Antiviral Agents... Flashcards
(123 cards)
1
Q
What is Acquired immunodeficiency
syndrome (AIDS)?
A
Condition is caused by HIV. Number of T-cells decrease to a certain point and the decreased immunity allow for opportunistic infections and cancers.
2
Q
What is AIDS-related complex (ARC)?
A
A group of symptoms that occur in individuals who are HIV positive but don’t meet the criteria for an AIDS diagnosis. The helper T-cell count has not reached the cutoff for it to be considered AIDS.
3
Q
What is CCR5 coreceptor antagonist?
A
A type of drug that blocks the receptor site that HIV binds to in healthy cells. This prevents the spread of the infection.
4
Q
What is Coronavirus?
A
A group of RNA viruses that mostly causes respiratory problems. Corona-19 is type of coronavirus.
5
Q
What is Cytomegalovirus (CMV)?
A
A DNA virus that affects all ages and often remains dormant after initial infection. Mostly infects lungs, eyes and liver.
6
Q
What is Fusion inhibitor?
A
Drug that stops HIV from binding to cell membranes, this decreases the spread of the infection.
7
Q
What is Helper T cell?
A
A Lymphocyte that helps kick off immune response.
8
Q
What is Hepatitis B?
A
A virus that infects the liver and may be fatal. Transferred through blood.
9
Q
What is Hepatitis C?
A
A virus that infects the liver, yet not as severe as Hep. B. Patients may however need a liver transplant over time.
10
Q
What is Herpes?
A
A DNA virus that causes chickenpox or varicella zoster. Causes genital herpes, cold sores and can cause encephalitis (rare but serious condition that causes inflammation of the brain)
11
Q
What is Human immunodeficiency virus (HIV)?
A
The virus that destroys helper T-cells which leads to AIDS & ARC.
12
Q
What is Influenza A?
A
The common cold or flu.
13
Q
What is Integrase strand transfer inhibitor?
A
A drug that blocks integrase, which is a vital part of virus replication.
14
Q
What is Interferon?
A
A hormone that is released by the tissues when there is a viral replication and this stop it further replicating.
15
Q
What is Nonnucleoside reverse transcriptase inhibitors?
A
Drugs that bind to reverse transcriptase which is responsible for breaking down cell DNA. This stops DNA replication.
16
Q
What is Nucleoside reverse transcriptase inhibitors?
A
Drugs that bind to the reverse transcriptase that is responsible for inserting viral DNA into cell DNA, this stops replication.
17
Q
What is Protease inhibitors?
A
Drugs that inhibit the protease enzyme in HIV which prevents immature HIV cells from becoming fully mature infective HIV cells.
18
Q
What is Virus?
A
A tiny bit of DNA or RNA protected by a protein coat. It lives by hijacking other cells to do its bidding. There are several viruses that do respond to antiviral therapy, but not all viruses do.
19
Q
What are Viruses That Respond to Antiviral Therapy?
A
●Influenza A and some respiratory viruses (seasonal flu)
●Herpes viruses (chickenpox, shingles, genital herpes)
●Cytomegalovirus (CMV)
●Human immunodeficiency virus (HIV) that causes acquired- immune deficiency syndrome (AIDS)
●Hepatitis B and C
● Warts and eye infections.
20
Q
What are some Characteristics of Common Viruses?
A
●A virus cannot replicate on its own and rely on other cells to reproduce. They’re strands of DNA/RNA code in a shell.
●It must attach to and enter a host cell.
●It then uses the host cell’s energy to synthesize protein, DNA, and RNA.
●Viruses are difficult to kill because they live inside our cells.
●Any drug that kills a virus may also kill our cells
21
Q
Explain the stages of virus replication
A
1) Virus attaches to the cell wall in the cell of a host.
2) Enters cell and releases RNA/DNA fragments.
3) Using the cell’s own hardware the virus replicates the fragments and protein shells.
4) New virions get released to infect other cells.
22
Q
What are some lifespan considerations that we need to keep in mind with children and antivirals?
A
Children are more sensitive to drugs and more severe reactions expected.
Particularly vulnerable to effects on kidneys, bone marrow and liver.
