Antiviral drugs ( oseltamivir , acyclovir, zidovudine)
Case Study Robert is a 30-year old stockbroker who has been diagnosed with genital herpes simplex (HSV-2) infection. The health care provider has prescribed topical acyclovir (Zovirax).
1. What patient teaching do you provide to Robert regarding administration of this drug? Wear gloves 2. Robert asks you how long it will take for acyclovir to his herpes. What is your reply? Can not be cured. Can manage symptoms 3. What else will you discuss with Robert, who is sexually active? Discuss treatment and ways to prevent virus
The order for a 1-year-old child reads, "Give amantadine 4.4mg/kg/day in 2 divided doses." The child weights 22lb. How many milligrams will the child receive per dose?
22 mg
Which intervention would the nurse question for client who diagnosis influenza but has had symptoms for 4 days?
A. Acetaminophen B. Ibuprofen C. Oseltamivir * D. Antihistamine such as loratadine for rhinorrhea (runny nose)
Key drug for herpes viruses
Acyclovir(zovirax)
Nursing Implications
Assessment Diagnosis. Decrease level of knowledge related to lack of information and experience about the viral infection Planning • Patient demonstrates improved knowledge about disease process. Implementation ~ good hand washing. Wear gloves when applying medication. Talk to doctor if taking orher medications, let patient know that antiviral medication is not a cure it helps with symptoms . Tell patient to start medication as soon as symptoms start Evaluation. Monitor for theraputic effects
As a nurse what do you monitor with antiviral drugs?
Energy, wt loss, vs, labs ans superinfections
Antiretroviral
HIV HAART three or more medications
Antiretroviral
HIV and HAART drug: MOA Indications- HIV Contraindications- known severe drug allergy other intolerable toxicity Interactions- -Cytotreere duug, Asyclover Adverse effects- bone marrow suppression nausea , Nursing Implications- Assess energy level, weight loss, vital signs, lab values including CD4 cells Assess for superinfections
4 routes a virus can enter the body
Inhalation Ingestion Transplacentally • Inoculation ~ by mucuos membranes, bite or blood transfusion
Does antiviral drug work well with a immunocomprised infection? (Weak immune system)
No. Oppoortunity for infection. Requires long term protophalasis and anti~infective drug therapy
Antivirals Categories
Nonretroviral &. Antiretroviral
Acyclovir (Zovirax)
Used for chicken pox or shingles Must wear gloves when applying Side effects is nausea vomiting ans headache
What can a virus do to a cell?
Takes the host cell
oseltamivir (Tamiflu) nonretroviral drug
Treats infuenza A& B Must be started with in 48 hours ~ 2days of symptoms Reduces duration of illness Side effect is nausea and vomiting
Summary
Viruses are hard to treat because they are inside the cell Antiviral drugs work well with strong immune system Monitor for infection Two categories of antiviral- nonretroviral (non HIV) and antiretroviral (HIV)
Antiretroviral Key drug:
Zidovudine (Retrovir) Onset- 6 months
Nonretroviral virus
herpes simplex, varicella zoster, cytomegalovirus, herpes simplex , influenza A&B
Antiviral drugs MOA-
kills or suppress the virus Works well with a good immune system
Key drug for influenza A &B
oseltamivir (Tamiflu)
Antiretroviral -Key Drug
zidovudine/lamivudine/abacavir (Trizivir)
Nonretroviral
МОА treatment of non HIV Indications Contraindications ~ hypersensitivity, immunosuppressed patients with shingles * Renal disease, lactation, pregnancy, dehydration Interactions ~ interferon, dopamine, probenazide Adverse effects Nursing Implications ~ assess infection, anemia, hemauria, hepatic blood sheading, CNS treatment, increase fluids, report fever, fatique, bleeding, malaise, assess hepatic and renal function, ( bun, cr, ast, alt). Teel patient to take full course
Antiviral drugs uses
• Cytomegalovirus (CMV) • Hepatitis viruses Herpesviruses HIV • Influenza viruses (the "flu") • Respiratory syncytial virus (RSV)
