Liver Disease Flashcards
BBW for all DAAs
risk of reactivating HBV
Mayvret
glecaprevir/pibrentasvir
Epclusa
sofosbuvir/velpatasvir
Harvoni
sofosbuvir/ledipasvir
Vosevi
sofosbuvir/velpatasvir/voxilaprevir
Zepatier
elbasvir/grazoprevir
HCV treatments approved for all HCV genotypes
Epclusa, Mayvret
HCV treatment approved for 8 week course
Mayvret
HCV treatment approved for salvage therapy
Vosevi and Mayvret
DAAs are CI’ed with what?
CYP3A4 inducers
When can ribavirin be used in HCV?
Add-on treatment to DAAs
BBW for ribavirin
teratogenicity, hemolytic anemia, not effective as monotherapy
CIs for ribavirin
pregnancy, male partners of pregnant women
When to avoid pregnancy when taking ribavirin
during therapy and 6 months after; use 2 reliable forms of contraception
BBW for all HBV NRTIs
lactic acidosis and severe hepatomegaly with steatosis
TDF
Viread
TAF
Vemlidy
All HBV NRTIs need dose adjustment when?
CrCl <50
Warnings for tenofovir
renal toxicity, Fanconi syndrome, osteomalacia, decreased bone mineral density
Entecavir
Baraclude
Baraclude counseling point
Take on an empty stomach
Lamivudine
Epivir HBV (HIV one is just Epivir)
Epivir HBV side effects
N/V/D, HA
Pegasys BBW
Can cause or exacerbate neuropsychiatric, autoimmune, ischemic, or infectious disorders
Teratogenic risk if used with ribavirin
Pegasys side effects
CNS effects, increased LFTs, GI upset, flu-like syndrome (can pre-treat)
Vasoconstriction medications for bleeding varices
Octreotide
Vasopressin
Meds for portal HTN
Nadolol
Propranolol
Carvedilol
These are all non-selective!
Meds for hepatic encephalopathy
lactulose, rifaximin
Meds for ascites
diuretic therapy: spironolactone monotherapy or furosemide WITH spironolactone
Ratio of spironolactone:furosemide for ascites
100mg:40mg
SBP treatment
CTX x5-7 days
SBP prophylaxis treatment
Bactrim or cipro
SBP hepatorenal syndrome treatment
albumin, octreotide, midodrine
Preferred HCV treatments
2-3 DAAs with different MOAs