No proven safety for many; extreme caution should be used
Doses should be calculated by weight
Monitor closely
23
Q
What are some lifespan considerations that we need to keep in mind with adults and antivirals?
A
Antibiotics won’t work for viral infections
Drugs do not cure HIV - it will slow progression of the disease. There is no cure for HIV.
Caution in pregnancy - antivirals have been used to prevent the mother from passing infection on to the fetus.
Advise childbearing women to use barrier-contraceptives
HIV can be transferred through breastmilk so alternative feeding measures should be used.
24
Q
What can possibly happen if patients use antivirals to attempt to treat bacterial infections?
A
Antivirals are ineffective in treating bacterial infections, however more importantly, doing this may create a mutated virus that is drug resistant to both antivirals and antibiotics.
25
What are some lifespan considerations that we need to keep in mind with older adults and antivirals?
○More susceptible to adverse effects; monitor closely
○Hepatic/renal dysfunction may be worsened by these medications
○Dose may need to be lowered
26
Name 3 Common Respiratory Viruses.
●Influenza A
●Influenza B
●Respiratory Syncytial Virus (RSV) - leading cause of respiratory infections in infants and may often result in bronchiolitis or pneumonia.
27
What are the 5 Agents for Influenza A and B & Respiratory Viruses that we need to know?
"-mantadine" "-amivir"
●Amantadine - influenza A, West Nile virus and Parkinson's disease.
●Rimantadine - influenza A (prevent and treat)
●Oseltamivir - influenza A & B (reduces duration & severity, but need to be shortly after symptoms occur)
●Peramivir - acute influenza (IV for patients who cannot take PO meds)
●Zanamivir - Influenza A & B (inhaled)
28
What are the indications for using Agents for Influenza A and Respiratory Viruses?
Treatment of influenza and other respiratory infections.
29
Which patients are most likely to use antiviral medications?
Patients who are already immunocompromised, as an acute viral infection will be harder to fight of and may cause severe complications.
30
What are the MOA's for the Agents for Influenza A and Respiratory Viruses?
Prevents viral replication by inhibiting an enzyme that allow the cell to release viral particles which slows the progression of the infection.
31
What are the contraindications of Agents for Influenza A and Respiratory Viruses
Allergy, renal impairment, pregnancy, or lactating.
32
What are the known adverse reactions of Agents for Influenza A and Respiratory Viruses
Influenza agents have and effect on dopamine levels and may cause mood disturbances and changes in sleep pattern.
Orthostatic hypotension r/t vasodilation by altering smooth muscle tone and body's ability to regulate blood flow.
Dizziness, nausea, and urinary retention.
Peramivir associated with Stevens-Johnson Syndrome due to hypersensitivity or allergy to the drug.
33
What assessments should we be doing prior to giving patients Agents for Influenza A and Respiratory Viruses?
Assess for contraindications or cautions (pre-existing liver or kidney problems, pregnant or lactating or previous reaction to an influenza agent)
Perform a physical assessment : Orientation (pre-existing CNS), consciousness or cognitive function and strength and coordination.
Observe for mood anxiety levels, unusual behavior r/t dopamine levels.
Monitor BP/
Assess for orientation and reflexes; vital signs; urinary output; and skin
Monitor renal and hepatic function tests
34
What nursing diagnoses can be made prior to giving patients Agents for Influenza A and Respiratory Viruses?
○Impaired comfort related to GI, CNS, or GU effects of the drug
○Altered sensory perception (kinesthetic) related to CNS effects of the drug
○Knowledge deficit regarding drug therapy
35
What implementations should we be prepared to make when giving patients Agents for Influenza A and Respiratory Viruses?
○Start the drug regimen as soon after exposure to the virus as possible, usually
within 2 days of the start of symptoms
○Administer influenza A vaccine before the flu season begins, if at all possible
○Administer the full course of the drug
○Provide safety provisions if CNS effects occur
○Instruct the patient about the appropriate dosage-scheduling regimen; safety precautions.
36
What evaluations should we be doing once we've started a patient on Agents for Influenza A and Respiratory Viruses?
