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Ppt chapter 10

Nov 12, 2014

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  • 1. Antiviral AgentsChapter 10Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

2. Viruses That Respond to Antiviral Therapy Influenza A and some respiratory viruses Herpes viruses Cytomegalovirus (CMV) Human immunodeficiency virus (HIV) that causesacquired-immune deficiency syndrome (AIDS) Some viruses that cause warts and certain eye infectionsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 3. Antivirals Across the LifespanCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 4. Characteristics of Common Viruses A virus cannot replicate on its own. It must attach to and enter a host cell. It then uses the host cells energy to synthesize protein,DNA, and RNA.Viruses are difficult to kill because they live inside our cells. Any drug that kills a virus may also kill our cells.Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 5. Stages of Virus ReplicationCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 6. Characteristics of Antiviral Drugs Able to enter the cells infected with virus Interfere with viral nucleic acid synthesis and/orregulation Some agents interfere with ability of virusto bind to cells Some agents stimulate the bodys immune systemCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 7. Common Respiratory Viruses Influenza A Influenza B Respiratory Syncytial VirusCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 8. Signs and Symptoms of RespiratoryViruses Cough Fever Inflammation of the nasal mucosa Inflammation of the mucosa of the respiratory trackCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 9. Influenza A and Respiratory Viruses Action Prevent shedding of the viral protein coat Pharmacokinetics Administered oral, excretedunchanged in the urine Contraindications Allergy, pregnancy, or lactating Adverse Reactions Dizziness, insomnia, nausea,orthostatic hypotension Drug-to-Drug Interactions Anticholinergic agentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 10. Nursing Considerations for RespiratoryAntiviral Therapy Assessment: History and Physical Exam Nursing Diagnosis Implementation EvaluationCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 11. Prototype of Respiratory Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 12. QuestionTell whether the following statement is true or false.Treatment of a viral infection is difficult without serioustoxic effects for the host.Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 13. AnswerTrueRationale: A virus must enter a human cell to survive,making it difficult to treat without serious toxic effects forthe host.Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 14. Signs and Symptoms of Herpes Virus Painful vesicles that often occur in clusters on skin,cornea, or mucous membranes. Usual course of primary disease is two weeks Duration of recurrences variesCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 15. Signs and Symptoms of CMV May be asymptomatic Fatigue Nausea Jaundice If contracted during pregnancy can result in stillbirth,brain damage, or birth defects.Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 16. Herpes and Cytomegalovirus Action Inhibit viral DNA replication by competing withviral substrates to form shorter, non-effective DNA chains Pharmacokinetics Administered oral, IV or topically,excreted unchanged in the urine Contraindications Pregnancy and lactation Adverse Reactions Nausea, vomiting, headache, rash,and hair loss Drug-to-Drug Interactions Nephrotoxic drugs,zidovudineCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 17. Prototype of Herpes and CytomegalovirusAgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 18. Nursing Considerations for Herpes Virusand Cytomegalovirus Assessment: History and Physical Exam Nursing Diagnosis Implementation EvaluationCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 19. Signs and Symptoms of HIV/AIDS Attach helper T-cells Acute Infection Fever, rash, myalgia Asymptomatic Infection Follows acute infectionduration varies Persistent Generalized Lymphadenopathy Adenopathypersists more than 3 months Constitutional Symptoms: Fever lasting more than amonth, involuntary weight loss, chronic fatigue. Neurological Disease DementiaCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 20. Signs and Symptoms of HIV/AIDS (cont.) Secondary Infections Pneumocystis carinii,disseminated herpes simplexCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 21. QuestionYou are caring for a patient that has been diagnosed with herpessimplex and are given a prescription. What should you teachthis patient about taking their medication?A. When applying the drug topically be sure to use absorbentpads to decrease risk of exposure to the drug.B. Warn the patient that GI upset, nausea, and vomiting are tobe expected.C. Start taking the medicine as soon as possible to improveeffectiveness of antiviral activity.D. Be sure to take most of the medication prescribed toimprove effectiveness of antiviral activity.Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 22. AnswerC. Start taking the medicine as soon as possible to improveeffectiveness of antiviral activity.Rationale: Administer the drug as soon as possible afterthe diagnosis has been made to improve effectiveness ofthe antiviral activity.Copyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 23. Drugs Used to Treat HIV/AIDS Reverse Transcriptase Inhibitors Protease Inhibitors Nucleosides Fusion InhibitorsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 24. Reverse Transcriptase Inhibitors Action Bind directly to HIV reverse transcriptaseblocking both RNA and DNA dependent DNA polymeraseactivities Pharmacokinetics Given orally, metabolized in the liver,excreted in the urine Contraindications Pregnancy and lactation Adverse Reactions Headache, nausea, vomiting, rash,chills, fever, diarrheaCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 25. Protease Inhibitors Action Block protease activity within the HIV virus Pharmacokinetics Contraindications Pregnancy and lactation Adverse Reactions Drug-to-Drug InteractionsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 26. Nucleosides Action Interfere with HIV replication by inhibiting cellprotein synthesis Pharmacokinetics Given orally or IV; metabolized in theliver and excreted in the urine Contraindications Adverse Reactions HA, insomnia, dizziness, nausea,diarrhea, fever, rash Drug-to-Drug InteractionsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 27. Fusion Inhibitors Action Prevents the fusion of the virus with the humancellular membrane Pharmacokinetics Given sub-q; metabolized in the liverit is recycled in the tissues it is not excreted Contraindications No true contraindication Adverse Reactions HA, dizziness, myalgia, nausea,vomiting, and diarrhea Drug-to-Drug Interactions Pimozide, rifampin,triazolam, midazolam, oral contraceptiveCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 28. Prototype of HIV/AIDS Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 29. Prototype of HIV/AIDS Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 30. Prototype of HIV/AIDS Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 31. Prototype of HIV/AIDS Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 32. Prototype of HIV/AIDS Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 33. Prototype of HIV/AIDS Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 34. Nursing Considerations for HIV/AIDSAntiviral Therapy Assessment: History and Physical Exam Nursing Diagnosis Implementation EvaluationCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 35. QuestionYou are caring for a patient with HIV. A nursing diagnosisfor this patient is acute pain related to GI, CNS, ordermatological effects of the drugs. What type of drug isthis patient taking?A. Integrase InhibitorB. NucleosideC. Reverse Transcriptase InhibitorD. Protease inhibitorCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 36. AnswerA. Integrase InhibitorRationale: Nursing diagnoses related to drug therapy mightinclude: Acute Pain related to GI, CNS, or dermatologicaleffects of the drugsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 37. Anti-Hepatitis B Agents Therapeutic Actions and Indications Pharmacokinetics Contraindications and Cautions Adverse Effects Clinically Important DrugDrug InteractionsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 38. Nursing Considerations for ReceivingAgents for Hepatitis B Assessment: History and Physical Exam Nursing Diagnosis Implementation EvaluationCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 39. Prototype of Hepatitis B Antiviral AgentsCopyright 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 40. Locally Active Antiviral Agents Action Act on viruses by interfering with normal viralreplication and metabolic processes Pharmacokinetics Not absorbed systemically Contraindications Allergy to the drug Adverse Reactions Local burning, stinging, anddiscomfort Drug-to-Drug InteractionsCopyright 2013 Wolters