Anti-Virals Flashcards
(94 cards)
1
Q
What are the key characteristics of antiviral drugs?
A
- able to enter the cells infected with a virus
- interfere with viral nucleic acid synthesis, regulation, or both
- some drugs interfere with the ability of a virus to bind to cells
- some drugs stimulate the body’s immune system
2
Q
What are some common patient teachings for most antivirals?
A
- taking a missed dose as soon as the patient remembers unless time for the next dose (DO NOT DOUBLE DOSE)
- patient should not share medication
- the patient should notify the HCP of all medications (prescription or not) being taken
3
Q
What are two types of Herpes Simplex Virus?
A
HSV1- perioral blisters
HSV2- genital blisters
4
Q
How is Herpes Simplex Virus contagious?
A
highly transmissible through close physical contact
5
Q
What are the symptoms of Herpes Simplex Virus?
A
Periods of latency and painful outbreaks
6
Q
How can you treat Herpes Simplex Virus?
A
- No cure, but meds can speed up the process of remission (especially if started early)
- Ongoing low dose for prophylaxis of outbreaks
7
Q
What is Varicella Zoster?
A
- Herpes virus that causes chickenpox; acute infectious disease
- Common childhood illness
– illness may be more severe for adults - highly contagious viral infection
8
Q
What are the symptoms of Varicella Zoster?
A
Causes an itchy, blister-like rash
9
Q
How can you prevent Varicella Zoster?
A
By a vaccine
10
Q
Do you need a varicella zoster vaccine after having chicken pox?
A
No, because after a person has had chickenpox, the varicella-zoster virus can remain inactive in the body for many years
11
Q
What is Herpes Zoster caused by?
A
the reactivation of varicella
12
Q
What are the symptoms of Herpes Zoster?
A
- Skin lesions follow nerve tracts
- Painful lesions (often requiring narcotics)
- Postherpetic neuralgias (long-term nerve pain)
13
Q
How to treat Herpes Zoster?
A
Must give medication w/in 72 hours of symptom onset
14
Q
How to treat HSV1, HSV2, VZV, & Herpes Zoster?
A
acyclovir
15
Q
What is acyclovir?
A
- Antiviral; synthetic nucleoside analogue
- Used to suppress HSV1, HSV2, VZV, Herpes Zoster
- Drug of choice for both initial and recurrent episodes of viral infections of herpes simplex virus
16
Q
How is acyclovir administered?
A
- PO- Recurrent genital herpes infection; localized cutaneous herpes zoster infections (shingles) and varicella (chickenpox)
- IV- Severe episodes of genital herpes in non-immunocompromised clients, mucosal or cutaneous herpes simplex in immunocompromised clients, herpes simplex encephalitis, and neonatal herpes simplex infection
17
Q
What is a contraindication of acyclovir?
A
hypersensitivity to acyclovir or valacyclovir
18
Q
What are some adverse effects of acyclovir?
A
- GI: N/V/D
- Local: burning sensation/pain when applied topically
19
Q
Which drug does acyclovir have drug interactions with?
A
zidovudine: increased risk for neurotoxicity
20
Q
What to educate the patient about acyclovir?
A
- medication is not a cure, virus will lie dormant in the ganglia
- will not prevent spread to others (use condoms)
- women with genital herpes should get yearly pap smears b/c of the likelihood of developing cervical cancer
21
Q
What is hepatitis B?
A
a liver infection caused by the hepatitis B virus
22
Q
How is Hep B contagious?
A
when blood, semen, or other body fluids from a person infected w/ the virus enters the body of someone who is not infected
- sexual contact
- sharing needles
- during pregnancy or delivery
23
Q
How to prevent Hep B?
A
vaccine
24
Q
How to treat Hep B?
A
tenofovir alafenamide
25
What is tenofovir alafenamide?
- Nucleoside reverse transcriptase inhibitor (NRTI)
- Indicated for chronic Hep B
26
What is a contraindication of tenofovir alafenamide?
- end-stage renal disease (ESRD)
- liver impairment
- use cautiously in pregnancy, only if the benefit outweighs the risk
27
What are some adverse effects of tenofovir alafenamide?
- Fluid & Electrolyte: lactic acidosis
- GI: hepatomegaly w/ steatosis, abdominal pain, increased liver enzymes
- GU: renal failure
28
Which drugs do tenofovir alafenamide have drug interactions with?
acyclovir and valacyclovir
- may increase tenofovir levels and toxicity
- avoid if possible
29
What to educate the patient about tenofovir alafenamide?
- the client should be tested for HIV infection before starting medication
- avoid missing doses
- advise patients to take non-hormonal methods of birth control
- patients should notify HCP immediately of symptoms of lactic acidosis and if pregnancy or breastfeeding is planned
30
What is Hepatitis C?
