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GI - 2 > Hepatitis C Medications > Flashcards

Hepatitis C Medications Flashcards

1
Q

What is the goal of treatment for Hepatitis C infection?

A

ERADICATION of the virus

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2
Q

What is the goal of treatment for Hepatitis C infection?

A

ERADICATION of the virus

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3
Q

What is the sustained viral response (SVR)?

A

Absence of detectable viremia 24 weeks after therapy

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4
Q

Is relapse possible in some patients?

A

Yes

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5
Q

Why may some practitioners wait to start therapy after the initial HCV infection?

A

20-25% of HCV will clear on its own

– delay therapy to see if it will do so

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6
Q

What are the agents and combos to treat HCV?

A 
PEG Interferon Alfa-2b
Elbasvir/Grazoprevir
Ledipasvir/Sofosbuvir
Velpatasvir/Sofosbuvir
Ribivarin
Boceprevir
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7
Q

What are the agents and combos to treat HCV?

A 
PEG Interferon Alfa-2b
Elbasvir/Grazoprevir
Ledipasvir/Sofosbuvir
Velpatasvir/Sofosbuvir
Ribivarin
Boceprevir
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8
Q

What are the agents and combos to treat HCV?

A 
PEG Interferon Alfa-2b
Elbasvir/Grazoprevir
Ledipasvir/Sofosbuvir
Velpatasvir/Sofosbuvir
Ribivarin
Boceprevir
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9
Q

Indications for PEG Interferon Alfa-2b?

A
    • > 18

- Chronic HCV with history of blood exposure and (+) HCV antibody

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10
Q

Contraindications and adverse effects of PEG Interferon Alfa-2b?

A
  • Autoimmune Hepatitis
  • Hepatic Decompensation
    = Flu-like effects
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11
Q

BB warning for PEG Interferon Alfa-2b?

A

May cause or worsen LIFE-THREATENING neuropsych, autoimmune, ischemic and infectious disorders

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12
Q

MOA for Elbasvir/Grazoprevir

A

Elbasvir - Ns5A (-)

Grazoprevir - Ns3/4 Protease (-)

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13
Q

Contraindications for Elbasvir/Grazoprevir?

A
  • Hepatic impairment

- May also cause ALT increase

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14
Q

Adverse effects of Elbasvir/Grazoprevir?

A

Headache, fatigue, nausea

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15
Q

Do not give Elbasvir/Grazoprevir with?

A

CYP3A inducers = decrease the concentrations of these drugs!

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16
Q

MOA for Ledipasvir/Sofosbuvir?

A

Ledipasvir - Ns5A (-)

Sofosbuvir - Nucleotide analog Ns5B polymerase (-)

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17
Q

Contraindications for Ledipasvir/Sofosbuvir?

A

Do not give with other drugs that contain Sofosbuvir

18
Q

Adverse effects of Ledipasvir/Sofosbuvir?

A

Headache, fatigue

19
Q

Do not give Ledipasvir/Sofosbuvir with?

A

Polyglycoprotein inducers = alter concentrations of these drugs!

20
Q

What are examples of polyglycoprotein inducers that should not be given with Ledipasvir/Sofosbuvir?

A

Rifampin

St. John’s Wort

21
Q

MOA for Velpatasvir/Sofosbuvir?

A

Velpatasvir - Ns5A (-)

Sofosbuvir - Nucleotide analog Ns5B polymerase (-)

22
Q

Indications for Velpatasvir/Sofosbuvir?

A

HCV infection w/o or w/ compensated cirrhosis

23
Q

What can you add to Velpatasvir/Sofosbuvir to treat decompensated cirrhosis?

A

Ribavirin

24
Q

Contraindications for Velpatasvir/Sofosbuvir?

A
  • If ribavirin is contraindicated

- Can potentiate bradycardia with amiodarone

25
Q

When should you use caution with Velpatasvir/Sofosbuvir?

A

Patients on beta blockers, or that have cardiac and liver disease

26
Q

Adverse effects of Velpatasvir/Sofosbuvir?

A

Headache and fatigue

27
Q

Do not give Velpatasvir/Sofosbuvir with?

A

Polyglycoprotein and CYP inducers = decreases concentrations of these drugs!

28
Q

What are examples of polyglycoprotein inducers that should not be given with Velpatasvir/Sofosbuvir?

A

Rifampin

St. John’s wort

29
Q

Nucleoside analog

A

Ribavirin

30
Q

Ribavirin is used in combo with?

A

In combo with PEG Interferon Alfa-2a

31
Q

Contraindications for Ribavirin?

A

Pregnant women and their male partners

Hemoglobinopathies

32
Q

Adverse effects of Ribavirin?

A

Fatigue, weakness, fever, muscle aches

33
Q

BB warning for Ribavirin?

A

Birth defects and fetal death

– Do not use in pregnancy

34
Q

When should you not use Ribavirin?

A

During pregnancy or 6 months before coming pregnant

35
Q

MOA for Boceprevir?

A

Ns3/4A protease (-)

36
Q

Boceprevir is given with?

A

PEG Interferon Alfa and Ribavirin

37
Q

Boceprevir is given with?

A

PEG Interferon Alfa and Ribavirin

38
Q

Adverse effects of Boceprevir?

A 
Altered taste (dysguesia)
Fatigue, headache, nausea
39
Q

Which drug is for those who have failed previous treatments?

A

Boceprevir

- + PEG interferon Alfa and Ribavirin

40
Q

Which drug can cause altered taste (dysguesia)?

A

Boceprevir

GI - 2 (61 decks)

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