Pharm-Viral Hepatitis Flashcards Preview

Gastrointestinal > Pharm-Viral Hepatitis > Flashcards

Flashcards in Pharm-Viral Hepatitis Deck (29):
1

treatment of acute HBV infection

95% resolve, little need for intervention unless fulminant (lamivudine?, nRTI)

2

goal with tx of chronic HBV

suppress virus (prevent flare, prevent progression to cirrhosis and HCC)

3

treatment of HBeAg+ disease is based on level of ____ and ____

HBV DNA; ALT

4

if HBV DNA is less than 2K, you should?

monitor only

5

if HBV DNA is more than 2K and ALT is normal you should?

monitor ALT or consider biopsy (treat if significant dz)

6

if HBV DNA is more than 2K and ALT is elevated you should?

begin long-term treatment

7

treatment of HBV+ compensated cirrhosis should be initiated when?

HBV DNA is >2000

8

all patients with decompensated cirrhosis should be ______; patients with _____ should be treated with _____ medications

put on a waitlist for transplant; oral tx (NO interferon)

9

there is a ____ threshhold for treatment of patients who are HBeAg+ and a ____ threshhold for tx of patients who are anti-Hbe+

higher; lower

10

first line agents for chronic HBV in US are?

entecavir, tenofovir, PegIFN

11

these HIV medications are also active against HBV

emtricitabine, truvada (emtric/tenofovir)

12

these should not be used to treat HBV infection because they have a black box warning for lactic acidosis

oral nucleosides (adefovir, lamivudine)

13

patients with HBeAg are monitored every 3-4 months to check for?

seroconversion to anti-HBeA

14

the goal of HCV tx is to?

CURE the disease (when tx is deemed necessary)

15

how long and how severe are the side effects for HCV tx?

6-12 months of therapy with lots of side effects

16

current recommendations for dose and duration of PEG-IFN + ribaviron depend on _____

genotype of HCV (G1/4 have longer, stronger tx)

17

conjunction tx for HCV genotype 1 includes ____, which improves SVR rates and can decrease duration of tx

protease inhibitor (telaprevir, boceprevir)

18

major side effects of interferon

depression, blood dyscrasias, thyroid disorders, fatigue/flue-like sx

19

major side effect of ribavirin

anemia

20

side effects of telaprevir

rash, anorectal sx

21

side effects of boceprevir

anemia, dysgeusia

22

neutropenia is worse with (interferon/peg-interferon)

peg-interferon (for severe forms)

23

relationship between interferon and thrombocytopenia

minimal, not much risk of TCP

24

what are three major causes of depression in HCV

interferon-induced, baseline mental illness, and substance abuse (occurs in 30-60% of pts)

25

thyroid dysfunction occurs in ___% of pts receiving INF, and up to ___% of those become thyroid antibody positive (IIT)

15%, 40% (IRREVERSIBLE)

26

most frequently reported extrahepatic sx in pts with HCV

fatigue (could be related to depression and therapy)

27

flu-like sx from interferon tx are worse (early/late) in therapy (what do you tx it with?)

early (tx with acetaminophen)

28

genotic polymorphisms in the IL28B gene confer SVR advantage to what races?

caucasian, asian

29

name 3 classes of new HCV drugs

2nd gen protease inhibitors, nucleoside pol inhibitors, non-nucleoside pol inhibitors