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NAPLEX 21 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

This hepatitis virus is acute, fecal-oral transmission, has a vaccine and first line is supportive treatment

A

HEP A

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2
Q

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)

A

HEP B

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3
Q

This hepatitis virus is both acute & chronic, bodily fluid/blood transmission, no vaccine and first line is (naive: DAA combo)

A

HEP C

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4
Q

preferred HCV regimens consist of 2-3 _____ with different mechanisms, usually for 8-12 weeks

A

direct-acting antivirals

some combos include ritonavir, which is NOT active for HCV, but to boost levels of HCV protease inhibitors

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5
Q

Mechanism: NS3/4A, protease inhibitor

A

glecaPREVIR
grazoPREVIR
paritaPREVIR
voxilaPREVIR

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6
Q

mechanism: NS5A replication complex inhibitor

A

ledipASVIR
ombitASVIR
pibrentASVIR
velpatASVIR

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7
Q

mechanism: NS5B polymerase inhibitor

A

dasaBUVIR

sofosBUVIR

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8
Q

What do the protease inhibitors used for HIV and HCV have in common?

A

they are taken with food

“Protease Inhibitor & Grub = PIG)
*except for fosamprenavir

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9
Q

for treatment naive patients - recommended regimens are?

A
  • glecaprevir/pibrentasvir

- sofosbuvir/velpatasvir

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10
Q

ALL DAAs have a BBW for?

A

risk of reactivating HBV; test all patients for HBV before starting a DAA

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11
Q

What are warnings for sofosbuvir containing regimens?

A

serious symptomatic bradycardia when taken with AMIODARONE - do not use with each other

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12
Q

Brand: Epclusa

A

generic: sofosbuvir/velpatasvir

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13
Q

Brand: Mavyret

A

generic: glecaprevir/pibrentasvir

* with food

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14
Q

What HCV drugs do you dispense in original container?

A

Sovaldi, epclusa, harvoni, vosevi

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15
Q

Pan-genotypic - approved for all 6 HCV genotypes for treatment naive

A

epclusa and mavyret

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16
Q

approved for salvage therapy

A

vosevi, mavyret

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17
Q

approved for 8 week course of therapy

A

mavyret

18
Q

approved for HCV/HIV co infection

A

epclusa, harvoni, mavyret

19
Q

approved for children >12 with certain genotypes

A

Sovaldi and harvoni

20
Q

What HCV drugs do you avoid or minimize with acid suppressive therapy?

A

epclusa

harvoni

vosevi

21
Q

All DAAs are contraindicated with strong inducers of

A

CYP 3A4

carbamazepine/oxcarbamazpine

phenobarbital

phenytoin

rifampin

rifabutin

st johns wort

22
Q

most DAAs increase concentration of

A

statins and increase myopathy risk

*monitor BG too

23
Q

harvoni should not be used with

A

stribild

24
Q

technivie and viekira are contraindicated with

A

strong inducers of 3A4, ethinyl estradiol containing products, lova, simva

25
Q

What are the BBW for ribavirin

A

teratogenic effects, not monotherapy

hemolytic anemia

*AVOID IN PREGNANCY and male patients; even 6 months after completion

26
Q

Interferon alpha is used for

A

HBV, HCV and some cancer

27
Q

interferon beta is used for

A

MS

28
Q

what are the BBW for interferon alpha

A

neuropsychiatric, autimmune, ischemic, or infectious disorders; if used with ribavirin, teratogenic/anemia risk

29
Q

how often is interferon alpha dosed?

A

weekly (peg)

30
Q

what are the side effects of interferon alpha?

A

extensive –

CNS - fatigue, depression

GI upset, inc LFTs, myelosuppresion

flu like syndrome - pre treat with APAP and antihistamine

31
Q

_________ is approved as monotherapy and is a PREFERRED treatment for HBV

A

interferon alfa

32
Q

these drugs inhibit HBV replication by inhibiting HBV polymerase resulting in DNA chain termination

A

NRTIs

33
Q

ALL HBV NRTIs should decrease the dose or frequency when CrCl

A

50

34
Q

What are the BBW for all HBV NRTIs?

A

lactic acidosis and severe hepatomegaly with steatosis (can be fatal)

exacerbations of HBV

35
Q

What is the preferred therapy for hep B (NRTIs)

A

Vemlidy

Viread

Bacaclude (empty stomach)

36
Q

Brand: Viread

A

generic: tenofovir disoproxil fumarate

37
Q

Brand: Vemlidy

A

generic: tenofovir alafenamide

38
Q

Brand: Baraclude

A

generic: entecavir

39
Q

Brand: Epivir HBV

A

generic: lamivudine

40
Q

Warnings:

renal tox
fanconi syndrome, osteomalacia and dec bone density

A

TDF

TAF (nausea)

41
Q

Do not use ____ for treatment of HIV

A

Epivir HBV (resistance)

NAPLEX 21 (60 decks)

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