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Pgx > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

What is NS5A?

A

Viral protein for HCV

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2
Q

What are the NS5A inhibitors?

A

Ledipasvir (harvoni)
Elbasvir
Velpatasvir (Epclusa)
Pibrentasvir

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3
Q

What are the alleles for NS5A resistance and how do we get them?

A

1a and 3
When it hits 15% we
6-16% jut have it randomly

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4
Q

Do you need to test prior for NS5A?

A

Yes bc treatment naive can have RAV

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5
Q

Which pt are we concerned about for NS5A and SVR?

A

No cirrhosis, Treatment tried
Cirrhosis, treatment tried

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6
Q

What do we do for Zepatier( elbasvir/grazoprevir)?

A

Testing recommended for 1a TN TE

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7
Q

What do we do for Harvoni (Ledipasvir/Sofosbuvir)?

A

Considering testing for 1a TE with C or NC
Recommend different therapy

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8
Q

What do we do for Epclusa (Sofosbuvir/Velpatasvir)?

A

Testing recommended for genotype 3 TN w/ C and TE NC
If Y93H you use weight based dosing

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9
Q

ITPA does what to RBV?

A

On chromosome 20
Cause a deficiency that allows more inosone triphosphate to be available for ATP = heather RBC

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10
Q

How does RBV cause anemia?

A

Depletes Intracellular ATP of RBC and makes they more sensitive to oxidative stress and hemolysis

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11
Q

What type of polymorphism is ITPase?

A

Pharmacodynamic genetic polymorphism

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12
Q

What does SLC28A2 do to RBV?

A

CNT2 encoded for better uptake so better bioavailability
More anemia

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13
Q

What type of polymorphism is SCL28A2?

A

Pharmacokinetic

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14
Q

Treatment plan for Genotype 3 positive NS5A and Y93H?

A

Check for ITPA and SCL28A2

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15
Q

What does OATP1B1 CC do?

A

Decreased activity and increase Statin conversion which leaves more in the blood and makes a higher risk for SAMS

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16
Q

What happens in the Velpatasvir and OATP1B1 CC combo?

A

Very high risk for myopathy, SAMS
Drug - Epclusa

17
Q

What did the PNPLA GWAS study show?

A

Shows more aggressive of NAFLD and MASH
Found Asian and Hispanic carry the M which makes it 2-3 of NALFD and HCC

18
Q

What does PNPLA do and what is the polymorphism

A

Increase intracellular TG
Gene from C>G

19
Q

PNPLA3 study did what and what did it show?

A

Gave lifestyle modification to one group and the M mutation for NAFLD respond better to the environmental life styles changes than the no mutation group
Showed that environment and gene play a big role in therapy

20
Q

What is HLA-DRB115 __-DQB106__?

A

Affect DILI and cause liver toxicity
01 02 common for amoxicillin (more common for euro)
02 01 also cause amoxicillin (just 1502 ) more common Indians

Pgx (5 decks)

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