Monitor BP for orthostatic hypotension.
Monitor their eyes for possible urinary retention which could be caused by kidney impairments.
37
What could patients do to mitigate some of the adverse reactions r/t Agents for Influenza A and Respiratory Viruses?
Keeping hydrated
Standing up slowly, making sure environment is safe (no tripping hazards)
Take medication with food to avoid nausea.
38
What are the name /suffix(es) of the agents used to treat Herpes and Cytomegalovirus (CMV) ?
(-clovir)
●Acyclovir - genital herpes, cold sores, chicken pox and shingles
●Ganciclovir - cytomegalovirus (CMV)
●Valacyclovir - genital herpes, cold sores and shingles
●Valganciclovir - treat and prevent cytomegalovirus (CMV)
39
Which agents for Herpes and Cytomegalovirus are particularly good for immune compromised patients, such as organ transplant patients and HIV/AIDS patients?
Ganciclovir and Valganciclovir
40
What are the MOA's for the Herpes and Cytomegalovirus agents?
Interrupting the making of viral DNA. The DNA becomes too short (not full code) to be replicated and therefore cannot make more viruses. This hurts the virus without damaging human cells.
41
What are the known contraindications to giving a patient Herpes and Cytomegalovirus agents?
Known allergy.
Highly toxic in pregnancy and lactation and renal disease (benefit must outweigh risk).
Serious hypersensitivity reactions may occur - assess for previous reaction.
Severe CNS disorders (Alzheimer's, Parkinson's, MS, epilepsy) should not take as diseases may be exacerbated.
42
What are some known adverse reactions to Herpes and Cytomegalovirus agents?
Nausea & vomiting,
headache, paresthesia, neuropathy (CNS effect)
rash, and hair loss,
renal dysfunction -due to the nephrotoxic effect of the drug.
43
Are there any known drug-drug interactions with Herpes and Cytomegalovirus agents, and if so, what are they?
Nephrotoxic drugs (increases effect)
Zidovudine; a retroviral drug used for treatment of HIV & AIDS (increased drowsiness)
44
What should we be assessing prior to giving patients Herpes and Cytomegalovirus agents?
○Assess for contraindications and cautions : Renal or Neurological diagnoses. Pregnant or lactating.
○Perform a physical assessment : Skin orientation and cognitive assessment & renal and hepatic labs.
■Assess orientation and reflexes
■Examine skin (color, temperature, and lesions)
○Evaluate renal function tests
45
What nursing diagnoses should anticipate prior to giving patients Herpes and Cytomegalovirus agents?
○Impaired comfort related to GI, CNS, or local effects of the drug
○Impaired sensory (kinesthetic) perception related to CNS effects of the drug
○Knowledge deficit regarding drug therapy
46
What nursing implementations should we be prepared to make when giving patients Herpes and Cytomegalovirus agents?
○Administer the drug as soon as possible after the diagnosis has been made (most effective at beginning of infection)
○Ensure good hydration (reduces kidney damage)
○Ensure that the patient takes the complete course of the drug regimen (reduce medication resistance)
○Wear protective gloves when applying the drug topically
○Provide safety precautions (fall risk due to CNS effect)
○Warn the patient that GI upset, nausea, and vomiting can occur
○Monitor renal function tests periodically during treatment
○ Patients treated for genital herpes should avoid sexual activity during an outbreak.
○Provide patient teaching
47
What are the 6 categories of drugs used to slow the progression of HIV and AIDS?
●Nonnucleoside reverse transcriptase inhibitors
●Nucleoside reverse transcriptase inhibitors (NRTIs)
●Protease inhibitors
●Fusion inhibitors
●CCR5 coreceptor antagonists
●Integrase strand transfer inhibitors
48
What type of virus is HIV?
Retrovirus. This is a type of virus that has RNA instead of DNA?
49
What happens once HIV has infected a T-cell?
The T-cell can no longer perform its immune function to stimulate an immune response. This means that the virus can keep reproducing as well as enabling other infectious agents introduced to the body to replicate without an immune response from the body.
HIV can mutate and lay dormant for years without any symptoms.
