Hepatic Drugs Flashcards Preview

pharm 516 > Hepatic Drugs > Flashcards

Flashcards in Hepatic Drugs Deck (16):
1

drug induced liver disease

some acute, some chronic, some cholestatic, some hepatocellular

2

severe liver injury

bili x 2, encephalopathy, coagulopathy

3

fulminant liver injury

happens within 4 weeks, fast onset

4

portal hypertension

every condition of liver damage r/t to this, splenomegaly, hepatic encephalopathy, perotinitis, ascites, bleeding disorders, interstitial fluid shift

5

tylenol

40% drug induced liver disease, if glutiones depleted in etoh use, liver injury develops more easily, if liver dx no more than 1500mg/24 h

6

rule of 140

if more than 140 mg/kg r/f hepatotoxicity,
if tylenol level 4 h later, if >140 , 25% to 30% of hepatoxicity
dose of NAC, 140mg/kg loading dose, then 70mg/kg every 4 h for 17 doses

7

tylenol drug induced injury

if ast>10,000, bili>4, lft elevated, prolongation of PTT,hypoglycemia, --->renal failure and then multio organ failur

8

n-acetylcysteine, NAC

treatment for tylenol overdose, smells like rotten egg

9

spironolactone

200-400 mg, decreases Na and therefore ascites, also, restrict sodium, add low loop diuretic 20-40 to reduce hyperkalemia (careful, intravascular depletion)

10

low albumin

high aldosterone

11

Treatment for Hep B

Interferon, 16 weeks, 30-40% cure rate
Nucleotide analogs, inc famciclovir and adefovir, don't cure but decrease viral load and liver injury

12

Hep C treatment

PEG interferon and ribuviron, 61%cure rate
Genotype 1/4, 48 weeks
Genotype 2/3, 24 weeks

13

PEG intron monotherapy

better response if non-1 genotype
HCV RNA level lower
cirrhosis or bridging fibrosis- absence
younger age
lighter body weight

14

Protease inhibitors for hep c treatment

boceprevir and telaprevir

15

boceprevir

CYP 3A4 inhibitor
24,000-48,000$ for 6 mohths
take with food
preg cat x
12 capsules/day
refrigerate
no renal dosing

16

telaprevir

6 tablets/day
skin rash very common
preg cat x
fatigue/nausea/vomitting
no renal dosing, only crcl>50