HEP C

Question 1

**

diagnostic test for HEP C

Answer 1

1st test for Hep C antibody

2nd test: test HCV RNA test to confirm HCV

person whom HCV test recommended:
- H/o drug injection h/o receiving blood prod prior to 1987

Question 2

Direct acting antiviral for HCV

Answer 2

1. NS3/4A Protease Inhibitor
   - Paritaprevir, Grazoprevir
2. NS5B nucleoside polymerase inhib
   - Sofosbuvir
3. NS5B (non nuclesoide polymerase inhib)
   - Dasabuvir
4. NS5A Inhibitor
   - Ledipasvir
   - Ombitasvir
   - Elbasvir

5b: buvir
5a: asvir
PI: previr

Question 3

HCV treatment

Answer 3

**Sofosbuvir (sovladi) QD for 12 weeks

Ledipasvir + sofosbuvir: Harvoni- 12 weeks

Velpatasvir+ sofosbuvir+ Voxilaprevir: VoSeVi- 12 weeks

Paritepravir+ Ombitasvir+ ritonavir+ dasabuvir: **Vikiera Pak BID - 12 weeks **

Elbasvi +grazoprevir **(zepatier) **12 weeks

Glecaprevir+ pibrenstavir: Mavyret QD w/food for 8 wks **

Question 4

drug interaction with HEP C

Answer 4

avoid sofosubir + amiodorane
- enhance severe bradycaridiac effect of amiodorane

Anticonvulsant: Avoid CYP3A4 Inducer- dec hepc level
- recommend valproic acid or lamictal

Supplement s with St. john wort (indcuer) avoid

All but sofosubir inc statin

Valproid : a for INC ammnia, L : liver, P: pancreatitis
- used for bipolar, migrain, seizure
-

Question 5

ribavarin

Answer 5

Rabetrol - PO
Indication:
- oral formulation for HCV
- Inhaled ribavarin (virazole) for treatment RSV inf
- RSV prevention: Palitumab (synergist)

CAution
- preg cat x
- hemolytic anemia
- two reliave contraceptive

Question 6

sofosbuvir

Answer 6

sovaldi

DUR: fatal bradycardia when taken with amiodorane (cordarone)

COMBO
- lepidasvir+ sofosbuvir: harvoni
- Velpatasvir+ sofosbuvir: epclupsa
- velpatasvir+ sofosbuvir+ Voxilaprevir: VoSeVi

Question 7

harvoni

Answer 7

lepidisavir+ ledipasvir
- 1tab po qd
- No antacids

Dur: P-gp inducer
- ( rifampin, carbamazapine, st. john wort) - dec ser conc of harvoni
- avoid rosuvastatin
- combining amiodorane w/ sofosbuvir may lead to bradycardia and cardiac arrest.

hary and lady in sofa

Question 8

Epclusa

Answer 8

• velpatasvir+ sofosbuvir
• 1 tab qd for 12 weeks
• No antacids

Black box: Hep B activation

Question 9

Vosevi

Answer 9

• Velpatasvir + sofosbuvir+ voxilaprevir
• No antacids
• QD with with food for 12 wks

Question 10

REview

Answer 10

1. Ribavarin ( copegus) BiD with food and 2 form of BC
2. sofosbuvir (sovaldi)- 1pill qd
   - combo= harvoni, eclupsa
   - don’t give with antacid
   - risk with amiodrande- bradycardia
3. Harvoni ( ledipasvir+ sofosbuvir)
4. Eclupsa ( Velpatasvir+ sofosbuvir)
5. VoSeVi: ( Velpatasvir+ sofosbuvir+ voxilaprevir) with food
6. VIkiera pak: paritaprevir+ ombitasvir+ ritonavir+ dasabuvir
   - 3tab am and 1 tab pm
   - not with COC
7. zepatier (Elbasvir+ garazoprevir)
8. Mavyret( glecprevir+ pibrentasvir)
   - 3tab qd wit food
   - not with coc

Question 11

vikiera pak

Answer 11

two pink tab+ 1tan tab in am and 1 tan tab in evening
- 3 tab in am and 1 tab in pm
- take with food

Question 12

zepatier

Answer 12

elbasvir + grazoprevir

not recom with cyp3a4 inhint and inducer

Question 13

Mavyret

Answer 13

Glecaprevir+ Pibrenstavir

take three tablet qd with food

man gets piss

Question 14

recommendation for hep C pt

Answer 14

Hep B screening before starting hep c med

Question 15

RSV -respiratory syncytial virus

Answer 15

common cause of bronchitis and pneumonia in <1 y/o

• prevention of rsv n high risk pt (premature, chronic lung, heart dx_
• give Palivizumab (Synagis)
• IM Qmonth
• Treatment: Ribavarin

Question 15

vaccine for hep c

Answer 15

• Hep A
• Hep B
• Inluenza
• Pneumonia
• Dtap

avoid alcohol and kava kava (otc)