50
How many different medications will an HIV patient typically be on and why?
Typically 3 different medication that all attack the virus at a different point in the cycle to produce the maximum antiviral effect. This prevents the virus from adapting to one medication.
51
What are the drugs that we need to know for Nonnucleoside reverse transcriptase inhibitors (NNRTIs) ?
●Delavirdine
●Efavirenz
●Nevirapine
52
How does Nonnucleoside reverse transcriptase inhibitors work and why are they given?
By binding to and inhibiting the reverse transcriptase enzyme, preventing it from converting viral RNA into DNA, which blocks the virus's ability to replicate.
53
What are the contraindications to Nonnucleoside reverse transcriptase inhibitors?
Allergy,
pregnancy and lactation (benefit outweigh risk) HIV positive mothers should not breastfeed.
54
What are the know adverse reactions to Nonnucleoside reverse transcriptase inhibitors?
Dry mouth, abdominal pain, n/v, constipation, diarrhea (GI effect most common adverse reaction)
Dizziness, blurred vision, headache, flu-like syndrome (r/t neurotoxic and inflammatory properties of the drugs)
55
Are there any Drug-Drug Interactions to Nonnucleoside reverse transcriptase inhibitors and if so, what are they?
numerous - consult resources prior to administration.
56
What are the drugs that we need to know for Nucleoside Reverse Transcriptase Inhibitors (NRTIs)?
●Abacavir
●Emtricitabine
●Lamivudine
●Tenofovir
●Zidovudine
57
How does Nucleoside Reverse Transcriptase Inhibitors work and why are they given?
Compete with naturally occurring nucleosides within the cell that the virus would use to build the DNA chain - prevents formation of complete viral DNA.
58
How does NRTIs and NNRTI's differ from each other in terms of MOA's?
Non-nucleosides (NNRTI's) work on the enzyme responsible for transcribing viral DNA
Nucleosides (NRTI's) insert themselves into viral DNA as a stop code. So when transcriptase goes to read the viral DNA, instead of reading a full code, it gets to the RTI section and stops reading DNA altogether.
59
Which category of medications is the preferred treatment for pregnant HIV patients?
Nucleoside Reverse Transcriptase Inhibitors. They would also be on antivirals during pregnancy to avoid infecting the baby during delivery.
60
Can new mothers that are HIV positive breastfeed their babies?
No. Babies can get infected with HIV from breastmilk.
61
Are there any contraindications with Nucleoside Reverse Transcriptase Inhibitors, and if so, what are they?
Allergy (death have occurred from allergic reactions- sensitivity assessment is vital. If any flu like reactions are occurring the medications need to be stopped immediately)
Lactation
62
What are the some cautions that we need to be aware of when giving patients Nucleoside Reverse Transcriptase Inhibitors?
hepatic dysfunction,
renal impairment,
bone marrow suppression (NRTI's can increase suppression)
63
What are some adverse reactions that we may see when patients are taking Nucleoside Reverse Transcriptase Inhibitors?
Hypersensitivity,
Pancreatitis r/t toxic drug effect
Hepatomegaly r/t toxic drug effect - may cause jaundice
Neurological problems r/t drug passing blood brain barrier - may cause neurological changes.
Bone marrow suppression
64
Are there any Drug-Drug Interactions to Nucleoside Reverse Transcriptase Inhibitors?
Numerous - do not mix with any other antivirals may risk organ toxicity.
65
What are the suffix(es)/drug names that we need to know for Protease Inhibitors?
(-navir)
●Darunavir
●Fosamprenavir
●Lopinavir
●Ritonavir
●Tipranavir
66
What are the MOA's and indications of Protease Inhibitors?
Block protease activity which is responsible for maturing the young HIV particles.
Protease is responsible for cleaving viral polyproteins into functional components necessary for formation of mature infectious viral particles. If they cannot mature, they cannot infect other cell and eventually will die without spreading the infection.
67
Are there any contraindications to Protease Inhibitors and if so, what are they?
Lactation and hepatic dysfunction (can worsen)
68
What are some known adverse reactions to Protease Inhibitors?
