Non-HIV antivirals

Question 1

what explains the antigenic DRIFT?

Answer 1

minor changes; why people need to have annual flu vaccines

Question 2

what is an antigenic SHIFT?

Answer 2

MAJOR shift in the influenza strains

Question 3

what is the most readily used influenza vaccine?

Answer 3

inactivated influenza vaccine (IFV)

Question 4

the IFV vaccine can be _____ or _____ (strains)

Answer 4

trivalent or quadrivalent

Question 5

what population are we concerned about getting the live, attenuated influenza vaccine?

Answer 5

immunocompromised, kids <2 yrs, pregnant people or people they live with (can pass on)

Question 6

starting at what age is the influenza vaccine recommended?

Answer 6

6 months and older

Question 7

SE of influenza vaccine

Answer 7

injection site soreness, malaise, fever, muscle aches - DOES NOT GIVE YOU THE FLU… this is your body mounting an immune response!

Question 8

if someone has an egg allergy, which flu vaccine should they use?

Answer 8

recombinant hemagglutinin vaccine (RIV)

Question 9

3 types of influenza vaccines

Answer 9

1. inactivated influenza vaccine
   2 recombinant hemagglutinin vaccine
2. live, attenuated influenza vaccine

Question 10

what is oseltamivir?

Answer 10

influenza antiviral (Tamiflu)

Question 11

what timing is imperative with oseltamivir tx?

Answer 11

treat EARLY! no later than 2 days after symptoms - within 12 hours is best!

Question 12

mechanism of action for oseltamivir

Answer 12

prevents budding of viral particles = prevents spread

often used prophylaxis in congregate settings

Question 13

which hepatitis is most likely to go into carrier state - cx, cirrhosis, bleeding, liver transplants?

Answer 13

hep C

Question 14

which hepatitis infection does NOT have a vaccine?

Answer 14

hep C

Question 15

how does the hepatitis virus spread?

Answer 15

blood + body fluids

Question 16

what is the best option for Hep B tx?

Answer 16

PREVENTION w/vaccine

Question 17

tx for which Hep is not needed unless there is active liver disease?

Answer 17

Hep B

Question 18

which Hep treatment is based on patient’s genotype?

Answer 18

Hep C

Question 19

AE of Hep C treatment

Answer 19

nausea, fatigue, weakness, liver fxn changes (watch ALT, AST)

Question 20

Hep C tx has drug-drug interactions with which drugs?

Answer 20

antacids, lipid-lowering, anti-seizure, antiretroviral

Question 21

HSV1 is manifested as what?

Answer 21

cold sores

Question 22

HSV2 is manifested as what?

Answer 22

genital sores/STIs

Question 23

what is the drug of choice for HSV 1+2 and Varicella Zoster Virus?

Answer 23

acyclovir

Question 24

mechanism of action of acyclovir

Answer 24

suppresses synthesis of viral DNA

Question 25

AE of IV acyclovir

Answer 25

phlebitis, nephrotoxicity

Question 26

re: AE of IV acyclovir, what are nursing considerations for these patients?

Answer 26

HDYRATE WELL - to prevent nephrotoxicity

Question 27

what is the prodrug form of acyclovir?

Answer 27

valacyclovir

Question 28

comparing acyclovir and valacyclovir and dosing, what drug is better for compliance? why?

Answer 28

valacyclovir, because dosing is 1-2 x day vs 4!!

Question 29

what are the 3 topical therapy drugs for herpes labialis?

Answer 29

1. acyclovir
2. penciclovir
3. docosanol (Abreva)

Question 30

cytomegaly virus is HSV ___?

Answer 30

HSV 5

Question 31

re: cytomegaly virus, which populations are at high risk for reactivation?

Answer 31

immunocompromised

Question 32

what infection is the leading cause of birth defects r/t infectious diseasese?

Answer 32

cytomegaly virus (CMV)

Question 33

what test can we give during pregnancy to test for CMV? (to prevent birth defects)

Answer 33

TORCH test

Question 34

AE of CMV infection

Answer 34

1. CMV retinitis = vision loss

2. collitis = GI tract disturbance

Question 35

what is drug of choice for CMV?

Answer 35

ganciclovir /valganciclovir

Question 36

what are the serious AE of ganciclovir? (3)

Answer 36

bone marrow suppression
teratogenic
mutagenesis/carcinogenesis

Question 37

administration time for valganciclovir (IV)

Answer 37

over 1 hour … sloooooow

Question 38

what drug should you avoid direct contact with as an RN; it should arrive from pharmacy in hazardous drug packaging

Answer 38

ganciclovir/valganciclovir