Antivirals, Antifungals, Parasite Drugs Table PDF

DRUGS FOR VIRUSES Drug Name and Class Mechanism of Action Use(s) Nursing Implications DRUGS FOR HERPESVIRUS acyclovir (Zovirax) - interrupts viral DNA replications - herpes simplex virus (HSV) - apply topical with glove...

DRUGS FOR VIRUSES Drug Name and Class Mechanism of Action Use(s) Nursing Implications DRUGS FOR HERPESVIRUS acyclovir (Zovirax) - interrupts viral DNA replications - herpes simplex virus (HSV) - apply topical with gloved hand - genital herpes (decreases pain and - IV formulation may cause duration) encephalopathy Drug Name and Class Mechanism of Action Use(s) Nursing Implications DRUGS FOR CYTOMEGALOVIRUS (CMV) ganciclovir (Cytovene) - inhibits viral DNA synthesis - CMV - renal impairment - 2 BBWs - granulocytopenia (neutropenia), thrombocytopenia - maintain contraceptive precautions during and 90 days after treatment (causes birth defects) - valganciclovir (oral version, same BBWs) Drug Name and Class Mechanism of Action Use(s) Nursing Implications DRUGS FOR RESPIRATORY SYNCYTIAL VIRUS (RSV) ribavirin (Virazole) - interferes with DNA and RNA - RSV in children - BBW for several teratogenic effects replication - given via inhalation - monitor for signs of respiratory distress, such as nasal flaring Drug Name and Class Mechanism of Action Use(s) Nursing Implications DRUGS FOR INFLUENZA oseltamivir phosphate (Tamiflu) - does not allow new viruses to escape - influenza in pts at least 1 year old - may take prophylactically (ppx) cell - some side effects are similar to flu symptoms (N/V/D) - take with food to decrease GI upset Drug Name and Class Mechanism of Action Use(s) Nursing Implications DRUGS FOR HEPATITIS lamivudine (Epivir) Incorporates into viral DNA and Chronic hepatitis B Pancreatitis terminates it. HIV (off-label) BBW Lactic acidosis (may present as musculoskeletal pain) Hepatomegaly with steatosis DRUGS FOR HIV Drug Name and Class Mechanism of Action Use(s) Nursing Implications NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs) zidovudine (AZT, Retrovir) - incorporates into viral DNA and - can prevent HIV transmission from - BBW: granulocytopenia, terminates mother to fetus pancytopenia, lactic acidosis, hepatomegaly Drug Name and Class Mechanism of Action Use(s) Nursing Implications NONNUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs) efavirenz (Sustiva) Similar to NRTI’s - Stevens-Johnson Syndrome - CNS effects (take at night to counter) - Not for patients with hepatic  impairment Drug Name and Class Mechanism of Action Use(s) Nursing Implications PROTEASE INHIBITORS (PIs) saquinavir mesylate (Invirase) Prevents viral maturation - Monitor for QT prolongation - Take within 2 hours of a meal Drug Name and Class Mechanism of Action Use(s) Nursing Implications INTEGRASE STRAND INHIBITORS (INSTIs) raltegravir (Isentress) Blocks enzyme HIV integrase, which Resistant HIV-1 Only for strains resistant to multiple would normally make more viruses antiretroviral drugs Drug Name and Class Mechanism of Action Use(s) Nursing Implications FUSION PROTEIN INHIBITORS enfuvirtide (Fuzeon) Prevents HIV from entering cell Given as subcutaneous injection Must have already tried other antiretroviral drugs Drug Name and Class Mechanism of Action Use(s) Nursing Implications CCR5 ANTAGONIST maraviroc (Selzentry) Prevents HIV from entering cell - Not for patients with poor kidney function - BBW · May cause hepatotoxicity and/or allergy symptoms 1 month into treatment.  DRUGS FOR FUNGI Drug Name and Class Mechanism of Action Use(s) Nursing Implications POLYENES prototype: Amphotericin B Disrupts membrane, stopping Reserved for potentially fatal infections Ampho-terrible deoxycholate (Fungizone) reproduction (BBW) · Renal impairment common · Keep hydrated with IV sodium chloride · Organ failure, cardiac arrest, respiratory arrest Premedicate patient Separate IV line and use filter Lipid formulation of amphotericin Less nephrotoxic (Abelcet, AmBisome) Do NOT use in-line filter Drug Name and Class Mechanism of Action Use(s) Nursing Implications AZOLES (-CONAZOLE) fluconazole (Diflucan) Disrupts membrane permeability Drug of choice for candida infections If poor renal function, halve the dose Hepatotoxicity Enzyme inhibitor · Increases levels…especially phenytoin and warfarin Drug Name and Class Mechanism of Action Use(s) Nursing Implications ECHINOCANDINS (-FUNGIN) caspofungin (Cancidas) Inhibits fungal cell wall synthesis Aspergillosis Only given IV Candida infections in intra-abdominal Not compatible with any other IV space drug · …including dextrose Drug Name and Class Mechanism of Action Use(s) Nursing Implications PYRIMIDINE ANALOG flucytosine (Ancobon) Affects cell membrane, resulting in cell Adjunct with Amp B for candida and - BBW death cryptococcus. - · Caution in renal impairment - Hepatotoxicity and bone marrow toxicity · Monitor labs closely to adjust dose Drug Name and Class Mechanism of Action Use(s) Nursing Implications MISC. AGENTS griseofulvin Disrupts cell division Tinea infections of skin, hair, nails - Avoid in hepatic impaired - Give with high-fat meal - Contraceptives are diminished DRUGS FOR PARASITES Drug Name and Class Mechanism of Action Use(s) Nursing Implications AMEBICIDES metronidazole (Flagyl) Diffuses across cell membrane, resulting Intestinal amebiasis - BBW – only for indicated uses; in cell death carcinogenic in rats Trichomoniasis (fairly common STD) - Avoid alcohol (disulfiram reaction) During treatment and 3 days after - Assess stools for less diarrhea - May experience metallic taste, dark urine Drug Name and Class Mechanism of Action Use(s) Nursing Implications ANTIMALARIALS (-QUINE) Chloroquine phosphate (Aralen) Interferes with parasite DNA, RNA, and Treatment and prophylaxis (ppx) of - Visual disturbances metabolism malaria - Electrocardiogram changes - Take weekly (same day of week) for ppx; take daily for treatment Drug Name and Class Mechanism of Action Use(s) Nursing Implications ANTHELMINTICS mebendazole (Enverm) Blocks glucose uptake Parasitic worms (pinworm, - Chew/crush and swallow hookworm, roundworm, etc). - Teratogenic Drug Name and Class Mechanism of Action Use(s) Nursing Implications SCABICIDES AND PEDICULICIDES permethrin (Elimite, Nix) Stops influx of sodium, thus paralyzes Lice - Topical and kills the parasites Scabies - Lice · Wash hair, apply cream, let it sit for 10 minutes, rinse with water, use lice comb. Nits will be difficult to remove. · Repeat in one week if still present…but keep drug on hair overnight this time. - Scabies · Apply head to toe and leave on for 8-14 hours