GI effects (most common adverse reaction) - nausea, diarrhea, abdominal pain and dyspepsia.
Changes in liver function (ALT and AST should be monitored)
Elevated cholesterol and triglyceride levels, redistribution of fat,
Pruritus & Stevens-Johnson syndrome (assess for severe itching, skin rash, blistering, peeling, fever and mucosal lesions)
69
Are there any DDI's to to Protease Inhibitors?
Numerous - not combine with other hepatotoxic medications due to increased risk of liver damage.
70
What is the drug name that we need to know for Fusion Inhibitors?
Enfuvirtide
71
What are the MOA of Enfuvirtide?
Prevents the fusion of the virus with the human cellular membrane
72
What are the known contraindications to giving a patient Enfuvirtide?
Allergy,
Lactation
73
Is there anything we should be cautious of before/when giving a patient Enfuvirtide?
Lung disease (can be exacerbated due to side effects such as cough and pneumonia)
Pregnancy (limited safety data, other drugs recommended)
74
What are some know adverse reactions to the drug Enfuvirtide?
Insomnia which may contribute to depression,
Peripheral neuropathy,
Nausea & Diarrhea,
Pneumonia,
Injection site reactions (IV)
75
Are there any DDI's to Enfuvirtide? If so, what are they?
None known
76
What is the agent that we need to know for CCR5 Coreceptor Antagonist?
Maraviroc
77
What is the MOA's and Indication of Maraviroc?
Blocks the receptor site on the cell membrane to which the HIV virus needs to interact to enter the cell. Blocks entry to helper T- cells.
78
What contraindicates giving a patient Maraviroc?
Hypersensitivity
Nursing mothers
Liver disease - toxic to liver
79
What are some known adverse reactions to the drug Maraviroc?
Dizziness and changes in consciousness due to CNS effect
Can increase risk of upper respiratory infections by affecting immune function of respiratory epithelium.
BP effect - may lead to cognitive impairment.
BBW for severe hepatotoxicity (routine liver labs are important)
80
Are there any DDI's to Maraviroc, and if so, what are they?
numerous
81
What are the two drugs names/ suffix, that we need to know for Integrase Strand Transfer
Inhibitors?
(-gravir)
Dolutegravir
Raltegravir
82
What is the MOA and indication to giving a patient Dolutegravir?
Block the activity of the integrase enzyme which is essential for integrating viral DNA into the host cells genome after reverse transcription.
If the virus cannot put its RNA into the host cells DNA, then the virus cannot be replicated.
*Integrase Strand Transfer Inhibitors
83
What is a contraindication to giving a patient Raltegravir?
Hypersensitivity to any antiviral medication.
*Integrase Strand Transfer Inhibitors
84
What are some cautions that we need to be mindful of when giving a patient Dolutegravir?
Rhabdomyolysis & Myopathy - associated with muscle related side effects like myalgia and muscle inflammation and damage.
Pregnancy (limited safety data)
*Integrase Strand Transfer Inhibitors
85
What are some adverse reactions to the drugs Dolutegravir & Raltegravir?
Headache, dizziness, insomnia r/t the drugs ability to cross blood brain barrier.
Weight gain (altered metabolic processes) ,
liver failure (hepatotoxic) , renal impairment, and suicidal ideation.
*Integrase Strand Transfer Inhibitors
86
Are there any DDI's to Dolutegravir & Raltegravir?
decreased serum levels of either drug if combined with rifampin
*Integrase Strand Transfer Inhibitors
87
What assessments should we be doing prior to giving patients agents for HIV and AIDS?
○Assess for contraindications and cautions
○Perform a physical assessment - focus on most common side effects such as effects on CNS, SKIN, GI, Kidney & Liver. Therefore assess level of orientation and reflexes, abdomen and examine the skin (color, temperature, and lesions).
■Check temperature
○Evaluate CBC, hepatic and renal function tests (BUN, Creatinine, ALT and AST)
88
What diagnoses can we anticipate prior to giving patients agents for HIV and AIDS?
○Impaired comfort related to GI, CNS, or dermatological effects of the drugs.
