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2571: EXAM 3 > Antiviral Drugs > Flashcards

Antiviral Drugs Flashcards

1
Q

Acyclovir

Chemical Classification

A

Purine nucleoside analog

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2
Q

Acyclovir

Mechanism of Action

A

Interferes with DNA synthesis by conversion to acyclovir triphosphate, thereby causing decreased viral replication

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3
Q

Acyclovir

Uses

A

Mucocutaneous herpes simplex virus, herpes genitalis (HSV-1, HSV-2), varicella infections, herpes zoster, herpes simplex encephalitis

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4
Q

Acyclovir

Contraindications

A

Hypersensitivity to this product, valacyclovir

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5
Q

Acyclovir

Side Effects

A

CNS: tremors, confusion, lethargy, hallucinations, SEIZURES, dizziness, headache, encephalopathic changes
EENT: gingival hyperplasia
GI: nausea, vomiting, diarrhea, increased ALT/AST, abdominal pain, glossitis, colitis
GU: OLIGURIA, PROTEINURIA, HEMATURIA, vaginitis, moniliasis, GLOMERULONEPHRITIS, ACUTE RENAL FAILURE, changes in menses, polydipsia
HEMA: THROMBOTIC THROMBOCYTOPENIA PURPURA, HEMOLYTIC UREMIC SYNDROME (immunocompromised patients)
INTEG: rash, urticaria, pruritus, pain or phlebitis at IV site, unusual sweating, alopecia, STEVENS-JOHNSON SYNDROME
MS: joint pain, leg pain, muscle cramps

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6
Q

Acyclovir

Nursing Considerations

A

ASSESS:

  • Signs of infection, anemia
  • TOXICITY: ANY PATIENT WITH COMPROMISED RENAL SYSTEM BECAUSE PRODUCT IS EXCRETED SLOWLY WITH POOR RENAL SYSTEM FUNCTION; TOXICITY MAY OCCUR RAPIDLY
  • HEPATIC, RENAL STUDIES: AST, ALT, URINALYSIS, PROTEIN, BUN, CREATININE, CCr, WATCH FOR INCREASING BUN AND SERUM CREATININE OR DECREASED CCr; I&O RATIO; REPORT HEMATURIA, OLIGURIA, FATIGUE, WEAKNESS; MAY INDICATE NEPHROTOXICITY; CHECK FOR PROTEIN IN URINE DURING TREATMENT
  • Blood studies: WBC, RBC, Hct, Hgb, bleeding time; blood dyscrasias may occur product should be discontinued
  • C&S before product therapy; product may be taken as soon as culture is taken; repeat C&S after treatment; determine the presence of other infections
  • Bowel pattern, before, during treatment; if severe abdominal pain with bleeding occurs, product should be discontinued
  • Skin eruptions: rash, urticaria, itching
  • Allergies before treatment, reaction of each medication; place allergies on chart in bright red letters
  • Neurologic status with herpes encephalitis

PERFORM/PROVIDE:
-adequate intake of fluids (2L) to prevent deposits in kidneys

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7
Q

Acyclovir

Overdose Treatment

A

Discontinue product, hemodialysis, resuscitate if needed

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8
Q

Ganciclovir

Functional Classification

A

Antiviral

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9
Q

Ganciclovir

Chemical Classification

A

Synthetic Nucleoside Analog

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10
Q

Ganciclovir

Mechanism of Action

A

Inhibits replication of herpesviruses; competitively inhibits human CMV DNA polymerase and is incorporated, resulting in termination of DNS elongation

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11
Q

Ganciclovir

Uses

A

Cytomegalovirus (CMV) retinitis in immunocompromised persons, including those with AIDS, after indirect ophthalmoscopy confirms diagnosis; prophylaxis for CMV in transplantation

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12
Q

Ganciclovir

Contraindications

A

Hypersensitivity to acyclovir, ganciclovir, famciclovir, penciclovir, valacyclovir, valganciclovir

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13
Q

Ganciclovir

Side Effects

A

CNS: Fever, chills, COMA, Confusion, abnormal thoughts, dizziness, bizarre dreams, Headache, psychosis, tremors, somnolence, Paresthesia, Weakness, SEIZURES, peripheral neuropathy
CV: dysrhythmia, hypo/hypertension
EENT: retinal detachment in CMV retinitis, ocular hypertension, ocular pain, conjunctival scarring, cataracts
GI: Abnormal LFTs, Nausea, Vomiting, Anorexia, Diarrhea, Abdominal Pain, HEMORRHAGE, PERFORATION, PANCREATITIS
GU: HEMATURIA, Increased Creatinine, BUN
HEMA: GRANULOCYTOPENIA, THROMBOCYTOPENIA, IRREVERSIBLE NEUTROPENIA, ANEMIA, EOSINOPHILIA, PANCYTOPENIA
INTEG: Rash, alopecia, Pruritus, urticaria, pain at site, phlebitis
RESP: dyspnea

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14
Q

Ganciclovir

Nursing Considerations

A

ASSESS:

  • CMV RETINITIS: culture should be completed before starting treatment (urine, blood, throat), ophthalmic exam
  • INFECTION: increased temp, sore throat, chills, fever; report to prescriber
  • LEUKOPENIA/NEUTROPENIA/THROMBOCYTOPENIA: CBC, WBCs, platelets q2days during 2x/day dosing and then q1wk for leukopenia with daily WBC count in patients with prior leukopenia with other nucleoside analogs or for whom leukopenia counts are /=q2wk, BUN; LFTs; ophthalmic exam
  • For seizures, dysrhythmias
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15
Q

Idinavir

Functional Classification

A

Antiretroviral

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16
Q

Idinavir

Chemical Classification

A

Protease Inhibitor

17
Q

Idinavir

Mechanism of Action

A

Inhibits human immunodeficiency virus (HIV-1) protease; this prevents the maturation of the virus

