Hepatitis Flashcards
This hepatitis virus is acute, fecal-oral transmission, has a vaccine and first line is supportive treatment
HEP A
This hepatitis virus is both acute & chronic, bodily fluid/blood transmission, has a vaccine and first line is PEG-INF or NRTI (tenofovir or entecavir)
HEP B
This hepatitis virus is both acute & chronic, bodily fluid/blood transmission, no vaccine and first line is (naive: DAA combo)
HEP C
preferred HCV regimens consist of 2-3 _____ with different mechanisms, usually for 8-12 weeks
direct-acting antivirals
some combos include ritonavir, which is NOT active for HCV, but to boost levels of HCV protease inhibitors
Mechanism: NS3/4A, protease inhibitor
glecaPREVIR
grazoPREVIR
paritaPREVIR
voxilaPREVIR
mechanism: NS5A replication complex inhibitor
ledipASVIR
ombitASVIR
pibrentASVIR
velpatASVIR
mechanism: NS5B polymerase inhibitor
dasaBUVIR
sofosBUVIR
What do the protease inhibitors used for HIV and HCV have in common?
they are taken with food
“Protease Inhibitor & Grub = PIG)
*except for fosamprenavir
for treatment naive patients - recommended regimens are?
- glecaprevir/pibrentasvir
- sofosbuvir/velpatasvir
ALL DAAs have a BBW for?
risk of reactivating HBV; test all patients for HBV before starting a DAA
What are warnings for sofosbuvir containing regimens?
serious symptomatic bradycardia when taken with AMIODARONE - do not use with each other
Brand: Epclusa
generic: sofosbuvir/velpatasvir
Brand: Mavyret
generic: glecaprevir/pibrentasvir
* with food
What HCV drugs do you dispense in original container?
Sovaldi, epclusa, harvoni, vosevi
Pan-genotypic - approved for all 6 HCV genotypes for treatment naive
epclusa and mavyret
approved for salvage therapy
vosevi, mavyret
approved for 8 week course of therapy
mavyret
approved for HCV/HIV co infection
epclusa, harvoni, mavyret
approved for children >12 with certain genotypes
Sovaldi and harvoni
What HCV drugs do you avoid or minimize with acid suppressive therapy?
epclusa
harvoni
vosevi
All DAAs are contraindicated with strong inducers of
CYP 3A4
carbamazepine/oxcarbamazpine
phenobarbital
phenytoin
rifampin
rifabutin
st johns wort
most DAAs increase concentration of
statins and increase myopathy risk
*monitor BG too
harvoni should not be used with
stribild
technivie and viekira are contraindicated with
strong inducers of 3A4, ethinyl estradiol containing products, lova, simva