○Altered sensory (kinesthetic) perception related to CNS effects of the drugs
○Malnutrition related to GI effects of the drugs
○Injury related to CNS effects of the drugs
○Knowledge deficit regarding drug therapy
89
What implementations should we be prepared for when giving patients agents for HIV and AIDS?
○Monitor renal and hepatic function before and periodically during therapy (follow up labs essential )
○Ensure that the patient takes the complete course of the drug regimen and takes all drugs included in a particular combination
○Administer the drug around the clock, if indicated - ensure consistent therapeutic levels in bloodstream.
○Monitor nutritional status
○Stop drug if severe rash occurs - monitor skin for breakdown and Stevens Johnsons syndrome.
○Provide safety precautions
○Teach the patient that these drugs do not cure the disease
○Provide patient teaching
90
What are the names of the 2 Anti-Hepatitis B Agents that we need to know?
Adefovir
Entecavir
91
Why are healthcare workers more at risk of contracting Hep B?
From accidental needle sticks.
92
What are the MOA and indications of Adefovir & Entecavir?
Inhibits reverse transcriptase in the hepatitis B virus and causes DNA chain termination - prevents replication (Same as NRTI's)
*Anti-Hepatitis B Agents
93
What makes Adefovir & Entecavir contraindicated in a patient?
Known allergy,
Lactation - due to this drug being toxic to babies.
*Anti-Hepatitis B Agents
94
What are some known adverse reactions of Adefovir & Entecavir?
Most significant are headache, dizziness, nausea, diarrhea, and elevated liver enzymes due to hepatic cell turnover or inflammation, renal impairment, lactic acidosis (rare but serious, particularly in patients with underlying kidney or liver disease and drug may interfere with mitochondrial function which leads to accumulation of lactic acid in the blood)
*Anti-Hepatitis B Agents
95
What are the known DDI's to Adefovir & Entecavir?
Increased risk of renal toxicity if these drugs are taken with other nephrotoxic drugs.
*Anti-Hepatitis B Agents
96
What patients assessments should we do prior to giving patients Adefovir & Entecavir?
○Assess for contraindications or cautions (renal or hepatic impairment and sensitivity)
○Perform a physical assessment
■Assess body temperature - as this may be a sign of infection
■Assess level of orientation and reflexes - may detect impairment in nervous system early.
○Evaluate renal and liver function tests
*Anti-Hepatitis B Agents
97
What diagnoses should we anticipate prior to giving patients Adefovir & Entecavir?
○Impaired comfort related to the CNS and GI effects of the drug
○Malnutrition related to the GI effects of the drug
○Knowledge deficit regarding drug therapy
*Anti-Hepatitis B Agents
98
What implementations should we be prepared for and do when giving patients anti-Hepatitis B agents?
○Monitor renal and hepatic function prior to and periodically during therapy
○Withdraw the drug and monitor the patient if patient develops signs of lactic acidosis or hepatotoxicity
○Caution patient to not run out of this drug and not stop using it abruptly.
○Advise women of childbearing age to use barrier contraceptives
○Advise women who are breastfeeding to find another method of feeding the baby
○Advise patients that there is still a risk of transferring the disease
○Provide patient teaching - report signs of hepatoxicity
*Adefovir & Entecavir
99
What are meassures that patients who are infected with Hep B can prevent spreading the infection to someone else?
Strictly adhering to medication regimen to reduce viral load.
Avoid sharing needles, razors and other items that could come into contact with their infected blood.
Practice safe sex by using condom to minimize the risk of sexual transmission.
100
What are the symptoms for Hepatitis B?
Jaundice, fever, nausea, vomiting, light stools and dark urine.
101
What are the names that we need to know for the Anti-Hepatitis C Agents?
Velpatasvir-sofosbuvir
Ledipasvir-sofosbuvir
Glecaprevir-pibrentasvir
Elbasvir-grazoprevir
102
TRUE/FALSE
Hep. C cannot be cured, just like HIV, AIDS and Hep. B.
FALSE
Unlike all the other diseases stated, Hep C. can be cured.
103
What are the MOA and indications of Anti-Hepatitis C Agents?