A liver infection caused by the hepatitis C virus
- can be short term but half of people develop chronic hep C causing cirrhosis and liver cancer
31
How is Hep C contagious?
Spread through contact with blood from an infected person
- Sharing needles or other equipment used to inject drugs
- Patients receiving hemodialysis are at high risk
32
How to treat Hep C?
**sofosbuvir**
33
What is sofosbuvir?
- First RNA polymerase inhibitor “breakthrough therapy”; 1st drug treatment
- Used in combo w/ other medications to treat Chronic Hep C
-- ribavirin (makes it Category X)
34
What is a contraindicaton of sofosbuvir?
- severe renal impairment or ESRD
- concurrent use of St. John’s Wort and ribavirin
35
What are some adverse effects of sofosbuvir?
- Derm: pruritis (itchy)
- Neuro: fatigue, headache, insomnia, irritability
36
What to educate patient for sofosbuvir?
- a negative pregnancy test must be obtained before beginning therapy
- administer once daily w/o regard to food
37
How should patients who can't swallow pills take sofosbuvir?
- sprinkle pellets on one or more spoonfuls of non-acidic soft foods (pudding, mashed potatoes) at or below room temperature
- take pellets within 30 minutes and do not chew pellets
38
How can HIV be contagious?
- sexual activity
- intravenous drug use
- perinatally from mother to child
39
What is HAART (highly active antiretroviral therapy)?
combo of 2 nucleoside analogues and a protease inhibitor
- reduce viral load by depressing HIV replication
40
How to treat HIV?
**zidovudine**
**abacavir**
**raltegravir**
41
What to educate patients about all HIV treatments and medications?
- does not cure HIV but does reduce transmission
- use nonhormonal methods of birth control
- patient must notify HCP if they plan or suspect pregnancy
42
What are the contraindications for HIV treatments and medications?
- not recommended for breastfeeding mothers with HIV
- hypersensitivity
43
What is zidovudine?
- First nucleoside reverse transcriptase inhibitor (NRTI)
- Safely used in pregnancy and in newborns
- Causes bone marrow suppression
- Oral (tablets, solution/syrup) or injectable (IV) forms
44
What is a contraindication of zidovudine?
- severe hepatic or renal disease
- bone marrow suppression
45
What are some adverse effects of zidovudine?
- Fluids/electrolytes: lactic acidosis
- GI: hepatomegaly with steatosis, abdominal pain, N/D
- Hem: anemia, granulocytopenia
- Neuro: headache, weakness
46
Which drugs do zidovudine have drug interactions with?
- acyclovir: Increased neurotoxicity
- other drugs that cause bone marrow suppression: Increased bone marrow suppression
47
What are some nursing considerations for zidovudine?
- monitor viral load and CD4 count before and during treatment
- monitor complete blood count
- when giving to neonates use a syringe with 0.1 mL graduations
48
What is abacavir?
- Nucleoside reverse transcriptase inhibitor (NRTI)
- Slows the progression of HIV infection
- Increases CD4 cell count and decreases viral load
- Oral only (solution and tablets)
49
What is a contraindication of abacavir?
- moderate to severe impairment
- use cautiously in patients with coronary heart disease
- concurrent use of antiviral combination products containing abacavir (toxicity risk)
50
What are some adverse effects of abacavir?
- CV: myocardial infarction
- Fluid & Electrolyte: lactic acidosis
- GI: hepatomegaly w/ steatosis, abdominal pain, N/V/D
51
Which drugs do abacavir have drug interactions with?
alcohol: Increased blood levels
52
What are some nursing considerations for abacavir?
- monitoring viral load and CD4 cell count regularly
- must always be used in combination with other antiretroviral drugs
53
What are some medications for HIV?
**emtricitabine**
**tenofovir disproxil**
54
What is emtricitabine?
- Nucleoside reverse transcriptase inhibitor (NRTI)
- Oral use only; used in combination with other agents
55
What is a contraindication of emtricitabine?
- Use cautiously in Hep B co-infection (can cause severe exacerbation of HBV)
56
What are some adverse effects of emtricitabine?
- Derm: rash
- Fluid & Electrolyte: lactic acidosis
- GI: hepatomegaly w/ steatosis, abdominal pain, N/D
- Neuro: dizziness, headache, insomnia, weakness
- Resp: cough
57
What are nursing considerations for emtricitabine?
- monitor for HBV, viral load, and CD4
- used in combination with other antiretroviral
58
What is tenofovir disproxil?
- Nucleoside reverse transcriptase inhibitor (NRTI)
- Used to treat HIV (and chronic Hep B)
- Oral use only
- Often used in combination with other agents
59
What is a contraindication of tenofovir disproxil?
- concurrent use of antiretroviral combination products containing tenofovir
- concurrent use of NSAIDs (increased risk of ARF)
60
What are some adverse effects of tenofovir disproxil?
