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PHA 550 > Hepatitis C > Flashcards

Hepatitis C Flashcards

1
Q

Who does USPSTF recommend screening for HepC?

A

pts born bt 1945-1965

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2
Q

What is the MC HepC genotype

A

genotype 1

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3
Q

What factors determine treatment eligibility in HepC?

A 
HCV genotype
cirrhosis (absent, compensated, decompensated)
prior tx
liver transplant
other health conditions
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4
Q

What is the duration for most HepC treatment regimens?

A

6-24weeks

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5
Q

NS3/4A protease inhibitors: MOI

A

prevent polyprotein processing

inhibits HCV replication directly binding to the NS3/4A protease that cleaves HCV encoded polyproteins

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6
Q

NS5B inhibitors: MOI

A

inhibit RNA dependent RNA polymerase activity

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7
Q

NS5A inhibitors: MOI

A

prevent viral assembly and formation of RNA replication complex

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8
Q

NS3/4A protease inhibitors: agents, targeted genotypes

A

“previr”

Simeprevir (1, 4)
Paritaprevir (1, 4)
Asunaprevir (1, 4)
Grazoprevir (1, 4-6)
Glecaprevir (1-6)
Voxilaprevir (1-6)
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9
Q

NS5B inhibitors: agents, targeted genotypes

A

“buvir”

sofosbuvir (1-6)
dasabuvir (1, 4)
beclabuvir (1)

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10
Q

NS5A inhibitors: agents, targeted genotypes

A

“asvir”

Daclatasvir (1-6)
Ledipasvir (1, 4-6)
Ombitasvir (1,4)
Elbasvir (1-6)
Velpatasvir (1-6)
Pibrentasvir (1-6)
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11
Q

Genotype 1 Specific Medications

A

Daklinza (daclatasvir) with Sovaldi (sofosbuvir) +/- ribavirin.

Harvoni (ledipasvir/sofosbuvir) +/- ribavirin

Olysio (simprevir) plus Sovaldi (sofosbuvir) +/- ribavirin

Viekira Pak (ombitasvir/paritaprevir/ritonavir tablets; dasabuvir) + ribavirin

Viekira XR (ombitasvir, paritaprevir, ritonavir, dasabuvir) + ribavirin

Zepatier (elbasvir/grazoprevir) +/- ribavirin

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12
Q

Genotype 2 Specific Medications

A

Sovaldi (sofosbuvir) + ribavirin

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13
Q

Genotype 3 Specific Medications

A

Daklinza (daclatasvir) with Sovaldi (sofosbuvir) +/- ribavirin.

Sovaldi (sofosbuvir) + ribavirin

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14
Q

Genotype 4 Specific Medications

A

Harvoni (ledipasvir/sofosbuvir) +/- ribavirin

Sovaldi (sofosbuvir) + ribavirin

Technivie (ombitasvir/paritaprevir/ritonavir) + ribavarin

Zepatier (elbasvir/grazoprevir) +/- ribavirin

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15
Q

Vosevi: agents, ADE

A

(pan-genotypic)

sofosbuvir/velpatasvir/voxilapresvir

HA
tiredness
diarrhea
nausea

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16
Q

Epclusa: drug interactions

A

take antacids containing Al, Mg 4hrs from Epclusa

inc levels of amiodarone –> bradycardia

dec level of epclusa w/ AED, proton pump inhibitors of H2

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

interaction w/ HIV meds

17
Q

Mavyret: drug interactions

A

reduced success w/ atazanavir, rifampin

can take digoxin concurrently

not recommended w/ immunosuppressants (cyclosporine)

Mavyret + OCP –> inc ALT levels

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

dec level of mavyret w/ AED, proton pump inhibitors of H2

interaction w/ HIV meds

18
Q

Vosevi: drug interactions

A

do not take BCRP substrate w/ vosevi

take antacids containing Al, Mg 4hrs from Epclusa

inc levels of amiodarone –> bradycardia

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

dec level of vosevi w/ AED, proton pump inhibitors of H2

interaction w/ HIV meds

19
Q

Vosevi: drug interactions

A

do not take BCRP substrate w/ vosevi

take antacids containing Al, Mg 4hrs from Epclusa

inc levels of amiodarone –> bradycardia

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

dec level of vosevi w/ AED, proton pump inhibitors of H2

interaction w/ HIV meds

20
Q

Epclusa: drug interactions

A

take antacids containing Al, Mg 4hrs from Epclusa

inc levels of amiodarone –> bradycardia

dec level of epclusa w/ AED, proton pump inhibitors of H2

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

interaction w/ HIV meds

21
Q

Mavyret: drug interactions

A

reduced success w/ atazanavir, rifampin

can take digoxin concurrently

not recommended w/ immunosuppressants (cyclosporine)

Mavyret + OCP –> inc ALT levels

dec level of mavyret w/ AED

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

interaction w/ HIV meds

22
Q

Vosevi: drug interactions

A

do not take BCRP substrate w/ vosevi

take antacids containing Al, Mg 4hrs from Epclusa

inc levels of amiodarone –> bradycardia

dec level of vosevi w/ AED, proton pump inhibitors of H2

inc levels of statin med

dec efficacy w/ rifampin, st john’s wart

interaction w/ HIV meds

23
Q

Daklinza with Sovaldi +/- ribavirin: genotype, ADEs

A

genotype 1
genotype 3

fatigue
HA
nausea
anemia

24
Q

Harvoni +/- ribavirin: genotype, ADEs

A

genotype 1
genotype 4
genotype 5
genotype 6

fatigue
HA
neuromuscular/skeletal weakness

w/ ribavirin:
weakness
HA
cough

25
Q

Olysio plus Sovaldi +/- ribavirin: genotype, ADEs

A

genotype 1

fatigue
HA
nausea
insomnia
itching
rash
photosensitivity
dizziness
diarrhea
26
Q

Viekira Pak + ribavirin: genotype, ADEs

A

genotype 1

nausea
itching
sleep problems

w/ribavirin:
tiredness
nausea
itching
sleep problems
feeling weak
skin reactions (redness, rash)
27
Q

Viekira XR + ribavirin: genotype, ADEs

A

genotype 1

nausea
itching
sleep problems

w/ribavirin:
tiredness
nausea
itching
sleep problems
feeling weak
skin reactions (redness, rash)
28
Q

Zepatier +/- ribavirin: genotype, ADEs

A

genotype 1
genotype 4

fatigue
HA
nausea

w/ribavirin:
anemia
HA
fatigue
SOB
rash
itching
29
Q

Sovaldi + ribavirin: genotype, ADEs

A

genotype 2
genotype 3
genotype 4

fatigue
HA

30
Q

Why do we administer HepB vaccine prior to HepC treatment?

A

new anti viral therapies can re activate past HepB infx

may also need HepA vaccine

PHA 550 (26 decks)

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