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320 Pharmacology > Anti-Virals > Flashcards

Anti-Virals Flashcards

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
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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
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3
Q

What are two types of Herpes Simplex Virus?

A

HSV1- perioral blisters
HSV2- genital blisters

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4
Q

How is Herpes Simplex Virus contagious?

A

highly transmissible through close physical contact

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5
Q

What are the symptoms of Herpes Simplex Virus?

A

Periods of latency and painful outbreaks

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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
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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
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8
Q

What are the symptoms of Varicella Zoster?

A

Causes an itchy, blister-like rash

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9
Q

How can you prevent Varicella Zoster?

A

By a vaccine

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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

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11
Q

What is Herpes Zoster caused by?

A

the reactivation of varicella

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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)
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13
Q

How to treat Herpes Zoster?

A

Must give medication w/in 72 hours of symptom onset

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14
Q

How to treat HSV1, HSV2, VZV, & Herpes Zoster?

A

acyclovir

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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
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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
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17
Q

What is a contraindication of acyclovir?

A

hypersensitivity to acyclovir or valacyclovir

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18
Q

What are some adverse effects of acyclovir?

A
  • GI: N/V/D
  • Local: burning sensation/pain when applied topically
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19
Q

Which drug does acyclovir have drug interactions with?

A

zidovudine: increased risk for neurotoxicity

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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
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21
Q

What is hepatitis B?

A

a liver infection caused by the hepatitis B virus

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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

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23
Q

How to prevent Hep B?

A

vaccine

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24
Q

How to treat Hep B?

A

tenofovir alafenamide

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25
Q

What is tenofovir alafenamide?

A
  • Nucleoside reverse transcriptase inhibitor (NRTI)
  • Indicated for chronic Hep B
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26
Q

What is a contraindication of tenofovir alafenamide?

A
  • end-stage renal disease (ESRD)
  • liver impairment
  • use cautiously in pregnancy, only if the benefit outweighs the risk
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27
Q

What are some adverse effects of tenofovir alafenamide?

A
  • Fluid & Electrolyte: lactic acidosis
  • GI: hepatomegaly w/ steatosis, abdominal pain, increased liver enzymes
  • GU: renal failure
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28
Q

Which drugs do tenofovir alafenamide have drug interactions with?

A

acyclovir and valacyclovir
- may increase tenofovir levels and toxicity
- avoid if possible

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29
Q

What to educate the patient about tenofovir alafenamide?

A
  • 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
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30
Q

What is Hepatitis C?

A

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

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31
Q

How is Hep C contagious?

A

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

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32
Q

How to treat Hep C?

A

sofosbuvir

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33
Q

What is sofosbuvir?

A
  • 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)
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34
Q

What is a contraindicaton of sofosbuvir?

A
  • severe renal impairment or ESRD
  • concurrent use of St. John’s Wort and ribavirin
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35
Q

What are some adverse effects of sofosbuvir?

A
  • Derm: pruritis (itchy)
  • Neuro: fatigue, headache, insomnia, irritability
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36
Q

What to educate patient for sofosbuvir?

A
  • a negative pregnancy test must be obtained before beginning therapy
  • administer once daily w/o regard to food
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37
Q

How should patients who can’t swallow pills take sofosbuvir?

A
  • 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
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38
Q

How can HIV be contagious?

A
  • sexual activity
  • intravenous drug use
  • perinatally from mother to child
39
Q

What is HAART (highly active antiretroviral therapy)?

A

combo of 2 nucleoside analogues and a protease inhibitor
- reduce viral load by depressing HIV replication

40
Q

How to treat HIV?

A

zidovudine
abacavir
raltegravir

41
Q

What to educate patients about all HIV treatments and medications?

A
  • 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
Q

What are the contraindications for HIV treatments and medications?

A
  • not recommended for breastfeeding mothers with HIV
  • hypersensitivity
43
Q

What is zidovudine?

A
  • 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
Q

What is a contraindication of zidovudine?

A
  • severe hepatic or renal disease
  • bone marrow suppression
45
Q

What are some adverse effects of zidovudine?

A
  • Fluids/electrolytes: lactic acidosis
  • GI: hepatomegaly with steatosis, abdominal pain, N/D
  • Hem: anemia, granulocytopenia
  • Neuro: headache, weakness
46
Q

Which drugs do zidovudine have drug interactions with?

A
  • acyclovir: Increased neurotoxicity
  • other drugs that cause bone marrow suppression: Increased bone marrow suppression
47
Q

What are some nursing considerations for zidovudine?

A
  • 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
Q

What is abacavir?

A
  • 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
Q

What is a contraindication of abacavir?

A
  • moderate to severe impairment
  • use cautiously in patients with coronary heart disease
  • concurrent use of antiviral combination products containing abacavir (toxicity risk)
50
Q

What are some adverse effects of abacavir?

A
  • CV: myocardial infarction
  • Fluid & Electrolyte: lactic acidosis
  • GI: hepatomegaly w/ steatosis, abdominal pain, N/V/D
51
Q

Which drugs do abacavir have drug interactions with?

A

alcohol: Increased blood levels

52
Q

What are some nursing considerations for abacavir?

A
  • monitoring viral load and CD4 cell count regularly
  • must always be used in combination with other antiretroviral drugs
53
Q

What are some medications for HIV?

A

emtricitabine
tenofovir disproxil

54
Q

What is emtricitabine?

A
  • Nucleoside reverse transcriptase inhibitor (NRTI)
  • Oral use only; used in combination with other agents
55
Q

What is a contraindication of emtricitabine?

