Virology Pharmacology Quiz

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Questions and Answers

What is the primary mechanism of action for acyclovir?

Interrupts viral DNA replications (correct)

Blocks viral protein synthesis

Disrupts viral membrane integrity

Inhibits viral RNA synthesis

Which of the following is a serious nursing implication for ganciclovir?

May cause gastrointestinal distress

Can lead to granulocytopenia (correct)

Requires skin protection during application

Might affect liver function

What safety precaution should be taken when administering ribavirin?

Provide contraceptive precautions for males only

Ensure the drug is given in oral form only

Monitor for signs of cardiac arrest

Avoid administering to patients with renal impairment (correct)

What is a notable side effect of oseltamivir phosphate when used as a prophylactic treatment?

Nausea, vomiting, and diarrhea Signup and view all the answers

Which of the following is an important nursing implication when treating chronic hepatitis B with lamivudine?

Assess for potential pancreatitis Signup and view all the answers

What is the primary mechanism of action of zidovudine (AZT)?

Incorporates into viral DNA and terminates Signup and view all the answers

Which nursing implication is specifically associated with efavirenz?

Not for patients with hepatic impairment Signup and view all the answers

Which of the following is a contraindication for maraviroc?

Poor kidney function Signup and view all the answers

What is a significant risk associated with the use of zidovudine?

Granulocytopenia Signup and view all the answers

What is the key benefit of using raltegravir in treatment?

Effective for resistant HIV-1 strains Signup and view all the answers

Which nursing implication is crucial when administering saquinavir mesylate?

Ensure administration within 2 hours of a meal Signup and view all the answers

Which protein inhibitor prevents HIV from entering cells?

Enfuvirtide Signup and view all the answers

Which nursing implication is critical for administering griseofulvin in patients with hepatic impairment?

Avoid use altogether Signup and view all the answers

What is a potential adverse effect of metronidazole that requires monitoring during treatment?

Metallic taste and dark urine Signup and view all the answers

Which of the following is true regarding the use of chloroquine phosphate for malaria prevention?

Visual disturbances may occur Signup and view all the answers

What is an important nursing consideration when administering mebendazole for parasitic infections?

Crushing the tablet will enhance absorption Signup and view all the answers

What is a critical risk associated with metronidazole usage that must be communicated to patients?

Potential carcinogenic effects in rats Signup and view all the answers

What is the primary mechanism of action for Amphotericin B?

Disrupts membrane, stopping reproduction Signup and view all the answers

Which of the following is a nursing implication specifically for the lipid formulation of Amphotericin?

Do not use in-line filter Signup and view all the answers

What drug is considered the first choice for treating candida infections?

Fluconazole Signup and view all the answers

What serious side effect is associated with fluconazole?

Hepatotoxicity Signup and view all the answers

Caspofungin is primarily indicated for which condition?

Aspergillosis Signup and view all the answers

What is the recommended action if a patient has poor renal function while taking fluconazole?

Halve the dose Signup and view all the answers

Flucytosine is used adjunctively with which medication for specific fungal infections?

Amphotericin B Signup and view all the answers

Which nursing implication is critical for administering caspofungin?

Only given IV Signup and view all the answers

What primary precaution must be taken when administering Amphotericin B to avoid severe complications?

Keep the patient well-hydrated Signup and view all the answers

What is the Black Box Warning associated with flucytosine?

Myelosuppression risk Signup and view all the answers

Study Notes

Herpesvirus Drugs

Acyclovir (Zovirax) interrupts viral DNA replication and is used to treat Herpes Simplex Virus (HSV) and genital herpes.
Topical acyclovir should be applied with a gloved hand.
IV acyclovir may cause encephalopathy.

Cytomegalovirus (CMV) Drugs

Ganciclovir (Cytovene) inhibits viral DNA synthesis and is used to treat CMV.
Ganciclovir can cause renal impairment, granulocytopenia (neutropenia), thrombocytopenia, and birth defects.
Valganciclovir is an oral version with the same black box warnings as ganciclovir.

Respiratory Syncytial Virus (RSV) Drugs

Ribavirin (Virazole) interferes with DNA and RNA replication and is used to treat RSV in children.
Ribavirin has black box warnings related to teratogenic effects and should be administered via inhalation.
Monitor patients for signs of respiratory distress, including nasal flaring.

Influenza Drugs

Oseltamivir phosphate (Tamiflu) prevents new viruses from escaping cells and is used to treat influenza in patients one year old and older.
Oseltamivir phosphate may be given prophylactically and can cause side effects similar to influenza symptoms (N/V/D).
Taking Tamiflu with food may decrease GI upset.

Hepatitis Drugs

Lamivudine (Epivir) incorporates into viral DNA and terminates it.
Lamivudine is used to treat chronic hepatitis B.
Lamivudine has black box warnings for pancreatitis, lactic acidosis, and hepatomegaly with steatosis.

