alenka
Forum Elite
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i'd say both.
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| ARJ
Forum Guru
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Lamivudine or interferon
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| ARJ
Forum Guru
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One more drug
nucleotide analog, adefovir dipivoxil, has activity against wild-type and lamivudine-resistant HBV
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| alenka
Forum Elite
Topics: 22
Posts: 330
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you are gonna kill this test,ARJ!
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| ARJ
Forum Guru
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adefovir dipivoxil is mentioned in CMDT.
I refered CMDT only because drkpp had asked this question otherwise it would be impossible for me to know this new drug
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| frontal
Forum Guru
Topics: 53
Posts: 421
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I haven't come across any catagorical statement about whether the two drugs can or cannot be used together. Note that specific therapy is given only in cases of chronic hepatitis B. The management of acute hepatitis B is supportive. (In rare instances of severe acute hepatitis B, treatment with lamivudine, has been attempted successfully-Harrison's).
So for chronic hepatitis B, all the three drugs you guys have mentioned (injectable interferon alpha and the oral agents lamivudine and adefovir dipivoxil)are approved. Interferon is most effective in patients with high serum transaminase concentrations and chronic active hepatitis on biopsy, who have not acquired infection at birth and in those who are HIV negative. Do not give interferon to those with decompensated liver disease. The course lasts 16 weeks.
(Retreatment of IFN nonresponders with another course of interferon may enhance response rates somewhat, though currently, most would opt to address IFN nonresponders by offering them one of the oral therapies.-Harrison's).
Remember: interferon is not given in the immunocompramised and in those with decompensated liver disease.
Phew!
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| ARJ
Forum Guru
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Posts: 792
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| drkpp
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kap says only one of them but usw says both together have prove to be more effective????
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| alenka
Forum Elite
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Posts: 330
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remember what Fischer said-"in real life anything can be anythig-but on the boards they just want to know if you can apply certain concepts in practice.that's why they are not gonna give you a situation where anything can be anything"
so i'd go for sources which are made SPECIFICALLY for passing boards-kaplan,UW,blueprints,first aid etc.I know harrison's is very good,but it is made for PRACTICING physicians,not for the boards.
but that's my opinion only .
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| nisha
lil monkey
Topics: 146
Posts: 919
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go wit UW, the info prob more recent then kaplan (unless u have 2005 edition)
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| ARJ
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"Combined used of interferon and Lamivudine offers no advantage over the use of either drug alone" as mentioned on page 640 CMDT 2005
I think we should contact USMLE world for that confusion
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| frontal
Forum Guru
Topics: 53
Posts: 421
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I consider Harrison's a reliable book and worthy of reference in cases of doubt. There's no harm done if a book unsuited for the exam is consulted for a question that apparently won't be put up in the exam, especially when the book happens to be a trusted one. But on the issue of reading books meant specifically for the boards, I couldn't agree more with you, because the most important thing for us is to clear the exam. Anyhow, ARJ seems to have picked up a clear statement from one of the recommended books, so I guess we can go with that.
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