Hepatitis Drugs Flashcards
What is sustained virology response
undetectable viral load for 12 weeks after finishing or 24 weeks after finishing with cirrhosis
Protease inhibitors end with
previr
NS5A inhibitors end with
asvir
Polymerase inhibitors end with
buvir
What are antivirals for treatment naive HCV? what about treatment experienced?
Naive: harmony, epclusa, mavyret (without protease i), zepatier
Experienced: vosevi, mavyret (with protease)
What does the Child Pugh score give indication about? what are the 3 classes?
severe liver disease
Class A 5-6 points
Class b 7-9 points
Class C 10-15 points
Do not use protease inhibitors in people with child Pugh score:
B or C (decompensated cirrhosis)
Which two (generic name) antiviral medications have sofosbuvir?
Harvoni and Epclusa
What genotypes does Harvoni treat
1, 4, 5, 6
Harvoni should be used for ___ weeks and can be used in _____
8 weeks
decompensated cirrhosis
What genotypes does Epclusa treat?
all genotypes
Epclusa should be used for ___ weeks and can be used in ______
12 weeks
decompensated cirrhosis
What antivirals are in Harvoni
ledipasvir and sofosbuvir
What antivirals are in epclusa
Velpatasir and sofosbuvir
What antivirals are in mavyret
flecaprevir and pibrentasvir
Which genotypes does mavyret treat
all genotypes
Mavyret should be treated for ___ and cannot be used in decompensated cirrhosis
8 weeks
Why are some treatments indicated for 8 weeks vs 12 weeks
cost and side effects
Between Harvoni/Epclusa vs Mavyret, which should be used in someone:
uses amiodarone? OCPs? How many daily tablets? PPIs? Crushing tablets?
Harvoni/Epclusa: no amiodarone, one tablet, PPI interaction, can crush
Mavyret: no OCPs, PPIs ok, three daily, no crushing
What genotypes does Zepatier treat?
genotypes 1 and 4
Which antivirals are in Zepatier?
elbasvir and grazoprevir
Zepatier should be used for __ weeks of therapy. To use this you must first test for ____
12 weeks
NS5A resistance for genotype 1a
What is Ribavirin? What does it do and how does it work?
boost DAAs (never use alone, can use in decomposition cirrhosis) Inhibits replication of RNA and DNA viruses
Ribavirin side effects?
anemia, HA, fatigue, depression, anxiety
no significant drug-drug
Why would someone not be able to take Ribavirin?
anemia, renal dysfunction, mental health disorders, CVD
What antivirals are in Vosevi?
voxilaprevir, velpatasvir, sofosbuvir
What genotypes does Vosevi treat?
all!
Vosevi should be taken for __ weeks and should not be used in ___ but ______
12 weeks
decompensated cirrhosis, certain patients with close monitoring
Vosevi interactions?
statins, PPI, amiodarone
If patients are not responding to like anything, what are the two regimes that are possible?
Mavyret for 16 weeks if patient previously treated with sofosbuvir ones
Mavyret + sofosbuvir + ribavirin for 16 weeks if already tried Mavyret already
Side effects for DAA are ___.
Mavyret only side effect is ____.
Epclusa only side effect is ____.
rare and no permanent side effects
pruritis
loose stools
Decompensated cirrhosis treatment requires either ____ or _____
adding ribavirin or longer course of Epclusa/Harvoni
