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What is the primary mechanism of action for acyclovir?
Which of the following is a serious nursing implication for ganciclovir?
What safety precaution should be taken when administering ribavirin?
What is a notable side effect of oseltamivir phosphate when used as a prophylactic treatment?
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Which of the following is an important nursing implication when treating chronic hepatitis B with lamivudine?
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What is the primary mechanism of action of zidovudine (AZT)?
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Which nursing implication is specifically associated with efavirenz?
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Which of the following is a contraindication for maraviroc?
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What is a significant risk associated with the use of zidovudine?
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What is the key benefit of using raltegravir in treatment?
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Which nursing implication is crucial when administering saquinavir mesylate?
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Which protein inhibitor prevents HIV from entering cells?
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Which nursing implication is critical for administering griseofulvin in patients with hepatic impairment?
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What is a potential adverse effect of metronidazole that requires monitoring during treatment?
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Which of the following is true regarding the use of chloroquine phosphate for malaria prevention?
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What is an important nursing consideration when administering mebendazole for parasitic infections?
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What is a critical risk associated with metronidazole usage that must be communicated to patients?
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What is the primary mechanism of action for Amphotericin B?
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Which of the following is a nursing implication specifically for the lipid formulation of Amphotericin?
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What drug is considered the first choice for treating candida infections?
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What serious side effect is associated with fluconazole?
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Caspofungin is primarily indicated for which condition?
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What is the recommended action if a patient has poor renal function while taking fluconazole?
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Flucytosine is used adjunctively with which medication for specific fungal infections?
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Which nursing implication is critical for administering caspofungin?
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What primary precaution must be taken when administering Amphotericin B to avoid severe complications?
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What is the Black Box Warning associated with flucytosine?
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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.
