Quiz #2 Study Guide Flashcards
General principles of virology include
- A virus cannot replicate on its own.
- It must attach to and enter a host cell.
- It then uses the host cell’s energy to synthesize protein, DNA and RNA.
- Viruses are difficult to kill because they live inside cells. (Any drug that kills a virus also kill healthy cells)
Purpose of Antiviral Drugs
Kill or suppress the virus by destroying virions or inhibiting the ability of viruses to replicate; controlled by current antiviral therapy
Antiviral Drugs are used for
Cytomegalovirus Hepatitis viruses Herpesviruses HIV Influenza viruses Respiratory syncytial virus
What antiviral drugs are used to treat the flu?
Amantadine
Rimantadine
Oseltamivir
Amantadine
Only active against Influenza A viruses.
Adverse Effects of Amantadine
Insomnia Nervousness Lightheaded ness Anorexia, Nausea Anticholinergic Effects Orthostatic Hypotension Blurred vision
Oseltamivir
Active against influenza A and B
Reduces duration of illness.
Treatment should begin within 2 days of influenza symptom onset.
Adverse Effect of Oseltamivir
Causes nausea and vomiting
Herpes Zoster (Shingles) HHV-3
Painful: opioids for pain control.
Follows nerve tracts (dermatomes) usually unilateral.
What drugs are used to treat herpes zoster?
Acyclovir
Acyclovir
Speeds recovery from shingles.
(Best results are generally seen when the antiviral drug is started within 72 hours of symptom onset.)
Synthetic nucleoside analog
Used to suppress replication of HSV-1, HSV-2 and HSV-3.
Adverse Effects of Acyclovir
Nausea, diarrhea
Headache
Burning when topically applied
HIV: Virus Characteristics
-Non living, intracellular parasites -> do not have normal cellular structures -> have RNA OR DNA but NOT both.
Must be in a host cell to replicate.
-Has a capsid around it (protein coating that protects itself)
-Glycoproteins, envelope
What drugs are used to treat HIV?
Zidovudine
Nevirapine
Adverse effects of Zidovudine
Bone marrow depression
Nephrotoxicity
Hepatoxicity
Decreased WBC
Adverse Effects of Nevirapine
Nonnucleoside reverse transcriptase inhbitor
Used in combination w/ nucleoside reverse transcriptase inhibitors
Well tolerated
What is the purpose of immunosuppressants?
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What is the use of immunosuppressants?
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Nursing implications of immunosuppressants
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Organ transplant
Transplanted organs have antigens that trigger immune response - rejection.
What drugs are used to prevent organ rejection?
Azathioprine (prevents rejection of kidney transplants)
What are the adverse effects of azathioprine?
Bone Marrow Suppression
Development of Lymphoma and other malignancies
Hepatosplenic T-cell lymphoma
What is systemic lupus erythematous?
Multisystem autoimmune inflammatory disease.
Pathophysiology of SLE
Antibodies react with circulating antigen (nucleic acids, erythrocytes, phospholipids, lymphocytes, platelets, etc.)
Reaction forms circulating immune complexes.
Clinical Manifestations of SLE
Photosensitivity, scaly erythematous: Butterfly skin rash Plaques with follicular plugging Scarring Nonerosive arthritis, pancreatitis, vasculitis, anemia, GN, pleural effusion, endocarditis, thrombosis of intracranial vessels
Treatment options of SLE
Hydroxychloroquine Glucocorticoids NSAIDS Immunosuppressive agents Chronic Support - education, counseling, eat well, exercise
Rheumatoid Arthritis
Autoimmune disorder
Causes inflammation and tissue damage in joints; can also cause anemia, inflammation in lungs, eyes, and pericardium; SQ nodules under the skin.
Rheumatoid Arthritis Clinical Manifestations
Pain and Stiffness in joints (particularly in the wrist hands, elbows, shoulders, knees and ankles)
Reduced ROM
Affects both sides equally
Drugs used to treat Rheumatoid Arthritis
Methotrexate
Entaracept (DMARDs)
Methotrexate
Inhibits lymphocyte multiplication
Can be used to treat psoriasis and RA
Entanercept
Used to treat RA and psoriasis
Patients must be screened for latex allergy (some dosage forms may contain latex)
Adverse effects of Methotrexate
*Bone Marrow Suppression
Adverse Effects of Etanercept
Headache Injection Site Reaction URT Infection Dizziness Weakness
What is MS?
Autoimmune response which causes:
- Degeneration of CNS myelin
- Scarring in brain
- Loss of axons
Pathophysiology of MS
Autoreactive T and B cells cross the blood-brain barrier and recognize myelin and oligodendrocyte autoantigens
Triggers inflammation and loss of oligodendrocytes (myelin producing cells)
Activation of brain macrophages contribute to inflammation and injury with plaque formation and axonal degeneration
Loss of myelin disrupts nerve conduction and death of neurons and brain
Clinical Manifestations of MS
Most common: Parasthesia of the face, trunk, or limbs Weakness (all four limbs) Impaired gait Visual disturbances Urinary incontinence