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HepC
UMSOPPY3 HepC Notes
28
Pharmacology
Graduate
04/10/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Which form of hepatitis is the leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma?
Definition
HepB
Term
What is the most common blood-born pathogen?
Definition
HepC
Term
What are the recommendation for HepC Virus screening?
Definition

current of past IV drug use

coinfection with HIV

blood transfusion before 1992

clotting factors before 1987

ever on chronic hemodialysis

unexplained elevated ALT levels or evidence of liver disease

health care and public safety workers after an occupational exposure

children born to HCV-positive moms

immigrants from countries with high prevalence

Term

acute hep c infection becomes chronic in what % of pts?

 

what determines if it is chronic?

Definition

up to 85%

 

persistently detectable HCV RNA for 6 months or more 

Term
What are contraindication to treatment of HCV?
Definition
autoimmune hepatitis, decompensated liver disease, women who are prego or whose female partner is prego, hemoglobinopathies, creatinine clearance <50mL/min, hemodialysis, ischemic CV or cerebrovascualr disease
Term
What is the recommended treatment for genotype 1?
Definition

peginterferon alpha2a 180mcg/week OR 

peginterferon alpha1.5mcg/week

 

PLUS Ribavirin dose for 48 weeks

Term
What is the treatment for genotypes 1 and 2?
Definition

peginterferon alpha2a 180mcg/week OR 

peginterferon alpha1.5mcg/week

 

PLUS Ribavirin dose for 24 weeks

Term
How is ribavirin dosed?
Definition

weight based:

<75kg 1,000mg

> 75kg 1,200mg

800mg (?)

Term

When should you check the viral load for early virologic response in genotype 1 treatment?

 

when d you check with genotypes 2 and 3?

Definition

at week 12

 

at week 4

Term

What is the brand name for pegylated interferon alpha 2a?

 

alpha 2b?

Definition

Pegasys

 

PEG-Intron

Term
Which peglyated interferon has weight-dependent dosing?
Definition
PEG-Intron: 15mcg/kg/wk
Term
How are the pegylated interferon drugs administered?
Definition
subcutaneously once a week
Term
Which peglyated interferon is also indicated for treatment of hepatitis B?
Definition
Pegasys (2a)
Term
What are common side effects of peginterferon?
Definition
fatigue, fever, HA, n, anorexia, rigors, myalgia, arthralgia, musculoskeletal p, insomnia, depression, anxiety, alopecia, inj site reaction
Term
what are the common side effects of ribavirin?
Definition
fatigue, flu-like symptoms, neutropenia, thrombocytopenia, anemia
Term
What are ribavirin's brands?
Definition

Copegus, Rebetol, RibaPak, Ribasphere, Virazole

Term
What is ribavirin's MOA?
Definition

inhibits replication of RNA and DNA viruses

inhibits influenza virus RNA polymerase activity 

inhibits the initation and elongation of RNA fragments resulting in inhibition of viral protein synthesis

Term
What are some pt counseling tips for ribavirin?
Definition

take capsules with food

if you are prego...step away

adequate hydration

increased susceptibility to inf

may cause dental or periodontal disorders

do not donate blood for 6mo following therapy (or ever with SCD)

if the man is taking the medication, it can still have teratogenic effects

 

Term
What is Pegasys' MOA?
Definition

alpha interferons are a family of proteins produced by nucleated cells that have antiviral, antiproliferative, and immune-regulating activity. 

 

there are 16 known subtypes of alpha interferons

 

they interact with cells throguh high affinity cell surface receptors 

 

following activation, multiple effects can be detected including induction of gene transcription

inh cellular growth, increases phagocytic activity of macrophages, and augments cytotoxicity of lympocytes for target cells

Term
How do you measure for decompensated liver disease?
Definition
Child-Pugh score > 6
Term
How do you store Pegasys?
Definition
frige...not freezer
Term
What are the two types of HepA vaccines?
Definition

Havirx

Vaqta`

Term
When is IG used?
Definition
when pre- or postexposure prophylaxis against infection is needed, it is most effective during incubation phase of infection at a single dose of 0.01mL/kg IM
Term
What are the stages of HepA?
Definition

Incubation 28d

acute hepatitis 2mo

convalescence

Term
What is the incubation period for HepB?
Definition
4-10weeks
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