Antiviral Medications

Acyclovir

• Acts by inhibiting viral DNA polymerase to stop replication
• Helps with HSV-1, HSV-2, and VZV outbreaks like oral/genital herpes, chickenpox, and shingles
• Causes nausea, diarrhea, and nephrotoxicity through IV, plus local irritation topically
• Implement proper hygiene by wearing gloves and washing hands, start treatment at the first sign, but know it's not a cure

Ribavirin

• Indicated for RSV in babies via inhalation and Hepatitis C
• Can lead to teratogenic issues, anemia, conjunctivitis, bronchospasm

Remdesivir

• Aimed at hospitalized COVID-19 patients
• Causes elevated liver enzymes and infusion reactions

Influenza A & B

• Counters flu symptoms for both treatment and prevention
• Symptoms include fever, chills, cough, and fatigue
• Use Oseltamivir (Tamiflu), Zanamivir (Relenza) within 48 hours
• Causes nausea, vomiting, and sinusitis

Antiviral Summary

• Blocks viral replication through DNA/RNA interference
• Treats herpes, hepatitis, flu, CMV, RSV, and COVID
• Can cause GI upset, nephrotoxicity, headaches, and impact the liver

HIV Stages & Treatment

• Progresses from acute infection to latency to AIDS, with low CD4 counts
• Treat with HAART, involving 3+ drugs
• NRTIs like Zidovudine suppress bone marrow
• NNRTIs, PIs, fusion inhibitors, and CCR5 antagonists such as Maraviroc are utilized, needs liver monitoring
• Integrase inhibitors, like Raltegravir, may carry myopathy risk
• PrEP is a preventative measure using Tenofovir + Emtricitabine (Truvada)

Antitubercular Drugs

• Used to treat active or latent tuberculosis for 3-6 months with sputum to examine effectiveness
• Avoid those with liver disease
• Can cause liver damage, nerve issues, orange secretions, or optic neuritis

Common Antitubercular Drugs

• Isoniazid (INH) damages the liver and nerves, so give Vitamin B6
• Rifampin causes red-orange secretions, lowers effectiveness of oral contraceptives
• Ethambutol gives optic neuritis
• Pyrazinamide hurts the liver and is a gout risk
• Streptomycin is toxic to ears and kidneys

Antitubercular Patient Care

• Take all prescribed medicines daily for 6–12 months
• Avoid alcohol and monitor liver enzymes
• Report jaundice and vision or hearing changes
• Sputum cultures are needed for diagnosis and monitoring

Antifungal Drugs

• Break down fungal cell membranes
• Treats thrush, skin infections, and systemic fungal infections

Key Antifungal Drugs

• Nystatin: After swishing and swallowing, don't eat or drink for 30 minutes
• Amphotericin B is IV-only and is reserved for serious infections due to nephrotoxic, also can cause shake & bake reaction
• Fluconazole can be taken orally or IV, used for candida, causing fewer side effects, liver monitoring
• Terbinafine treats nail fungus as a topical or oral

Antifungal Nursing

• Watch liver/renal labs
• Premedicate before giving amphotericin B
• Finish the full course of treatment
• Use gloves and hygiene when applying topical medications

Antimalarials

• Stops parasite replication in blood or liver
• Includes Hydroxychloroquine for RA, lupus, and malaria
  • Carries risk of retinopathy
• Quinine for Cinchonism (tinnitus, vision changes)
• Primaquine for liver phase, requires G6PD screening
• Mefloquine can cause CNS effects, avoid in psych disorders
• Should be taken 1-2 weeks before entering country and 4-8 weeks after

Antiprotozoals

• Metronidazole acts against Trichomoniasis, giardiasis, and C. diff, no alcohol
• Pentamidine helps against Pneumocystis pneumonia, watch BP and glucose
• Finish full course, report nerve or vision symptoms
• Should be taken with food, and avoid alcohol

Chemotherapy Drugs

• Chemotherapy side effects
  • Fatigue
  • Mucositis
  • Nausea
  • Diarrhea

Cell Cycle Specific (CCS)

• Act in phases like methotrexate
• General side effects
  • Affects bone marrow
  • Causes toxicity of organs

Cell Cycle Non-Specific (CCNS)

• Can affect cells in all cycles, like cyclophosphamide
• Can cause alopecia

Methotrexate

• Used for breast cancer
• Folate Antagonist, Nursing to rescue Monitor Liver & LFTs
• Nursing must monitor liver, CBC, LFTs, patients should take leucovorin

Hormonal Agents

• Tamoxifen treats breast cancer
  • Carries endometrial cancer risk
  • Side effects can include stroke and clots or reports of leg swelling and call for order, suspect DVT
• Anastrozole is for postmenopausal patients, can cause bone loss
• Megestrol stimulates appetite, carries clot risk

Safe Drug Administration

• If extravasation occurs, stop the infusion, aspirate the drug, give an antidote, then apply compression

Vaccines

• Body makes antibodies to fight long term illness
• Contraindications include immunosuppression or allergy.

Vaccine Specifics

• DTaP/Tdap: helps Prevent diphtheria, pertussis, can be for tetanus
• Hep B: yeast allergy
• Flu Yearly injection
• HPV Given from ages 11 and 12, it prevents the risk of cervical cancer, and contains yeast allergy
• Shingles Zoster : Adults, 50+

Passive Immunity

• Provides short term, immediate relief
• includes, HBIG, RIG, TIG, antivenins
• must educate about allergies and monitor for redness and fever once administering.

Medication Considerations

• Must educate and screen for allergies, keep a close eye 15 min past injection

H. Pylori

• Treat with Triple therapy : PPI +2 Antibiotics, needs to be completed fully, can't use NSAIDs
• Should not be stopped

Antacids

• Antacids help neutralize stomach acid
• Be careful when giving to individuals with renal failure due to possible hypermagnesemia,
• Must educate and give one to two hours prior and after medications.

PPI Medication

• PPI should be carefully taken as it has adverse affects such as increasing C. Diff as well as risk for fractures
• PPI indications, includes Gerd, H. Pylori, Ulcers
• Medication should never be crushed
• Take before Meals