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GI II: Test 1 > hepatitis tx > Flashcards

hepatitis tx Flashcards

1
Q

Peginterferon alfa

A

HBV agent/HCV agent

MOA: inhibits viral penetration, tln, txn, protein processing, maturation and release
- must be given subq: but has slower clearance, 1x/week injections

ADR’s: experience flu-like illness w/in first week
- increase in hepatic enzymes

  • neurotoxicity, meylosupression, fatigue

CI’s: hepatic decomposition, psychiatric disease

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2
Q

Adefovir

A

HBV agent

Nucleoside/NT analogs (NA’s): interfere w/ viral replication- inhibit HBV DNA pol, chain termination after incorporation into viral DNA

ADR’s: h/a, diarrhea, ab. pain; nephrotoxicity

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3
Q

Entecavir

A

HBV agent

Nucleoside/NT analogs (NA’s): interfere w/ viral replication-
MOA: inhibits DNA polymerase

ADR’s: welll- tolerated
** first line therapy for HBV

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4
Q

Lamivudine

A

(3TC) HBV agent

Nucleoside/NT analogs (NA’s): interfere w/ viral replication-
MOA: inhibits DNA pol

ADR’s: excellent safety profile, including use during pregnancy

USE: has high amount of resistnace, not first line therapy

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5
Q

Telbivudine

A

HBV agent

Nucleoside/NT analogs (NA’s): interfere w/ viral replication
MOA- inhibits DNA pol via competitive inhibition, causing chain termination

CIS’s: concurrent use w/ interferon alfa can cause peripheral neuropathy

not recommended first line

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6
Q

Tenofovir

A

HBV agent

Nucleoside/NT analogs (NA’s): interfere w/ viral replication-
MOA: comp. inhibits DNA pol, causing chain termination

ADR’s: nausea, diarrhea, vomiting, decreased bone mineral density

Use: recommended first-line therapy for HBV
resistance is rare

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7
Q

Ribavarin

A

HCV agent

MOA: inhibits initiation/elongation of RNA –> inhibition of viral protein synth (inhibits RNA pol)

ADR’s: dose dependent hemolytic anemia , teratogenic, oncogenic

Used for Chronic HCV

CI’s: anemia, ESRF, ischemic vascular disease, pregnancy

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8
Q

simeprevir

A

(OLYSIO) HCV agent

MOA: direct acting antiviral

ADR’s: skin rash/puritis

DDI’s: avoid with CYP inducers (rifampin) – super expensive tx

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9
Q

Sofosbuvir

A

(Sovaldi) HCV agent

MOA: direct acting antiviral - inhibits RNA pol

ADR’s: fatigue, h/a, insomnia

expensive!!!

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10
Q

Boceprevir

A

(Incivek) HCV agent = protease inhibitor

no longer recommended

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11
Q

Telaprevir

A

(Victrelis) HCV agent = protease inhibitor

no longer recommended

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12
Q

+ HBsAG

A

HBV surface protein; high level occur during acute/chronic infection - means pt. is infectious

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13
Q

+ anti-HBs

A

interpreted as recovery or immunity from HBV - also arise after succesful vaccination

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14
Q

+ anti-HBc

A

total hepatitis B core Ab - appears at onset of infection (will persist for life) and indicates previous or ongoing infection

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15
Q

IgM anti-HBc

A

delineates recent infection with HBV w/in 6 mos

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16
Q

HBeAg

A

indicates high levels of HBV - found during acute and chronic infection, indicating viral replication

17
Q

HBeAB

A

indicates lower levels of HBV - spontaneous Ag to AB conversion is a good predictor of viral clearance

18
Q

which of following is NOT a tx goal for HBV?

A

Viral cure

three risks if not cured? cirrhoisis, HCC, hepatic failure

seroconversion is a good predictor of viral clearance

19
Q

which drug class would be preferred if pt. has decompensated liver disease

A

nucleoside/nucleotide analogs

20
Q

first line tx for HBV?

A

tenofovir and entecavir

21
Q

high resistance for HBV?

A

lamuvidine, telbivudine

22
Q

favorable response to tx of HCV?

A

genotype 2
low baseline HCV-RNA
no cirrhosis

23
Q

what is an SVR?

A

sustained virologic response - absence of HCV RNA by polymerase chain reaction for 6 mos. after completion of therapy -

assoc/ w/ improved liver histology, decrease risk of cancer….

24
Q

HCV tx?

A

Peginterferon, ribavirin, sofosbuvir

25
Q

pregnancy category x?

A

ribavirin - must have negative pregnancy test at baseline and up to six months after tx - needs two forms of barrier tx.

26
Q

mechanism of action of sofosbuvir?

A

directing acting antiviral- inhibits RNA polymerase (incorporated into HCV RNA and causes chain termination of RNA)

27
Q

ribavirin adverse effect?

A

hemolytic anemia

- pregnancy X drug

28
Q

IFN contraindicated/use with caution?

A

hepatic decomposition, AI disease, cardiac arrythmia, pregnancy

caution: psychiatric disease, epilepsy, thyroid disease, renal insufficiency

29
Q

inhibits DNA pol?

A

adefovir, entecavir, lamivudine, telbivudine, tenofovir

30
Q

inhibits RNA pol?

A

ribavirin, sofosbuvir

31
Q

inhibits viral penetration, tln, maturation?

A

peginterferon

32
Q

inhibits viral protease?

A

semeprevir, boceprevir, teleprever

33
Q

common side effect of peginterferon?

A

flu like illness

34
Q

psych problems?

A

peginterferon

35
Q

first-line tx for HBV?

A

entecavir, tenofovir

36
Q

HCV tx?

A

peginterferon, ribavirin
+
(sofusbuvir also, but its expensive! )

37
Q

Fatigue, scleral icterus,

and pallor.

A

ribavirin

38
Q

when is IFN ineligible?

A 
Hepatic decomposition
Autoimmune disease
Cardiac arrhythmia 
Pregnancy (Category C?)
Caution
Psychiatric disease
Epilepsy
Thyroid disease
Renal insufficiency

GI II: Test 1 (6 decks)

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