Antiviral Agents
Understanding Viruses <ul><li>Viral Replication </li></ul><ul><li>A virus cannot replicate on its own. </li></ul><ul><li>I...
Understanding Viruses <ul><li>Viruses are difficult to kill because they live inside our cells. </li></ul><ul><li>Any drug...
Viral Infections <ul><li>Competent immune system: </li></ul><ul><li>Best response to viral infections </li></ul><ul><li>A ...
Antivirals <ul><li>Key characteristics of antiviral drugs: </li></ul><ul><li>Able to enter the cells infected with virus. ...
Antivirals <ul><li>Viruses killed by current antiviral therapy: </li></ul><ul><li>cytomegalovirus (CMV) </li></ul><ul><li>...
Antivirals: Mechanism of Action <ul><li>Inhibit viral replication </li></ul><ul><li>Inhibit viral attachment </li></ul><ul...
Antivirals  Synthetic Purine Nucleoside Analogues <ul><li>Two types of nucleosides: </li></ul><ul><li>Purine nucleosides <...
Antivirals: Purine Nucleosides <ul><li>Agent Antiviral Activity </li></ul><ul><li>guanines </li></ul><ul><li>acyclovir HSV...
Antivirals: Pyrimidine Nucleosides <ul><li>Agent Antiviral Activity </li></ul><ul><li>cytosines </li></ul><ul><li>lamivudi...
Other Antivirals <ul><li>amantadine  (Symmetrel) and rimantadine (Flumadine) </li></ul><ul><li>influenza A </li></ul><ul><...
Antivirals:  Side Effects <ul><li>acyclovir </li></ul><ul><li>Burning when topically applied, nausea, vomiting, diarrhea, ...
Antivirals:  Side Effects <ul><li>zidovudine (AZT) </li></ul><ul><li>Bone marrow suppression, nausea, headache </li></ul><...
Antivirals: Nursing Implications <ul><li>Before beginning therapy, thoroughly  assess underlying disease and medical histo...
Antivirals:  Nursing Implications <ul><li>Be sure to teach proper application technique for ointments, aerosol  powders, e...
Antivirals:  Nursing Implications <ul><li>Instruct patients to consult their physician before taking any other medication,...
Antivirals:  Nursing Implications <ul><li>Instruct patients on the importance of taking these medications exactly as presc...
Antivirals:  Nursing Implications <ul><li>Monitor for side effects: </li></ul><ul><li>effects are varied and specific to e...
Antivirals:  Nursing Implications <ul><li>Monitor for therapeutic effects: </li></ul><ul><li>effects will vary depending o...
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NurseReview.Org - Antivirals Updates (teaching pharmacology terminology for lpn nursing students)

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NurseReview.Org - Antivirals Updates (teaching pharmacology terminology for lpn nursing students)