18
Q

Idinavir

Uses

A

HIV-1 in combination with at least 2 other antiretrovirals

19
Q

Idinavir

Contraindications

A

Hypersensitivity, breastfeeding

20
Q

Idinavir

Side Effects

A

CNS: Headache, Insomnia, dizziness, somnolence
GI: Diarrhea, Abdominal Pain, Nausea, Vomiting, anorexia, dry mouth
GU: nephrolithiasis
INTEG: rash
MS: Pain
OTHER: asthenia, INSULIN-RESISTANT HYPERGLYCEMIA, hyperlipidemia, KETOACIDOSIS, lipodystrophy

21
Q

Idinavir

Nursing Considerations

A

ASSESS:

  • Complaints of lower back, flank pain; indicates kidney stones
  • Signs of infection, anemia, presence of other sexually transmitted diseases
  • Blood/hepatic studies: ALT, AST; total bilirubin, amylase, blood glucose, serum cholesterol/lipid profile, may be elevated
  • Plasma HIV RNA, viral load, CD4 during treatment
  • Bowel pattern before, during treatment; if severe abdominal pain with bleeding occurs, product should be discontinued; monitor hydration
  • Skin eruptions; rash, urticaria, itching
  • Allergies before treatment, reaction of each medication; place allergies on chart
22
Q

Nevirapine

Functional Classification

A

Antiretroviral

23
Q

Nevirapine

Chemical Classification

A

Nonnucleoside reverse transcriptase inhibitor (NNRTI)

24
Q

Nevirapine

Mechanism of Action

A

Binds directly to reverse transcriptase and blocks RNA, DNA, thus causing a disruption of the enzyme’s site

25
Q

Nevirapine

Uses

A

HIV-1 in combination with other highly active antiretroviral therapy (HAART)

26
Q

Nevirapine

Contraindications

A

Hypersensitivity, hepatic disease

27
Q

Nevirapine

Side Effects

A

CNS: Paresthesia, Headache, Fever, Peripheral Neuropathy
GI: Diarrhea, abdominal pain, Nausea, Stomatitis, HEPATOTOXICITY, HEPATIC FAILURE
HEMA: NEUTROPENIA, ANEMIA, THROMBOCYTOPENIA
INTEG: Rash, TOXIC EPIDERMAL NECROLYSIS
MISC: STEVENS-JOHNSON SYNDROME, ANAPHYLAXIS
MS: pain, myalgia, RHABDOMYOLYSIS

28
Q

Nevirapine

Nursing Considerations

A

ASSESS

  • Resistance testing before therapy and when therapy fails
  • Signs of infection, anemia, hepatotoxicity, immune reconstitution syndrome; hepatitis B or C, liver toxicity may occur
  • HIV: blood studies during treatment: ALT, AST, viral load, CD4, plasma HIV RNA, renal studies; if LFTs elevated significantly, product should be withheld; glucose levels in diabetic patients
  • RHABDOMYOLYSIS: pain, tenderness, weakness, edema; product should be discontinued
  • Bowel pattern before, during treatment; if severe abdominal pain with bleeding occurs, product should be discontinued; monitor hydration
  • STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, allergies before treatment, reaction to each medication; skin eruptions; rash, urticaria, itching; if rash is severe or systemic symptoms occur, discontinue immediately
29
Q

Zidovudine (Retrovir)

Functional Classification

A

Antiretroviral

30
Q

Zidovudine (Retrovir)

Chemical Classification

A

Nucleoside reverse transcriptase inhibitor (NRTI)

31
Q

Zidovudine (Retrovir)

Mechanism of Action

A

Inhibits replication of HIV-1 virus by incorporating into cellular DNA by viral reverse transcriptase, thereby terminating the cellular DNA chain

32
Q

Zidovudine (Retrovir)

Uses

A

Used in combination with at least 2 other antiretrovirals for HIV-1 infection

33
Q

Zidovudine (Retrovir)

Contraindications

A

Hypersensitivity

34
Q

Zidovudine (Retrovir)

Side Effects

A

CNS: Fever, Headache, Malaise, diaphoresis, Dizziness, Insomnia, paresthesia, somnolence, chills, tremor, twitching, anxiety, confusion, depression, lability, vertigo, loss of mental acuity, SEIZURES, malaise
EENT: taste change, hearing loss, photophobia
GI: Nausea, Vomiting, Diarrhea, Anorexia, cramps, Dyspepsia, Constipation, dysphagia, Flatulence, rectal bleeding, mouth ulcer, abdominal pain, HEPATOMEGALY
GU: dysuria, polyuria, urinary frequency, hesitancy
HEMA: GRANULOCYTOPENIA, ANEMIA
INTEG: Rash, acne, pruritus, urticaria
MS: myalgia, arthralgia, muscle spasm
RESP: dyspnea
SYST: LACTIC ACIDOSIS

35
Q

Zidovudine (Retrovir)

Nursing Considerations

A

ASSESS:

  • Blood counts q2wk; watch for decreasing granulocytes, Hgb; if low, therapy may have to be discontinued and restarted after hematologic recovery; blood transfusions may be required; viral load, CD4 counts, LFTs, plasma HIV RNA, serum creatinine/BUN at baseline and throughout treatment
  • LACTIC ACIDOSIS, SEVERE HEPATOMEGALY WITH STEATOSIS: Obtain baseline liver function tests, if elevated, discontinue treatment; discontinue even if liver function tests are normal but lactic acidosis, hepatomegaly are present; may be fatal
36
Q

Acyclovir

Functional Classification

A

Antiviral

2571: EXAM 3 (26 decks)

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