TABLE OF CONTENTS Clinical Course and Clinical Manifestation . .6 Book 7 Diagnosis . .7 Managing of Hepatitis B . .7 Preface . .i Prevention . .7 Hepatitis B Vaccine . .7 Editorial Board . ii Postexposure . .8 Chronic Hepatitis B . .9 Book 7 Panel . .iii Interferon . .9 Lamivudine . .9 Disclosure of Potential Conflicts of Interest . .ix Adefovir Dipivoxil . .10 Recommendations for Treating Continuing Education and Program Evaluation HBeAg-positive CHB . .11 Instructions . .x Recommendations for Treating HBeAg-negative CHB . .11 Roles of ACCP and BPS . .xiii Investigational Drugs for CHB . .12 Entecavir . .12 Clevudine . .12 Gastroenterology I Emtricitabine . .13 Telbivudine . .13 VIRAL HEPATITIS Pegylated Interferons . .13 Learning Objectives . .1 Hepatitis C . .13 Introduction . .1 Virology and Pathogenesis . .14 History . .1 Epidemiology and Risk Factors . .14 Definitions of Acute and Chronic Hepatitis . .1 Natural History . .14 Hepatitis A . .1 Clinical Course and Clinical Manifestation . .14 Virology and Pathogenesis . .1 Diagnosis and Serological Testing . .15 Epidemiology and Risk Factors . .2 Managing Hepatitis C . .15 Clinical Course and Clinical Manifestations . .2 Prevention . .15 Diagnosis and Serological Testing . .3 Treating Hepatitis C . .16 Managing of Hepatitis A . .3 HIV/HCV Coinfection . .18 Preexposure Prophylaxis . .4 Treating Recurrent HCV after Liver Postexposure Prophylaxis . .4 Transplantation . .18 Hepatitis A Vaccine . .4 Treating Nonresponders . .19 Treatment . .5 Treatment Duration for Hepatitis C . .20 Hepatitis B . .5 Side Effects Associated with HCV Therapy Virology and Serology . .5 and Management . .20 Epidemiology . .6 Flu-like Symptoms . .20 Risk Factors . .6 Psychological Symptoms . .20 Natural History . .6 Hematological Adverse Effects . .20 Pharmacotherapy Self-Assessment Program, 5th Edition xv Table of Contents Anemia . .20 Measurements of Intestinal Transit and Motility . .38 Neutropenia . .21 Gastric Emptying . .38 Thrombocytopenia . .21 Scintigraphy . .38 Other Adverse Effects . .22 Acetaminophen Absorption Model . .39 Contraindications and Warnings . .22 Carbon Radioisotopes . .39 Role of the Pharmacist in Treating Chronic Manometry . .39 Hepatitis C . .22 Small Intestinal Transit . .39 Investigational Drugs for Chronic Hepatitis C . .22 Overview . .39 Viramidine . .22 Intolerance to Enteral Feeding . .39 Merimepodib . .22 Causes . .39 Thymosin Alpha 1 . .23 Prokinetic Drugs . .40 Therapeutic Vaccine . .23 Selection . .40 Hepatitis D . .23 Non-pharmacological Strategies . .40 Virology and Pathogenesis . .23 Feeding Tube Placement . .40 Epidemiology . .23 Ileus . .41 Diagnosis, Clinical Course, and Clinical Causes . .41 Manifestation . .23 Complications . .41 Managing Hepatitis D . .24 Management . .41 Prevention . .24 Acute Intestinal Pseudo-obstruction . .41 Treating Hepatitis D . .24 Management . .42 Hepatitis E . .24 Mechanical Bowel Obstruction . .42 Virology and Pathogenesis . .24 Causes . .42 Epidemiology . .24 Complications . .42 Diagnosis, Clinical Course, and Clinical Management . .42 Manifestation . .25 Constipation . .42 Managing Hepatitis E . .25 Causes . .42 Conclusion . .25 Prevention . .43 Annotated Bibliography . .25 Management . .43 Self-Assessment Questions . .27 Laxative Agents . .43 Diarrhea . .43 GASTROINTESTINAL COMPLICATIONS Secretory Diarrhea . .43 IN THE INTENSIVE CARE UNIT Clostridium difficile Colitis . .43 Learning Objectives . .33 Causes . .43 Introduction . .33 Laboratory Evaluation . .44 Pathophysiology . .33 Treatment . .44 Gastrointestinal Motility . .33 Antibiotic-associated Causes of Diarrhea.