  1. 1. Antiviral Agents
  2. 2. Understanding Viruses <ul><li>Viral Replication </li></ul><ul><li>A virus cannot replicate on its own. </li></ul><ul><li>It must attach to and enter a host cell. </li></ul><ul><li>It then uses the host cell’s energy to synthesize protein, DNA, and RNA. </li></ul>
  3. 3. Understanding Viruses <ul><li>Viruses are difficult to kill because they live inside our cells. </li></ul><ul><li>Any drug that kills a virus may also kill our cells. </li></ul>
  4. 4. Viral Infections <ul><li>Competent immune system: </li></ul><ul><li>Best response to viral infections </li></ul><ul><li>A well-functioning immune system will eliminate or effectively destroy virus replication </li></ul><ul><li>Immunocompromised patients have frequent viral infections </li></ul><ul><li>Cancer patients, especially leukemia or lymphoma </li></ul><ul><li>Transplant patients, due to pharmacological therapy </li></ul><ul><li>AIDS patients, disease attacks immune system </li></ul>
  5. 5. Antivirals <ul><li>Key characteristics of antiviral drugs: </li></ul><ul><li>Able to enter the cells infected with virus. </li></ul><ul><li>Interfere with viral nucleic acid synthesis and/or regulation. </li></ul><ul><li>Some agents interfere with ability of virus to bind to cells. </li></ul><ul><li>Some agents stimulate the body’s immune system. </li></ul>
  6. 6. Antivirals <ul><li>Viruses killed by current antiviral therapy: </li></ul><ul><li>cytomegalovirus (CMV) </li></ul><ul><li>herpes simplex virus (HSV) </li></ul><ul><li>human immunodeficiency virus (HIV) </li></ul><ul><li>influenza A (the “flu”) </li></ul><ul><li>respiratory syncytial virus (RSV) </li></ul>
  7. 7. Antivirals: Mechanism of Action <ul><li>Inhibit viral replication </li></ul><ul><li>Inhibit viral attachment </li></ul><ul><li>Prevent genetic copying of virus </li></ul><ul><li>Prevent viral protein production </li></ul>
  8. 8. Antivirals Synthetic Purine Nucleoside Analogues <ul><li>Two types of nucleosides: </li></ul><ul><li>Purine nucleosides </li></ul><ul><li>guanine </li></ul><ul><li>adenosine </li></ul><ul><li>Pyrimidine nucleosides </li></ul><ul><li>thymine </li></ul><ul><li>cytosine </li></ul>
  9. 9. Antivirals: Purine Nucleosides <ul><li>Agent Antiviral Activity </li></ul><ul><li>guanines </li></ul><ul><li>acyclovir HSV 1 & 2, VZV </li></ul><ul><li>ganciclovir (DHPG) CMV retinitis and systemic CMV infection </li></ul><ul><li>ribavirin (RTCD) Influenza types A and B, RSV, LV, HV </li></ul><ul><li>adenosines </li></ul><ul><li>didanosine (ddl) HIV </li></ul><ul><li>vidarabine (Ara-A) HSV, herpes zoster </li></ul>
  10. 10. Antivirals: Pyrimidine Nucleosides <ul><li>Agent Antiviral Activity </li></ul><ul><li>cytosines </li></ul><ul><li>lamivudine (3TC) HIV </li></ul><ul><li>zalcitabine (ddC) HIV </li></ul><ul><li>thymine </li></ul><ul><li>idoxuridine (IDU) HSV </li></ul><ul><li>stavudine (d4T) HIV </li></ul><ul><li>trifluridine HSV </li></ul><ul><li>zidovudine (AZT) HIV </li></ul>
  11. 11. Other Antivirals <ul><li>amantadine (Symmetrel) and rimantadine (Flumadine) </li></ul><ul><li>influenza A </li></ul><ul><li>foscarnet (Foscavir) </li></ul><ul><li>CMV (retinitis and systemic) </li></ul><ul><li>Neuraminidase Inhibitors: oseltamivir (Tamiflu) and zanamivir (Relenza) </li></ul><ul><li>influenza types A and B </li></ul>
  12. 12. Antivirals: Side Effects <ul><li>acyclovir </li></ul><ul><li>Burning when topically applied, nausea, vomiting, diarrhea, headache </li></ul><ul><li>amantadine and rimantadine </li></ul><ul><li>Anticholinergic effects, insomnia, lightheadedness, anorexia, nausea </li></ul><ul><li>didanosine (ddl) </li></ul><ul><li>Pancreatitis, peripheral neuropathies, seizures </li></ul>
  13. 13. Antivirals: Side Effects <ul><li>zidovudine (AZT) </li></ul><ul><li>Bone marrow suppression, nausea, headache </li></ul><ul><li>foscarnet (Foscavir) </li></ul><ul><li>Headache, seizures, acute renal failure, nausea, vomiting, diarrhea </li></ul><ul><li>ganciclovir (Cytovene) </li></ul><ul><li>Bone marrow toxicity, nausea, anorexia, vomiting </li></ul>
  14. 14. Antivirals: Nursing Implications <ul><li>Before beginning therapy, thoroughly assess underlying disease and medical history, including allergies. </li></ul><ul><li>Assess baseline VS and nutritional status. </li></ul><ul><li>Assess for contraindications, conditions that may indicate cautious use, and potential drug interactions. </li></ul>
  15. 15. Antivirals: Nursing Implications <ul><li>Be sure to teach proper application technique for ointments, aerosol powders, etc. </li></ul><ul><li>Emphasize hand washing before and after administration of medications to prevent site contamination and spread of infection. </li></ul><ul><li>Patients should wear a glove or finger cot when applying ointments or solutions to affected areas. </li></ul>
  16. 16. Antivirals: Nursing Implications <ul><li>Instruct patients to consult their physician before taking any other medication, including OTC medications. </li></ul><ul><li>Emphasize the importance of good hygiene. </li></ul><ul><li>Inform patients that antiviral agents are not cures, but do help to manage symptoms. </li></ul>
  17. 17. Antivirals: Nursing Implications <ul><li>Instruct patients on the importance of taking these medications exactly as prescribed and for the full course of treatment. </li></ul><ul><li>With zidovudine: </li></ul><ul><li>Inform patients that hair loss MAY occur so that they are prepared for this rare adverse reaction. </li></ul><ul><li>This medication should be taken on an empty stomach. </li></ul>
  18. 18. Antivirals: Nursing Implications <ul><li>Monitor for side effects: </li></ul><ul><li>effects are varied and specific to each agent </li></ul>
  19. 19. Antivirals: Nursing Implications <ul><li>Monitor for therapeutic effects: </li></ul><ul><li>effects will vary depending on the type of viral infection </li></ul><ul><li>Effects range from delayed progression of AIDS and ARC to decrease in flu-like symptoms, decreased frequency of herpes-like flare-ups, or crusting over of herpetic lesions. </li></ul>

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