Hepatitis Drugs Flashcards

1
Q

What is sustained virology response

A

undetectable viral load for 12 weeks after finishing or 24 weeks after finishing with cirrhosis

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2
Q

Protease inhibitors end with

A

previr

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3
Q

NS5A inhibitors end with

A

asvir

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4
Q

Polymerase inhibitors end with

A

buvir

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5
Q

What are antivirals for treatment naive HCV? what about treatment experienced?

A

Naive: harmony, epclusa, mavyret (without protease i), zepatier
Experienced: vosevi, mavyret (with protease)

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6
Q

What does the Child Pugh score give indication about? what are the 3 classes?

A

severe liver disease
Class A 5-6 points
Class b 7-9 points
Class C 10-15 points

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7
Q

Do not use protease inhibitors in people with child Pugh score:

A

B or C (decompensated cirrhosis)

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8
Q

Which two (generic name) antiviral medications have sofosbuvir?

A

Harvoni and Epclusa

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9
Q

What genotypes does Harvoni treat

A

1, 4, 5, 6

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10
Q

Harvoni should be used for ___ weeks and can be used in _____

A

8 weeks

decompensated cirrhosis

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11
Q

What genotypes does Epclusa treat?

A

all genotypes

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12
Q

Epclusa should be used for ___ weeks and can be used in ______

A

12 weeks

decompensated cirrhosis

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13
Q

What antivirals are in Harvoni

A

ledipasvir and sofosbuvir

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14
Q

What antivirals are in epclusa

A

Velpatasir and sofosbuvir

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15
Q

What antivirals are in mavyret

A

flecaprevir and pibrentasvir

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16
Q

Which genotypes does mavyret treat

A

all genotypes

17
Q

Mavyret should be treated for ___ and cannot be used in decompensated cirrhosis

A

8 weeks

18
Q

Why are some treatments indicated for 8 weeks vs 12 weeks

A

cost and side effects

19
Q

Between Harvoni/Epclusa vs Mavyret, which should be used in someone:
uses amiodarone? OCPs? How many daily tablets? PPIs? Crushing tablets?

A

Harvoni/Epclusa: no amiodarone, one tablet, PPI interaction, can crush
Mavyret: no OCPs, PPIs ok, three daily, no crushing

20
Q

What genotypes does Zepatier treat?

A

genotypes 1 and 4

21
Q

Which antivirals are in Zepatier?

A

elbasvir and grazoprevir

22
Q

Zepatier should be used for __ weeks of therapy. To use this you must first test for ____

A

12 weeks

NS5A resistance for genotype 1a

23
Q

What is Ribavirin? What does it do and how does it work?

A
boost DAAs (never use alone, can use in decomposition cirrhosis)
Inhibits replication of RNA and DNA viruses
24
Q

Ribavirin side effects?

A

anemia, HA, fatigue, depression, anxiety

no significant drug-drug

25
Q

Why would someone not be able to take Ribavirin?

A

anemia, renal dysfunction, mental health disorders, CVD

26
Q

What antivirals are in Vosevi?

A

voxilaprevir, velpatasvir, sofosbuvir

27
Q

What genotypes does Vosevi treat?

A

all!

28
Q

Vosevi should be taken for __ weeks and should not be used in ___ but ______

A

12 weeks

decompensated cirrhosis, certain patients with close monitoring

29
Q

Vosevi interactions?

A

statins, PPI, amiodarone

30
Q

If patients are not responding to like anything, what are the two regimes that are possible?

A

Mavyret for 16 weeks if patient previously treated with sofosbuvir ones
Mavyret + sofosbuvir + ribavirin for 16 weeks if already tried Mavyret already

31
Q

Side effects for DAA are ___.
Mavyret only side effect is ____.
Epclusa only side effect is ____.

A

rare and no permanent side effects
pruritis
loose stools

32
Q

Decompensated cirrhosis treatment requires either ____ or _____

A

adding ribavirin or longer course of Epclusa/Harvoni