HIV Drugs

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Zidovudine (AZT, Retrovir) incorporates into viral DNA and terminates it.
Zidovudine is used to prevent HIV transmission from mother to fetus.
Zidovudine has black box warnings for granulocytopenia, pancytopenia, lactic acidosis, and hepatomegaly.

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Efavirenz (Sustiva) is similar to NRTIs.
Efavirenz has black box warnings for Stevens-Johnson Syndrome and CNS effects, which may necessitate taking the drug at night.
Efavirenz is not recommended for patients with hepatic impairment.

Protease inhibitors (PIs)

Saquinavir mesylate (Invirase) prevents viral maturation.
Monitor patients for QT prolongation and instruct them to take the drug within 2 hours of a meal.

Integrase Strand Inhibitors (INSTIs)

Raltegravir (Isentress) blocks the HIV integrase enzyme and is only used for strains resistant to multiple antiretroviral drugs.

Fusion Protein Inhibitors

Enfuvirtide (Fuzeon) prevents HIV from entering cells.
Enfuvirtide is given as a subcutaneous injection and should only be considered after other antiretroviral therapies fail.

CCR5 Antagonist

Maraviroc (Selzentry) prevents HIV from entering cells.
Maraviroc is not recommended for patients with poor kidney function.
Maraviroc has black box warning for hepatotoxicity and allergic symptoms that may present one month into treatment.

Fungi Drugs

Polyenes

Amphotericin B deoxycholate (Fungizone) disrupts the fungal membrane, stopping reproduction.
Amphotericin B deoxycholate has a black box warning for potentially fatal infections.
Amphotericin B deoxycholate is associated with renal impairment, organ failure, cardiac arrest, and respiratory arrest.
Amphotericin B deoxycholate requires premedication with a separate IV line and filter.
Lipid formulations of amphotericin are less nephrotoxic and do not require an in-line filter.

Azoles (-CONAZOLE)

Fluconazole (Diflucan) disrupts membrane permeability.
Fluconazole is the drug of choice for candida infections.
Halve the dose of fluconazole in patients with poor renal function.
Fluconazole can lead to hepatotoxicity and acts as an enzyme inhibitor.
Fluconazole increases the levels of phenytoin and warfarin.

Echinocandins (-FUNGIN)

Caspofungin (Cancidas) inhibits fungal cell wall synthesis.
Caspofungin is used to treat aspergillosis and candida infections in the intra-abdominal space.
Caspofungin is only available IV.
Caspofungin cannot be administered with any other IV drug, including dextrose.

Pyrimidine Analog

Flucytosine (Ancobon) affects the cell membrane, leading to cell death.
Flucytosine is used as an adjunct with Amp B for candida and cryptococcus infections.
Flucytosine has a black box warning for renal impairment, hepatotoxicity, and bone marrow toxicity.
Monitor labs closely to adjust flucytosine dose.

Misc. Agents

Griseofulvin disrupts cell division.
Griseofulvin is used to treat tinea infections of the skin, hair, and nails.
Avoid griseofulvin in patients with hepatic impairment.
Griseofulvin should be administered with a high-fat meal.
Griseofulvin can diminish the effectiveness of contraceptives.

Parasites Drugs

Amebicides

Metronidazole (Flagyl) diffuses across the cell membrane, resulting in cell death.
Metronidazole is used to treat intestinal amebiasis and trichomoniasis.
Metronidazole has a black box warning for use only for indicated purposes, as it is carcinogenic in rats.
Avoid alcohol during and three days after metronidazole treatment.
Assess stools for diarrhea and be aware of potential metallic taste and dark urine.

Antimalarials (-QUINE)

Chloroquine phosphate (Aralen) interferes with parasite DNA, RNA, and metabolism.
Chloroquine is used for the treatment and prophylaxis of malaria.
Chloroquine can cause visual disturbances and ECG changes.
Follow specific dosing schedules for prophylaxis and treatment.

Anthelmintics

Mebendazole (Enverm) blocks glucose uptake.
Mebendazole is used to treat parasitic worms, including pinworm, hookworm, and roundworm.
Chew or crush mebendazole and swallow.
Mebendazole is teratogenic.

Scabicides and Pediculicides

Permethrin (Elimite, Nix) stops the influx of sodium, paralyzing and killing parasites.
Permethrin is used to treat lice and scabies.
For lice treatment, wash hair, apply cream for 10 minutes, rinse, and use a lice comb.
For lice treatment, repeat in one week if lice are still present, but keep the drug on hair overnight.
For scabies treatment, apply permethrin head to toe and leave it on for 8-14 hours.

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Description

Test your knowledge on antiviral drugs used for various viral infections including Herpes Simplex Virus, Cytomegalovirus, Respiratory Syncytial Virus, and Influenza. This quiz includes important information regarding drug mechanisms, side effects, and administration methods.