage acute visceral bleed

Answer 15

Octreotide (greater potency and longer duration of action), Vasopressin. Also, at resolution of bleed add non-selective beta blockers.

Question 16

Octreotide

Answer 16

Sandostatin

Question 17

Vasopressin

Answer 17

Pitressin

Question 18

Drugs to treat hepatic encephalopathy

Answer 18

Lactulose, Rifaximin (Neomycin may also be used)

Question 19

Lactulose AEs

Answer 19

Flatulence, Diarrhea, Dyspepsia, Abdominal Discomfort

Question 20

Lactulose

Answer 20

Constulose, Enulose, Generlac, Kristalose

Question 21

Rifaximin

Answer 21

Xifaxan

Question 22

Neomycin (PO)

Answer 22

Neo-Frandin

Question 23

Neomycin Boxed Warnings

Answer 23

Neurotoxciity (hearing loss, vertigo, ataxia), nephrotoxicity, and neuromuscular blockade/resp. paralysis (esp when given soon after anesthesia or with muscle relaxants)

Question 24

Neomycin (PO) AEs

Answer 24

GI upset (also: ototoxicity, nephrotoxicity, irritation/soreness of mouth/rectal area)

Question 25

Treatment of SBP

Answer 25

Ceftriaxone x5-7d

Question 26

Ascites diuretic therapy

Answer 26

Restrict sodium ( good K balance.

Question 27

Pegylated vs. regular interferons

Answer 27

Pegylated has polyethylene glycol --> longer t1/2 --> weekly dosing

Question 28

Interferon AEs

Answer 28

Flu-like syndrome (1-2 hr after admin, can pretreat with APAP and antihistamine), GI upset, increased LFTs, myelosupression, mild alopecia

Question 29

Class of Lamivudine

Answer 29

NRTI

Question 30

Class of Adefovir

Answer 30

NRTI

Question 31

Class of Tenofovir

Answer 31

NRTI

Question 32

Class of Entecavir

Answer 32

NRTI

Question 33

Class of Telbivudine

Answer 33

NRTI

Question 34

NRTI class dosing

Answer 34

Decrease dose if CrCl<50

Question 35

NRTI Boxed Warnings

Answer 35

Lactic acidosis and severe hepatomegaly with steatosis, which may be fatal, Exacerbations of HBV may occur upon discontinuation

Question 36

Lamivudine Boxed Warning

Answer 36

Epivir HBV not used for HIV treatment due to lower doses of Lamivudine

Question 37

Adefovir Boxed Warning

Answer 37

May cause HIV resistance in patients with unrecognized or untreated HIV infection

Question 38

Adefovir Caution

Answer 38

(use caution in patients with renal impairment or those at risk of renal toxicity/on other drugs that are nephrotoxic/NSAIDs)

Question 39

Adefovir

Answer 39

Hepsera

Question 40

Lamivudine

Answer 40

Epivir

Question 41

Tenofovir

Answer 41

Viread

Question 42

Entecavir

Answer 42

Baraclude

Question 43

Telbivudine

Answer 43

Tyzeka

Question 44

Entecavir Boxed Warning

Answer 44

HIV resistance may be caused in patients with unrecognized/untreated HIV

Question 45

Which NRTI must be taken on an empty stomach (2 hr before or after a meal)?

Answer 45

Entecavir

Question 46

Telbivudine AE

Answer 46

Increased CPK

Question 47

Tenofovir AEs

Answer 47

Fanconi, renal insufficiency, osteomalacia, and decreased bone density

Question 48

AE of Lamivudine

Answer 48

Pancreatitis

Question 49

Tenofovir DI

Answer 49

Didanosine (increased risk of virologic failure and potential for increased AEs)

Question 50

NRTIS treat which type of Hepatitis?

Answer 50

HBV

Question 51

Interferons treat which type of hepatitis?

Answer 51

HBV and/or HCV

Question 52

Reactivation of which type of hepatitis can occur when taking certain immunosupressive therapies?

Answer 52

HBV

Question 53

Ribavirin in treatment of hepatitis

Answer 53

Only indicated for HCV in combo with other meds (interferon alfa, simeprevir, and/or sofosbuvir.

Question 54

Ribavirin boxed warnings

Answer 54

Teratogenic, Not monotherapy for HCV, Hemolytic anemia is primary toxciity

Question 55

Ribavirin pregnancy category

Answer 55

X (even sexual partners of male patients should not become pregnancy for 6 months following drug completion) - requires 2 forms of birth control

Question 56

Ribavirin

Answer 56

Copegus, Rebetol, Ribasphere, Ribasphere RibaPak, Virazole

Question 57

Protease inhibitors to treat which type of hepatitis

Answer 57

Chronic HCV genotype 1, but only in combination with peginterferon alfa, and ribavirin

Question 58

Boceprevir

Answer 58

Victrelis

Question 59

Simeprevir

Answer 59

Olysio

Question 60

Simeprevir

Answer 60

Due to co-administration ribavirin do not use in pregnant women or patients who have female partners who could become pregnant

Question 61

Simeprevir in treatment of hepatitis

Answer 61

Not monotherapy, must be used with peginterferon and ribavirin or in combo with sofosbuvir

Question 62

CYP activity of Boceprevir

Answer 62

CYP3A4 - strong inhibitor and P-glycoprotein inhibitor (many drug interactions)

Question 63

CYP activity of Simeprevir

Answer 63

3A4 substrate

Question 64

Sofosbuvir is used to treat which type of hepatitis

Answer 64

HCV genotypes 1-4

Question 65

Sofosbuvir

Answer 65

Sovaldi

Question 66

Ledipasvir/Sofosbuvir

Answer 66

Harvoni

Question 67

Single tablet/combo treatment of HCV

Answer 67

Harvoni

Question 68

Harvoni DI

Answer 68

Requires acidic environment, do not take with acid suppressants