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NAPLEX REVIEW > Hepatic > Flashcards

Hepatic Flashcards

1
Q

Interferon Alpha Treats…

A

HBV/HCV

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2
Q

Interferon Beta Treats…

A

Multiple Sclerosis

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3
Q

Boxed Warning Interferon Alpha

A

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

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4
Q

Hep A

A

Self-limiting, vaccine preventable, fecal-oral

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5
Q

Hep B

A

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

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6
Q

Hep C

A

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

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7
Q

Natural product used to treat liver dz

A

Milk Thistle

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8
Q

Naltrexone

A

Revia

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9
Q

Acamprosate

A

Campral

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10
Q

Disulfiram

A

Antabuse

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11
Q

Drugs used to prevent alcohol relapse

A

Revia, Campral, Antabuse

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12
Q

Tx of acute alcohol withdrawal

A

Benzos

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13
Q

Wernicke-Korsakoff syndrome caused by lack of ______

A

Vitamin B1 (Thiamine)

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14
Q

Used to help prevent portal HTN and variceal bleeds

A

Non-selective BBs (Nadolol, Propranolol)

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15
Q

Drugs to manage acute visceral bleed

A

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

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16
Q

Octreotide

A

Sandostatin

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17
Q

Vasopressin

A

Pitressin

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18
Q

Drugs to treat hepatic encephalopathy

A

Lactulose, Rifaximin (Neomycin may also be used)

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19
Q

Lactulose AEs

A

Flatulence, Diarrhea, Dyspepsia, Abdominal Discomfort

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20
Q

Lactulose

A

Constulose, Enulose, Generlac, Kristalose

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21
Q

Rifaximin

A

Xifaxan

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22
Q

Neomycin (PO)

A

Neo-Frandin

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23
Q

Neomycin Boxed Warnings

A

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

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24
Q

Neomycin (PO) AEs

A

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

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25
Q

Treatment of SBP

A

Ceftriaxone x5-7d

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26
Q

Ascites diuretic therapy

A

Restrict sodium ( good K balance.

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27
Q

Pegylated vs. regular interferons

A

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

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28
Q

Interferon AEs

A

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

29
Q

Class of Lamivudine

30
Q

Class of Adefovir

31
Q

Class of Tenofovir

32
Q

Class of Entecavir

33
Q

Class of Telbivudine

34
Q

NRTI class dosing

A

Decrease dose if CrCl<50

35
Q

NRTI Boxed Warnings

A

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

36
Q

Lamivudine Boxed Warning

A

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

37
Q

Adefovir Boxed Warning

A

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

38
Q

Adefovir Caution

A

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

39
Q

Adefovir

40
Q

Lamivudine

41
Q

Tenofovir

42
Q

Entecavir

43
Q

Telbivudine

44
Q

Entecavir Boxed Warning

A

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

45
Q

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

46
Q

Telbivudine AE

A

Increased CPK

47
Q

Tenofovir AEs

A

Fanconi, renal insufficiency, osteomalacia, and decreased bone density

48
Q

AE of Lamivudine

A

Pancreatitis

49
Q

Tenofovir DI

A

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

50
Q

NRTIS treat which type of Hepatitis?

51
Q

Interferons treat which type of hepatitis?

A

HBV and/or HCV

52
Q

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

53
Q

Ribavirin in treatment of hepatitis

A

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

54
Q

Ribavirin boxed warnings

A

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

55
Q

Ribavirin pregnancy category

A

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

56
Q

Ribavirin

A

Copegus, Rebetol, Ribasphere, Ribasphere RibaPak, Virazole

57
Q

Protease inhibitors to treat which type of hepatitis

A

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

58
Q

Boceprevir

59
Q

Simeprevir

60
Q

Simeprevir

A

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

61
Q

Simeprevir in treatment of hepatitis

A

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

62
Q

CYP activity of Boceprevir

A

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

63
Q

CYP activity of Simeprevir

A

3A4 substrate

64
Q

Sofosbuvir is used to treat which type of hepatitis

A

HCV genotypes 1-4

65
Q

Sofosbuvir

66
Q

Ledipasvir/Sofosbuvir

67
Q

Single tablet/combo treatment of HCV

68
Q

Harvoni DI

A

Requires acidic environment, do not take with acid suppressants

NAPLEX REVIEW (6 decks)

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