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Flashcards in Hepatitis and Liver Disease Deck (202)
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1

Hepatitis A transmission

fecal-oral route

2

Treatment of Hepatitis A

supportive

3

Treatment of Hepatitis B

interferons, select NRTIs

4

most common indication for liver transplant

hepatitis C

5

# of hepatitis C genotypes

6

6

treatment options for hepatitis C

peginterferons, ribaviron, direct acting antivirals (protease inhibitors, NS5B polymerase inhibitors, NS5A replication complex inhibitors)

7

Interferon alfa indicated for treatment of which hepatitis

HBV and HCV

8

Interferon alfa 2b brand name

intron A

9

interferon alfa 2b indications

hbc, hcv, many cancers

10

Pegylated interferon alfa 2a brand name

pegasys

11

pegylated interferon alfa 2a indications

HBV, HCV

12

Pegylated interferon alfa 2b brand name

peg-intron

13

pegylated interferon alfa 2b indications

HCV

14

Which dose reductions are required when treating with interferon alfa

thrombocytopenia, neutropenia, renal dysfunction

15

When in neutropenia should be interferon alfa be held

ANC

16

when in thrombocytopenia should interferon alfa be held

platelets

17

boxed warnings for interferon alfa

cause or exacerbate neuropsychiatric, autoimmune, ischemic, or infectious disorders. combination with ribavirin can cause birth defects, fetal mortality, or hemolytic anemia

18

contraindications to interferon alfa

autoimmune hepatitis, decompensated liver disease in cirrhotic patients, infant and neonates (Pegasys)

19

warning for interferon alfa

neuropsychiatric events, cardiovascular events, endocrine disorders (aggravates hypo/hyperthroidism, hypo/hyperglycemia), ophthalmologic disorders (retiniopathy, decrease in vision), pancreatitis, myelosuppression and serious skin reactions

20

interferon alfa side effects

CNS effects (fatigue, anxiety, depression, weakness), GI upset (N/V, anorexia, weight loss), increased LFTs (5-10x ULN), myelosuppression, mild alopecia, Flu-like syndrome (fever, chills, HA, malaise, arthralgia, myalgia, diaphoresis)

21

pretreatment required for interferon alfa

acetaminophen and antihistamine

22

Interferon alfa monitoring

CBC with differential and platelets, LFTs, urice acid, SCr, electrolytes, TGs, thyroid function tests, serum HBV DNA or HCV RNA levels

23

NRTIs MOA

inhibit HBV replication by inhibiting HBV polymerase resulting in DNA chain termination

24

Dose adjustment required for all NRTIs (HBV)

CrCl

25

Boxed warnings for ALL NRTIs (HBV)

Lactic acidosis and severe hepatomegaly with steatosis (may be fatal). Exacerbations of HBV upon discontinuation,

26

Lamuvidine brand name (HBV)

Epivir HBV

27

Lamuvidine dose for HBV only

100 mg daily

28

Lamuvidine dose for HBV with HIV coinfection

150 mg BID or 300 mg daily

29

Lamuvidine dose adjustment

decrease dose CrCL

30

Lamuvidine boxed warning

Do not use Epivir HBV for treatment of HIV (HIV resistance due to lower dose)