Hepatitis Drugs

Question 1

What is sustained virology response

Answer 1

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

Question 2

Protease inhibitors end with

Answer 2

previr

Question 3

NS5A inhibitors end with

Answer 3

asvir

Question 4

Polymerase inhibitors end with

Answer 4

buvir

Question 5

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

Answer 5

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

Question 6

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

Answer 6

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

Question 7

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

Answer 7

B or C (decompensated cirrhosis)

Question 8

Which two (generic name) antiviral medications have sofosbuvir?

Answer 8

Harvoni and Epclusa

Question 9

What genotypes does Harvoni treat

Answer 9

1, 4, 5, 6

Question 10

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

Answer 10

8 weeks

decompensated cirrhosis

Question 11

What genotypes does Epclusa treat?

Answer 11

all genotypes

Question 12

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

Answer 12

12 weeks

decompensated cirrhosis

Question 13

What antivirals are in Harvoni

Answer 13

ledipasvir and sofosbuvir

Question 14

What antivirals are in epclusa

Answer 14

Velpatasir and sofosbuvir

Question 15

What antivirals are in mavyret

Answer 15

flecaprevir and pibrentasvir

Question 16

Which genotypes does mavyret treat

Answer 16

all genotypes

Question 17

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

Answer 17

8 weeks

Question 18

Why are some treatments indicated for 8 weeks vs 12 weeks

Answer 18

cost and side effects

Question 19

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

Answer 19

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

Question 20

What genotypes does Zepatier treat?

Answer 20

genotypes 1 and 4

Question 21

Which antivirals are in Zepatier?

Answer 21

elbasvir and grazoprevir

Question 22

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

Answer 22

12 weeks

NS5A resistance for genotype 1a

Question 23

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

Answer 23

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

Question 24

Ribavirin side effects?

Answer 24

anemia, HA, fatigue, depression, anxiety

no significant drug-drug

Question 25

Why would someone not be able to take Ribavirin?

Answer 25

anemia, renal dysfunction, mental health disorders, CVD

Question 26

What antivirals are in Vosevi?

Answer 26

voxilaprevir, velpatasvir, sofosbuvir

Question 27

What genotypes does Vosevi treat?

Answer 27

all!

Question 28

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

Answer 28

12 weeks | decompensated cirrhosis, certain patients with close monitoring

Question 29

Vosevi interactions?

Answer 29

statins, PPI, amiodarone

Question 30

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

Answer 30

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

Question 31

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

Answer 31

rare and no permanent side effects pruritis loose stools

Question 32

Decompensated cirrhosis treatment requires either ____ or _____

Answer 32

adding ribavirin or longer course of Epclusa/Harvoni