Therapeutics: Viral Hepatitis 1

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  1. An antibody to what antigen will be produced in response to Hep B vaccination?
  2. If ________ antigen is present greater than or equal to 6 months after infection is detected, a chronic infection is indicated.
  3. I f a Hep B mutant strain does not produce what antigen, would you expect treatment to be refractory?
  4. What are the symptoms of Chronic Hep B that has progressed to fulminant hepatic failure?
    Jaundice, diarrhea, cola colored urine, pale stools, ascites, hepatic encephalopathy
  5. Aute symptoms of HBV require what treatment?
    Non, self-resolving
  6. What are the phases of HBV?
    • Incubation of weeks to months
    • Prodromal symptomic phase
  7. What consitiutes a diagnosis of chronic infection by HBV?
    • HBsAg for > 6 months
    • HBV DNA > 105 copies/mL and elevated AST/ALT
  8. What indicated protective immunity to Hep B conferred by a vaccine?
    • (+) Anti-HBs
    • AND
    • (-) HBsAg
  9. What options of prevention are available for Hep B?
    Vaccination and Passive immunity (HBV immunoglobulin)
  10. What are the indications for Hep B treatment?
    • + HBsAg for > 6 months with elevated AST/ALT enzymes
    • OR
    • + HBeAg with measurable HBV DNA in serum
  11. What are the goals of therapy for HBV treatment?
    • Disspaearance of HBV DNA, HBeAg and normal AST/ALT
    • Prevent progression to cirrhosis or carcinoma
  12. What are the drugs approved for first –line treatment of chronic Hep B?
    • Interferon α2b
    • Pegylated interferon α2a
    • Lamivudine
    • Adefovir
    • Entecavir
    • Tenofovir
    • Telbivudine
  13. What are the oral drugs available for chronic Hep B?
    • Nucleoside analogs:
    • Lamivudine
    • Entecavir
    • Telbivudine
    • Nucleotide analogs:
    • Adefovir
    • Tenofovir
  14. By what route are Interferon α2b and Pegylated interferon α2a administered?
  15. What I steh MOA of interferson treatments for Hep B (Interferon alpha2b and Pegylated interferon alpha2a)?
    Inhibits viral replication and stimulates the immune system to clear infected cells
  16. When are Interferon alpha2b and Pegylated interferon alpha2a CI?
    Don’t use in decompensated cirrhosis present
  17. How long does an Interferon alpha2b and Pegylated interferon alpha2a treatment take for HBV?
    Duration of therapy 12-24 months
  18. What Preparations of interferon are available in U.S. with indications for HBV?
    • Alpha-2b (Intron A)
    • PEG-interferon Alpha-2a (Pegasys)
  19. What is the efficacy of Interferon alpha2b and Pegylated interferon alpha2a in HBV treatment?
    • 30-40% have undetectable levels of HBV DNA or HBeAg
    • Genotypes A&B may respond better than C&D
  20. What are the side effects of Interferon α2b and Pegylated interferon α2a?
    Flu like illness (can pretreat), Depression/anxiety, neutropenia, thrombocytopenia, anemia
  21. What drugs are preferred for treatment of HBV if ALT >2xULN?
    • Entecavir
    • Tenofovir
    • Interferon-alpha or Peginterferon-alpha
  22. What drugs are preferred for treatment of HBV if HBV viral load is > 2000 U/mL?
    • Entecavir
    • Tenofovir
    • Adefovir
  23. What pretreatments can help alleviate side effects in interferon treatment of HBV?
    • Benadryl for injection site reactions
    • Tylenol for myalgias and fever associated with flu like SEs
  24. Which interferon is superior and why?
    Pegylated interferon alpha2a because it only as to be give weekly (long t1/2)
  25. What is the drug regimen if detectable HBV viral load is accompanied w/Decompensated Cirrhosis in HBV?
    • Lamivudine or Telbivudine
    • PLUS
    • Adefovir, Tenofovir, or Entecavir
Card Set:
Therapeutics: Viral Hepatitis 1
2014-04-27 03:21:02
Therapeutics Viral Hepatitis
Therapeutics: Viral Hepatitis 1
Therapeutics: Viral Hepatitis 1
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