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Pharmacology Exam #3 > Antiviral Agents > Flashcards

Antiviral Agents Flashcards

1
Q

Which viruses respond to Antiviral Therapy?

A
  • Influenza A and some respiratory viruses
  • Herpes viruses
  • Cytomegalovirus (CMV)
  • Human Immunodeficiency Virus (HIV) that causes Acquired Immune Deficiency Syndrome (AIDS)
  • Hepatitis B and C
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2
Q

Characteristics of Viruses

A
  • Cannot replicate on their own
  • Must attach to and enter a host cell
  • Uses the host cell’s energy to synthesize protein, DNA, and RNA
  • Difficult to kill because they live INSIDE our cells
  • Any drug that kills a virus may also kill our cells
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3
Q

Considerations for Antivirals
In Children

A
  • More severe reactions expected
  • No proven safety for many; extreme caution should be used
  • Doses should be calculated by WEIGHT
  • Monitor closely
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4
Q

Considerations for Antivirals
In Adults

A
  • Antibiotics will NOT work for viral infections
  • Drugs DO NOT CURE the disease
  • Caution in pregnancy
  • Advise childbearing women to use contraceptives
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5
Q

Considerations for Antivirals
In Older Adults

A
  • More susceptible to adverse effects; monitor closely
  • Hepatic/renal dysfunction may be worsened by these medications
  • Dose may need to be lowered
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6
Q

Common Respiratory Viruses

A
  • Influenza A
  • Influenza B
  • Respiratory Syncytial Virus (RSV)
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7
Q

Agents for Influenza and Respiratory Viruses
Drug Names and Indications

A
  • Amantadine: Influenza A and West Nile Virus
  • Oseltamivir: Influenza A and B (shortens severity if taken early)
  • Peramivir: Acute influenza
  • Rimantadine: Influenza A
  • Zanamivir: Influenza A and B (inhaled medication)
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8
Q

Agents for Influenza and Respiratory Viruses
Mechanism of Action

A

Prevents viral replication

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9
Q

Agents for Influenza and Respiratory Viruses
Contraindications

A

Absolute:
* Allergy
* Renal Impairment
* Pregnancy and lactation

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10
Q

Agents for Influenza and Respiratory Viruses
Adverse Effects

A
  • CNS: Headache, insomnia
  • GI: nausea
  • CV: Orthostatic hypotension (because of effect on dopamine –> vasodilation)
  • GU: Urinary Retention
  • Peramivir - associated with Stevens-Johnson Syndrome
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11
Q

Agents for Influenza and Respiratory Viruses
Assessment

A

History:
* Allergy
* Renal Impairment
* Pregnancy or lactation

Physical:
* CNS: Orientation, reflexes
* Vital Signs
* Urinary Output
* Skin

Labs:
* Renal and Hepatic function tests

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12
Q

Agents for Influenza and Respiratory Viruses
Nursing Conclusions/Diagnoses

A
  • Impaired Comfort (r/t GI, CNS, or GU effects)
  • Altered Sensory Perception (r/t CNS effects)
  • Knowledge deficit
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13
Q

Agents for Influenza and Respiratory Viruses
Implementation/Patient Teaching

A
  • Hydrate well
  • Change positions slowly
  • Avoid driving until CNS and hypotension effects are known
  • Start the drug regimen AS SOON after exposure to the virus as possible
  • Administer FULL course of the drug
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14
Q

Agents for Herpes and Cytomegalovirus (CMV)
Drug Names and Indications

A

“-clovir”
* Acyclovir: Genital herpes, cold sores, chicken pox, shingles
* Ganciclovir: Cytomegalovirus (CMV)
* Valacyclovir: Genital herpes, cold sores, shingles
* Valganciclovir: treat and prevent cytomegalovirus (CMV)

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15
Q

Agents for Herpes and Cytomegalovirus (CMV)
Mechanism of Action

A
  • Inhibits viral DNA replication
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16
Q

Agents for Herpes and Cytomegalovirus (CMV)
Contraindications

A

Absolute:
* Allergy
* Pregnancy (HIGHLY toxic)

Relative:
* Lactation
* Renal disease
* CNS disorders (MS, epilepsy, Alzheimer’s, stroke, etc.)