Fluid & Electrolyte: lactic acidosis
GI: hepatomegaly w/ steatosis, abdominal pain, N/D
GU: ARF
MSK: bone pain
Neuro: depression, headache
61
What drugs do tenofovir disproxil have drug interactions with?
- acyclovir- blood levels may be increased
- NSAIDs- increased risk for ARF
62
What to educate patients on for tenofovir disproxil?
- may cause hyperglycemia (patient should check for increased thirst, unexplained weight loss, increased urination)
- patient should monitor for lactic acidosis (weakness, fatigue, unusual muscle cramps)
63
What is raltegravir?
- Integrase Inhibitor
- PO
64
What is a contraindication of raltegravir?
- Use cautiously when patient's taking other medications that can cause rhabdomyolysis and/or myopathy
65
What are some adverse effects of raltegravir?
GI: diarrhea
Hem: anemia, neutropenia
MSK: rhabdomyolysis, myopathy
Neuro: suicidal thoughts, headache
66
What drugs do raltegravir have drug interactions with?
Administration w/ antacids containing magnesium or aluminum decreases absorption of raltegravir
67
What to educate patients about on raltegravir?
- **advise patient to report any signs of rhabdomyolysis (unexplained muscle pain, tenderness, weakness) or any signs of depression or suicidal thoughts**
- condoms should be used
68
What does Pre-exposure prophylaxis do (PrEP)?
highly effective at preventing HIV
69
What are two PrEP medications?
- Truvada
- Descovy
70
What is Post-exposure prophylaxis (PEP)?
- Emergency tx taken w/in 72 hours of exposure to HIV
- Must be HIV negative (will test before & after tx)
71
When should you take PEP?
PEP is taken for 28 days after potential exposure
72
What are two PEP medications?
Raltegravir and Truvada
73
What treats influenza?
**oseltamivir**
74
What is oseltamivir?
- Neuraminidase inhibitor
- Active against influenza types A and B
- Reduce the duration of illness
75
What is a contraindication of oseltamivir?
- Hypersensitivity
- ESRD (End-Stage Renal Disease)
- not receiving dialysis
76
What are some adverse effects of oseltamivir?
GI: N/V
77
What drugs do oseltamivir have drug interactions with?
- may decrease the therapeutic effect of influenza vaccine
- avoid use 2 days prior to and 2 weeks after vaccine administration
78
What are nursing considerations for oseltamivir?
- may be administered w/ food or milk to minimize GI irritation
- use correct oral dosing for measuring oral solution, if not available, capsules can be opened and mixed with food
- take oseltamivir as soon as influenza symptoms appear
- not a substitute for the influenza vaccine
79
What can treat COVID-19?
**remdesivir**
80
What is a contraindication of remdesivir?
- hypersensitivity and severe renal impairment (eGFR < 30 mL/min)
- safety is not established in pregnant clients or children < 12 or weighing < 40 kg
81
What are some adverse effects of remdesvir?
- GI: increased liver enzymes, nausea
- Misc: Infusion reactions and anaphylaxis
82
What drugs do remdesvir have drug interactions with?
Hydroxychloroquine/chloroquine: may decrease antiviral activity
83
What are nursing considerations for remdesivir?
- IV administration only
- reconstitute powder
- solution should be clear and colorless; discard meds that are cloudy, discolored, or contain particulate matter
84
What treats RSV?
**ribavirin**
85
What is ribavirin?
- antiviral; synthetic nucleoside analogues
- nasal inhalation
- **caution with pregnant and child-bearing aged health care workers**
86
What is a contraindication of ribavirin?
- hypersensitivity
- patients receiving mechanically assisted ventilation
- significant CV disease
- hemoglobinopathies
- concurrent use of zidovudine
- pregnant women (may cause fetal harm)
87
What are some adverse effects of ribavirin?
- EENT: blurred vision, photosensitivity
- Hem: hemolytic anemia
88
What drugs do ribavirin have drug interactions with?
Zidovudine: decreased antiretroviral action of zidovudine
89
What are nursing considerations and patient education for ribavirin?
- ECG/EKG in patients w/ pre-existing cardiac disease
- treatment should begin w/in the first 3 days of RSV infection
- inform that ribavirin may cause blurred vision and photosensitivity
90
What treats CMV?
**ganciclovir**
91
What is ganciclovir?
- antiviral; synthetic nucleotide analogue
- oral, parenteral forms
- dose limiting toxicity = bone marrow suppression
92
What is a contraindication of ganciclovir?
- hypersensitivity to ganciclovir or acyclovir
- bone marrow suppression
- immunosuppression
93
What are some adverse effects of ganciclovir?
Hem: neutropenia, thrombocytopenia
94
What are nursing considerations for ganciclovir?
- assess for cues of infection and bleeding
- monitor neutrophils and platelet counts
- ganciclovir is not a cure for CMV
- frequent follow-up exams to monitor blood counts
