Pulm and Antivirals Pharm PDF

Most Common Viral Pathogens Associated with Respiratory Tract Infections: Influenza (A and B), Respiratory Syncytial Virus (RSV), Parainfluenza, Rhinovirus, Adenovirus, and COVID-19 (SARS-CoV-2)(Pulmonary_Viral_Syndrom…). Typical Presentation of Viral Respiratory Tract Infection: Sym...

Most Common Viral Pathogens Associated with Respiratory Tract Infections: Influenza (A and B), Respiratory Syncytial Virus (RSV), Parainfluenza, Rhinovirus, Adenovirus, and COVID-19 (SARS-CoV-2)(Pulmonary_Viral_Syndrom…). Typical Presentation of Viral Respiratory Tract Infection: Symptoms include cough, sneezing, rhinorrhea, sore throat, headache, malaise, and fever (Pulmonary_Viral_Syndrom…). Vaccination and Antiviral Treatment: Vaccination: COVID-19, Influenza, RSV, Varicella (Chickenpox), Shingles, Hepatitis A & B, HPV. Antiviral Therapy: Influenza (Oseltamivir), COVID-19 (Nirmatrelvir/ritonavir for high- risk patients), and RSV (Ribavirin for severe cases)(Pulmonary_Viral_Syndrom…). Supportive Care Therapies: Hydration, rest, analgesics/antipyretics, humidified air, saline nasal sprays, and hot drinks for sore throat relief(Pulmonary_Viral_Syndrom…). Pathophysiology of Viral Pulmonary Infections: Viral infections lead to inflammation, causing increased sputum production and cough as the body attempts to clear the airways(Pulmonary_Viral_Syndrom…). When Antivirals are Appropriate: Antivirals are indicated when they can reduce viral replication early in the course of illness (e.g., within 48 hours for influenza) or for high-risk individuals (e.g., Paxlovid for COVID-19)(Pulmonary_Viral_Syndrom…). Symptomatic Management for Cough:  Dextromethorphan (antitussive), Benzonatate (cough suppressant), Guaifenesin (expectorant), and honey(Pulmonary_Viral_Syndrom…). Symptomatic Management for RSV in Pediatric Patients: Supportive care, bronchodilators, glucocorticoids, Ribavirin (for severe cases), and monoclonal antibodies like Palivizumab for high-risk infants (Pulmonary_Viral_Syndrom…). Prescription for Oral Herpes Simplex Prevention: Valacyclovir: 1g PO daily or Acyclovir: 400 mg PO twice daily (Pulmonary_Viral_Syndrom…). Prescription for Oral Herpes Simplex Treatment: Valacyclovir: 1g PO daily for 7-10 days or Acyclovir: 400 mg PO three times daily for 7-10 days(Pulmonary_Viral_Syndrom…). Drug Classes for Treating Hepatitis B and C: Hepatitis B: NRTIs (e.g., Tenofovir, Entecavir), Pegylated Interferon. Hepatitis C: NS5A inhibitors (e.g., Ledipasvir-sofosbuvir, Sofosbuvir-velpatasvir) (Pulmonary_Viral_Syndrom…). Oseltamivir (Tamiflu) o Medication Class: Antiviral Agent; Neuraminidase Inhibitor o Mechanism of Action: Inhibits viral neuraminidase, preventing virus release from infected cells o Indications: Influenza infection in patients older than two weeks, ideally initiated within 48 hours of symptoms o Adverse Effects: Nausea, vomiting, confusion, delirium, hallucinations o Contraindications: Infants under two weeks o Interactions: Limited known interactions o Monitoring: Not generally required o Patient Education: Take with food to reduce GI upset; complete the full course even if symptoms improve early(Pulmonary_Viral_Syndrom…). Nirmatrelvir/ritonavir (Paxlovid) o Medication Class: Antiviral Agent; Cytochrome P-450 Inhibitor  o Mechanism of Action: Inhibits viral replication o Indications: COVID-19 infection in high-risk patients, ideally within 72 hours of symptom onset o Adverse Effects: Diarrhea, altered taste (dysgeusia) o Contraindications: N/A o Interactions: Numerous interactions due to CYP450 inhibition; caution with drugs metabolized via CYP3A4 o Monitoring: Not generally required o Patient Education: Report any unusual side effects, and consult about concurrent medications due to interaction potential(Pulmonary_Viral_Syndrom…). Benzonatate (Tessalon Perles) o Medication Class: Antitussive, Non-narcotic o Mechanism of Action: Suppresses cough by anesthetizing respiratory stretch receptors o Indications: Symptomatic relief of cough o Adverse Effects: Mild GI disturbances, drowsiness o Contraindications: Children under 10 years due to risk of choking o Interactions: Minimal known interactions o Monitoring: None typically required o Patient Education: Do not chew or crush; swallow capsules whole to avoid oral mucosal anesthesia(Pulmonary_Viral_Syndrom…). Dextromethorphan o Medication Class: NMDA Receptor Antagonist, Antitussive o Mechanism of Action: Reduces cough reflex sensitivity and transmission through medullary cough center depression o Indications: Cough suppression o Adverse Effects: Drowsiness, dizziness, nervousness, gastrointestinal symptoms o Contraindications: Use with or within two weeks of MAOIs; caution in children under two o Interactions: SSRIs, MAOIs (risk of serotonin syndrome) o Monitoring: None generally needed o Patient Education: Avoid driving if drowsy; potential for abuse if taken in high doses(Pulmonary_Viral_Syndrom…). Guaifenesin o Medication Class: Expectorant o Mechanism of Action: Thins mucus secretions, aiding expectoration o Indications: Chest congestion with productive cough o Adverse Effects: Dizziness, drowsiness, headache, nausea o Contraindications: Caution in children under two to four years (depends on formulation) o Interactions: Avoid with alcohol (ethanol-containing products) o Monitoring: None typically required o Patient Education: Drink plenty of fluids to assist in mucus thinning; may cause mild GI upset(Pulmonary_Viral_Syndrom…). Acyclovir o Medication Class: Antiviral Agent  o Mechanism of Action: Inhibits viral DNA synthesis, preventing replication o Indications: Herpes simplex, varicella-zoster, and bell palsy o Adverse Effects: Renal toxicity (AKI), neurotoxicity, thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) o Contraindications: Caution with renal impairment o Interactions: Few significant interactions o Monitoring: Renal function in patients with kidney disease o Patient Education: Stay hydrated to reduce the risk of kidney side effects (Pulmonary_Viral_Syndrom…). Valacyclovir o Medication Class: Antiviral Agent o Mechanism of Action: Converted to acyclovir in the body, then inhibits viral DNA synthesis o Indications: Herpes simplex, herpes zoster, and varicella o Adverse Effects: Similar to acyclovir (renal toxicity, neurotoxicity, TTP/HUS) o Contraindications: Use caution in renal impairment o Interactions: Limited significant interactions o Monitoring: Kidney function in patients with compromised renal health o Patient Education: Hydrate well; take as prescribed for the full course (Pulmonary_Viral_Syndrom…).