Alters viral replication by targeting different stages of the virus' s lifecycle; used in combination to treat chronic hepatitis C
104
What would contraindicate the use of Anti-Hepatitis C Agents?
Known allergy,
Pregnancy & Lactation - toxic to fetus and infants
105
What condition should we be cautious of when considering Anti-Hepatitis C Agents to patients?
Severe liver disease - should be taken with extreme caution.
106
What are some known adverse reactions to Anti-Hepatitis C Agents?
Most common HA, fatigue due to CNS effect.
Nausea, diarrhea due to irritation of GI tract.
Rash, and severe skin reactions due to triggered immune reaction.
107
Are there any DDI's to Anti-Hepatitis C Agents, and if so, what are they ?
Consult guide if a patient is being treated for HIV and Hep C at the same time as there are many drug drug interactions with these classes.
Protease inhibitors - compounding liver problem and altered effectiveness
St. John’s wort - reduce effectiveness by increasing metabolism of the drug.
108
What should we be assessing prior to giving patients Anti-Hepatitis C Agents?
Assess for contraindications or cautions - allergy & liver impairment
Perform a physical assessment - body temperature to detect signs of infection or drug reactions
Assess level of orientation and reflexes - for neurological side effects/
Evaluate liver function (monitor liver labs)
109
What are some nursing diagnosis that we can anticipate prior to giving Anti-Hepatitis C Agents?
○Impaired comfort related to the CNS and GI effects of the drug
○Malnutrition related to the GI effects of the drug
○Knowledge deficit regarding drug therapy 36
110
What nursing implementations should we be prepared for while giving Anti-Hepatitis C Agents?
○Monitor hepatic function prior to and periodically during therapy
○Advise women of childbearing age to use barrier contraceptives
○Advise women who are breastfeeding to find another method of feeding the baby
○Advise patients that these drugs do not immediately cure the disease
○Provide patient teaching
111
How long does the medical treatment for Hep C normally take?
10-12 weeks. It important to complete the medication regimen and not stopping it early.
112
How do we determine if medication treatment of Hep C is effective?
Monitor blood and ensuring that the Hep C viral load is going down.
113
Which drug classes do we need to know for the Locally Active Antiviral Agents?
Docosanol
Ganciclovir
Penciclovir
Acyclovir
114
What are the MOA and indication to giving patients Locally Active Antiviral Agents?
Prevent viral entry into the human cell or interfere with the viral DNA replication. Used to treat specific local viral infections such as warts, cold sores and eye infections.
115
What contraindicates the use of Locally Active Antiviral Agents?
Allergy to the drug
116
What are some known adverse reactions to Locally Active Antiviral Agents?
Local burning, stinging, and discomfort - not absorbed systemically so there are less adverse reactions. Should not be applied to open wounds.
117
What should we assess prior to giving patients Locally Active Antiviral Agents?
○Assess for history of allergy (previous reaction to antivirals)
○Perform a physical assessment :
-Assess the infected area, including location, size, and character of lesions
-Evaluate for signs of inflammation at the site of infection
118
How should the patients be instructed to take the topical medications?
Clean the skin and dry before putting on a thin layer of the medication followed by prescribed frequency. Hand washing should be done prior to and after use and patient should avoid touching the lesions. Treatment need to be continued for the full duration even if conditions improve. Locally active agents does not cure the disease.
119
What nursing diagnoses can we anticipate before giving patients Locally Active Antiviral Agents?
○Impaired comfort related to local effects of the drug
○Knowledge deficit regarding drug therapy
120
What implementations should we be prepared to do while giving patients Locally Active Antiviral Agents?
○Ensure proper administration of the drug
○Stop the drug if severe local reaction occurs or if open lesions occur near the
site of administration
○Instruct the patient about the drug being used
○Teach that these drugs do not cure the disease
○Encourage the patient to report severe local reaction or discomfort
121
What is the leading cause of respiratory infections in infants?
RSV - Respiratory Syncytial Virus.
122
What do we call a virus that virus that has RNA instead of DNA?
Retrovirus.
123
What is reverse transcriptase?
A building block of viral DNA. Preventing this, prevents the virus from making more copies of itself.
