Lilley Chapter 45: Antiviral Drugs Flashcards
The nurse is obtaining a medication history from a patient diagnosed with genital herpes. Which drug would the nurse expect this patient to be prescribed?
A. amantadine
B. acyclovir (Zovirax®)
C. ribavirin (Virazole®)
D. zidovudine (Retrovir®)
B. acyclovir (Zovirax®)
Acyclovir is the drug of choice to treat herpes simplex infections, which includes the virus type 2 that causes genital herpes. Ribavirin is effective against respiratory syncytial virus, zidovudine against human immunodeficiency virus (HIV), and amantadine against Haemophilus influenzae type A.
To assess for the dose-limiting toxicity of ganciclovir (Cytovene®), the nurse will monitor which laboratory test result?
A. Creatine phosphokinase
B. Blood urea nitrogen
C. Liver function tests
D. Complete blood count (CBC)
D. Complete blood count (CBC)
Bone marrow suppression is a dose-limiting toxicity of ganciclovir; therefore, the CBC should be monitored.
Medications used to treat HIV infections are more specifically classified as what type of drugs?
A. Antifungal
B. Antiviral
C. Antiparasitic
D. Antiretroviral
D. Antiretroviral
HIV is a member of the retrovirus family; therefore, drugs used to treat this virus are classified as antiretroviral drugs. Although antiretroviral drugs also fall under the broader category of antiviral drugs in general, their mechanisms of action are unique to the acquired immune deficiency syndrome virus. So, they are more commonly referred to by their subclassification as antiretroviral drugs.
How is the effectiveness of antiviral drugs administered to treat HIV infection assessed and evaluated?
A. By viral load
B. By red blood cell counts
C. By lymphocyte counts
D. By megakaryocytes
A. By viral load
All antiretroviral drugs work to reduce the viral load, which is the number of viral ribonucleic acid (RNA) copies per millilitre of blood.
Which patient statement regarding his or her diagnosis of HIV infection indicates a need that further teaching is necessary?
A. “I don’t need to use condoms as long as I take my medication as prescribed.”
B. “I should remain upright for 30 minutes after taking my zidovudine to prevent esophageal ulceration.”
C. “I must take these medications exactly as prescribed for the rest of my life.”
D. “I will notify my health care provider immediately if I bruise or bleed more easily than normal.”
A. “I don’t need to use condoms as long as I take my medication as prescribed.”
Antiretroviral drugs do not stop the transmission of HIV, and patients need to continue standard precautions and safe sex practice, including condom use. Potential serious adverse effects of zidovudine are bone marrow suppression and esophageal ulceration.
When providing health promotion teaching at a centre for older adults, the nurse would include information about which medication used to decrease the duration of influenza A and B?
A. enfuvirtide (Fuzeon®)
B. indinavir (Crixivan®)
C. oseltamivir (Tamiflu®)
D. ganciclovir (Cytovene®)
C. oseltamivir (Tamiflu®)
Oseltamivir (Tamiflu) and zanamivir (Relenza®) are active against influenza virus types A and B and have been shown to reduce the duration of influenza infection by several days.
A new vaccine, Zostavax®, has been approved to prevent the development of what condition in adults older than 60 years of age?
A. Herpes zoster
B. Avian influenza
C. Herpes simplex
D. Influenza A
A. Herpes zoster
Zoster vaccine is a vaccine for the prevention of herpes zoster. Herpes zoster, also known as shingles, is an extremely painful condition caused by the varicella-zoster virus that also causes chickenpox. The vaccine is approved for patients 60 years of age or older to prevent reactivation of the zoster virus that causes shingles, although patients as young as 50 years of age may receive it. Zostavax is a one-time vaccine.
The most significant drug interactions with the use of antivirals occur when antivirals are administered how in regard to route?
A. Rectally
B. Topically
C. Optically
D. Intravenously
D. Intravenously
Significant drug interactions that occur with antiviral drugs arise most often when they are administered via systemic routes such as intravenously and orally. Many of these drugs are also applied topically to the eye or body, however, and the incidence of drug interactions associated with these routes of administration is much lower.
Through which of the following routes can viruses enter the body? (Select all that apply.)
Select all that apply.
A. Localized allergic reaction to medication
B. Inhalation through the respiratory tract
C. Through an animal bite
D. Ingestion via the gastrointestinal tract
E. Transplacentally from mother to infant
B, C, D, E.
Viruses can enter the body through at least four routes: (1) inhalation through the respiratory tract, (2) ingestion via the GI tract, (3) transplacentally via mother to infant, and (4) inoculation via skin or mucous membranes. The inoculation route can take several forms, including sexual contact, blood transfusions, sharing of syringes or needles, organ transplantation, and animal bites (including human, animal, insect, spider, and others). Viruses cannot enter the body through an allergic reaction caused by medication.
Which types of antiviral drugs are used to treat HIV infection? (Select all that apply.)
Select all that apply.
A. Fusion inhibitors
B. Reverse transcriptase inhibitors
C. Protease inhibitors
D. Neuraminidase inhibitors
E. Nonnucleoside reverse transcriptase inhibitors
A, B, C, E.
Neuraminidase inhibitors are used in the treatment of the influenza virus.
Before administration of any antiviral medication, what nursing responsibilities would be performed? (Select all that apply.)
Select all that apply.
A. Monitoring for medication adverse effects
B. Head-to-toe physical assessment
C. History of medication use
D. Documentation of known allergies
E. Assessment of baseline vital signs
B, C, D, E.
Before administering an antiviral drug, perform a thorough head-to-toe physical assessment and take a medical and medication history. Document any known allergies before use of these and any other medications. Also assess the patient’s nutritional status and baseline vital signs because of the profound effects of viral illnesses on physiological status, especially if the patient is immunocompromised. Assess and document any contraindications, cautions, and drug interactions associated with all of the antiviral drugs. Monitoring for adverse effects would occur after the medication has been administered.