17
Q

Agents for Herpes and Cytomegalovirus (CMV)
Adverse Effects

A
  • GI: Nausea, vomiting
  • Headache
  • Rash
  • Hair loss
  • Paresthesias
  • Neuropathy
  • Renal Dysfunction
18
Q

Agents for Herpes and Cytomegalovirus (CMV)
Drug Interactions

A
  • Nephrotoxic Drugs
  • Zidovudine (HIV drug)
19
Q

Agents for Herpes and Cytomegalovirus (CMV)
Assessment

A

History:
* Allergy, pregnancy, lactation, renal disease, CNS disorders

Physical:
* CNS: Orientation, reflexes
* Skin: Color, temperature, lesions

Labs:
* Renal function tests

20
Q

Agents for Herpes and Cytomegalovirus (CMV)
Implementation/Patient Teaching

A
  • Adminsiter drug AS SOON AS possible after diagnosis
  • Ensure good hydration
  • Administer complete course of treatment
  • Wear protective gloves when applying drug topically
  • Warn patient about GI upset, nausea, vomiting
  • Monitor renal function tests periodically during treatment
  • Avoid sexual intercourse during outbreak
  • Avoid driving w/CNS effects
  • Patient teaching: infection is not curable, just managed with drug therapy
21
Q

Agents for HIV and AIDS
ALL the Drug Classes

A
  • Protease Inhibitors
  • Nonnucleoside Reverse Transcriptase Inhibitors
  • Nucleoside Reverse Transcriptase Inhibitors
  • Fusion Inhibitors
  • CCR5 Coreceptor Antagonists
  • Integrase strand transfer inhibitors
    Typically on 3 different agents at the same time. Work to SLOW the progress of the infection
22
Q

Nonnucleoside Reverse Transcriptase Inhibitors: NNRTIs
Drug Names

A

Delavirdine
Efavirenz
Nevirapine

23
Q

Nonnucleoside Reverse Transcriptase Inhibitors: NNRTIs
Mechanism of Action

A
  • Bind DIRECTLY to HIV Reverse Transcriptase
  • Block both RNA- and DNA- dependent DNA polymerase activities
24
Q

Nonnucleoside Reverse Transcriptase Inhibitors: NNRTIs
Contraindications

A

Absolute:
* Allergy
* Pregnancy and Lactation

25
Q

Nonnucleoside Reverse Transcriptase Inhibitors: NNRTIs
Adverse Effects

A
  • Mostly GI effects: abdominal pain, N/V, constipation, diarrhea
  • Dry Mouth
  • Dizziness, blurred vision, headache
  • Flu-like symptoms
26
Q

Nonnucleoside Reverse Transcriptase Inhibitors: NNRTIs
Drug Interactions

A

Numerous

27
Q

Nucleoside Reverse Transcriptase Inhibitors: NRTIs
Drug Names

A

Abacavir
Emtricitabine
Lamivudine
Tenofovir
Zidovudine

28
Q

Nucleoside Reverse Transcriptase Inhibitors: NRTIs
Mechanism of Action

A
  • Compete with naturally occuring nucleosides within the cell that the virus would use to build the DNA chain.
  • Inserts into the viral DNA as a STOP CODON

Preferred method for pregnant patients

29
Q

Nucleoside Reverse Transcriptase Inhibitors: NRTIs
Contraindications

A

Absolute:
* Allergy
* Lactation

Caution:
* Hepatic dysfunction
* Renal impairment
* Bone Marrow Suppression

30
Q

Nucleoside Reverse Transcriptase Inhibitors: NRTIs
Adverse Effects

A
  • Hypersensitivity
  • Pancreatitis
  • Hepatomegaly (abd. pain, Inc. liver enzymes)
  • Neurological problems
  • Bone Marrow Suppression

with Flu symptoms/any sensitivity symptoms –> STOP drug immediately

31
Q

Nucleoside Reverse Transcriptase Inhibitors: NRTIs
Drug Interactions

A
  • Numerous

Don’t mix with other antivirals

w/immunosuppressants = monitor closely

32
Q

Protease Inhibitors
Drug Names

A

“-navir”

Darunavir
Fosamprenavir
Lopinavir
Ritonavir
Tripanavir

33
Q
A

Pharmacology Exam #3 (6 decks)

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