o Unable to work depend on symptom relief o Takes longer for the pt to recover

O unable to work depend on symptom relief o takes

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o Unable to work- depend on symptom relief o Takes longer for the pt to recover. Has a longer incubation and recovery time than A or C o Keep follow up appointments o Avoid all modes of transmission – including sexual contact Medications o Alpha interferon – single modality of treatment – offers most promise Given for 4-6 months Result – remission of disease in approximately 1/3 of patients Administered by injection Subcutaneous only Side effects – fever, chills, anorexia, nausea, myalgias, and fatigue flu like aches and pains b/c of inflammatory response from medication action itself Delayed side effects – more serious side effects If these side effects develop generally they will have to stop therapy bone marrow suppression, thyroid dysfunction, alopecia, and bacterial infections – may warrant dose reduction o Bone marrow suppression is the biggest worry – not a common side effect but this will be seen the most of the long term PROBLEM WITH TX: Pt may be non compliant with this medication b/c it makes them sick ( flu-like symptoms) o Lamivudin (epivir) and adefovir (Hepsera) – antiviral - improved seroconversion rates, loss of detectable virus, improved liver function, and reduced progression to cirrhosis with lamivudin Helps decrease inflammation of the liver Lamivudin can be used in patient with decompensated cirrhosis who are waiting for a liver transplant Hepatitis C Most common type of Hep in the US Chronic carrier state frequently occurs – increased risk for chronic liver disease (cirrhosis, liver cancer) 1/3 cases of liver cancer and most common reason for liver transplant 1/8 of population of U.S. infected Transmission o Blood, sexual contact, needle sticks and shared needles o Most common blood borne infection Chronic carrier state frequently occurs Risk factors o Health care workers o Exposure to blood products, needle sticks, IV drug use o Multiple sex partners Incubation period 5
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Hepatitis 6 o 15-160 days (varies) Manifestations o Mild, similar to Hep B Prevention o Screening of blood o Prevention of needle sticks o Reduce spread of infection Avoid alcohol & medications that affect the liver – cause further destruction of liver Antiviral agents – Interferon, Ribavirin o Effective in producing improvement and in treating relapse o Complete remission may be seen using combination therapy o Hemolytic anemia – most common side effect Hepatitis D Only persons with Hep B are at risk Needs Hep B surface antigen to replicate Transmission o Blood and sexual contact Symptoms and treatment – similar to Hep B Hepatitis E Areas with poor sanitation Transmission o Fecal-oral route Incubation o 15-65 days Resembles Hep A with abrupt onset Will almost always be jaundice 6
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  • Spring '14
  • ClaudiaG.Hebert
  • chronic hepatitis

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