A
  • Use cautiously in Hep B co-infection (can cause severe exacerbation of HBV)
56
Q

What are some adverse effects of emtricitabine?

A
  • Derm: rash
  • Fluid & Electrolyte: lactic acidosis
  • GI: hepatomegaly w/ steatosis, abdominal pain, N/D
  • Neuro: dizziness, headache, insomnia, weakness
  • Resp: cough
57
Q

What are nursing considerations for emtricitabine?

A
  • monitor for HBV, viral load, and CD4
  • used in combination with other antiretroviral
58
Q

What is tenofovir disproxil?

A
  • Nucleoside reverse transcriptase inhibitor (NRTI)
  • Used to treat HIV (and chronic Hep B)
  • Oral use only
  • Often used in combination with other agents
59
Q

What is a contraindication of tenofovir disproxil?

A
  • concurrent use of antiretroviral combination products containing tenofovir
  • concurrent use of NSAIDs (increased risk of ARF)
60
Q

What are some adverse effects of tenofovir disproxil?

A

Fluid & Electrolyte: lactic acidosis
GI: hepatomegaly w/ steatosis, abdominal pain, N/D
GU: ARF
MSK: bone pain
Neuro: depression, headache

61
Q

What drugs do tenofovir disproxil have drug interactions with?

A
  • acyclovir- blood levels may be increased
  • NSAIDs- increased risk for ARF
62
Q

What to educate patients on for tenofovir disproxil?

A
  • 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
Q

What is raltegravir?

A
  • Integrase Inhibitor
  • PO
64
Q

What is a contraindication of raltegravir?

A
  • Use cautiously when patient’s taking other medications that can cause rhabdomyolysis and/or myopathy
65
Q

What are some adverse effects of raltegravir?

A

GI: diarrhea
Hem: anemia, neutropenia
MSK: rhabdomyolysis, myopathy
Neuro: suicidal thoughts, headache

66
Q

What drugs do raltegravir have drug interactions with?

A

Administration w/ antacids containing magnesium or aluminum decreases absorption of raltegravir

67
Q

What to educate patients about on raltegravir?

A
  • 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
Q

What does Pre-exposure prophylaxis do (PrEP)?

A

highly effective at preventing HIV

69
Q

What are two PrEP medications?

A
  • Truvada
  • Descovy
70
Q

What is Post-exposure prophylaxis (PEP)?

A
  • Emergency tx taken w/in 72 hours of exposure to HIV
  • Must be HIV negative (will test before & after tx)
71
Q

When should you take PEP?

A

PEP is taken for 28 days after potential exposure

72
Q

What are two PEP medications?

A

Raltegravir and Truvada

73
Q

What treats influenza?

A

oseltamivir

74
Q

What is oseltamivir?

A
  • Neuraminidase inhibitor
  • Active against influenza types A and B
  • Reduce the duration of illness
75
Q

What is a contraindication of oseltamivir?

A
  • Hypersensitivity
  • ESRD (End-Stage Renal Disease)
  • not receiving dialysis
76
Q

What are some adverse effects of oseltamivir?

A

GI: N/V

77
Q

What drugs do oseltamivir have drug interactions with?

A
  • may decrease the therapeutic effect of influenza vaccine
  • avoid use 2 days prior to and 2 weeks after vaccine administration
78
Q

What are nursing considerations for oseltamivir?

A
  • 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
Q

What can treat COVID-19?

A

remdesivir

80
Q

What is a contraindication of remdesivir?

A
  • hypersensitivity and severe renal impairment (eGFR < 30 mL/min)
  • safety is not established in pregnant clients or children < 12 or weighing < 40 kg
81
Q

What are some adverse effects of remdesvir?

A
  • GI: increased liver enzymes, nausea
  • Misc: Infusion reactions and anaphylaxis
82
Q

What drugs do remdesvir have drug interactions with?

A

Hydroxychloroquine/chloroquine: may decrease antiviral activity

83
Q

What are nursing considerations for remdesivir?

A
  • IV administration only
  • reconstitute powder
  • solution should be clear and colorless; discard meds that are cloudy, discolored, or contain particulate matter
84
Q

What treats RSV?

A

ribavirin

85
Q

What is ribavirin?

A
  • antiviral; synthetic nucleoside analogues
  • nasal inhalation
  • caution with pregnant and child-bearing aged health care workers
86
Q

What is a contraindication of ribavirin?

A
  • hypersensitivity
  • patients receiving mechanically assisted ventilation
  • significant CV disease
  • hemoglobinopathies
  • concurrent use of zidovudine
  • pregnant women (may cause fetal harm)
87
Q

What are some adverse effects of ribavirin?

A
  • EENT: blurred vision, photosensitivity
  • Hem: hemolytic anemia
88
Q

What drugs do ribavirin have drug interactions with?

A

Zidovudine: decreased antiretroviral action of zidovudine

89
Q

What are nursing considerations and patient education for ribavirin?

A
  • 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
Q

What treats CMV?

A

ganciclovir

91
Q

What is ganciclovir?

A
  • antiviral; synthetic nucleotide analogue
  • oral, parenteral forms
  • dose limiting toxicity = bone marrow suppression
92
Q

What is a contraindication of ganciclovir?

A
  • hypersensitivity to ganciclovir or acyclovir
  • bone marrow suppression
  • immunosuppression
93
Q

What are some adverse effects of ganciclovir?

A

Hem: neutropenia, thrombocytopenia

94
Q

What are nursing considerations for ganciclovir?

A
  • 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

320 Pharmacology (36 decks)

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