Anti-Infective – Antivirals
Included In This Lesson
Outline
Overview
- Overview
- Classes of DNA viruses / 14 classes of RNA viruses
- Mechanism of Action
- Kill or suppress viruses – inhibiting replication
- Blocking the activity of a polymerase enzyme
- Subclass – Immunoglobins
- Concentrated antibodies that can attack and destroy viruses
- Nonspecific (human gammaglobulin)
- Specific (rabies immunoglobulin, varicella-zoster immunoglobulin)
- Concentrated antibodies that can attack and destroy viruses
- Types
- Acyclovir
- Valacyclovir
- Famciclovir
- Ganciclovir
- Oseltamivir
- Zanamivir
- Didanosine
- Idoxuridine
- Lamivudine
- Stavudine
- Trifluridine
- Zalcitabine
- Amantadine
- Ribavirin
- Foscarne
- Indications
-
- Smallpox (poxviruses)
- Sore throat and conjunctivitis (adenoviruses)
- Warts (papovaviruses)
- Influenza (ortho-myxoviruses
- Respiratory infections (coronaviruses, rhinoviruses)
- Gastroenteritis (rotavirus, Norwalk-like viruses)
- HIV/AIDS (retroviruses)
- Herpes (herpesviruses)
- Hepatitis (hepadnaviruses)
III. Contraindications
A. Amantadine
1. Lactating women
2. Children younger than 12 months of age
B. Cidofovir
1. Compromised renal function
C. Ribavirin
1. Hemoglobinopathies (sickle-cell anemia)
IV. Interactions
A. Acyclovir
1. Interferon – increased antiviral effects
2. Zidovudine – increased risk of neurotoxicity
B. Amantadine
1. Anticholinergic drugs – increase anticholinergic effects
2. CNS stimulants – increases CNS stimulant effects
C. Didanosine
1. Antacids – increase antiviral effects
2. Itraconazole / Ketoconazole – decrease antifungal absorption
3. Quinolones – decrease quinolones effects
4. Tetracyclines – decrease tetracycline effects
D. Ganciclovir
1. Imipenem – increased risk for seizures
V. Side Effects
A. Acyclovir
1. N / V / D
2. Headache
B. Amantadine
1. Insomnia
2. Nervousness
C. Rimantadine
1. Lightheadedness
2. Anorexia
D. Didanosine
1. Pancreatitis
2. Peripheral neuropathies
3. Seizures
E. Foscarnet
1. Seizures
2. Hypocalcemia
3. Hypokalemia
4. Renal failure
5. Bone marrow suppression
6. N / V/ D
F. Ribavirin
1. Rash
2. Conjunctivitis
3. Anemia
G. Zidovudine
1. Bone marrow suppression
2. Nausea
3. Headache
Transcript
Welcome back and today we are going to discuss antivirals.
Antiviral meds work by killing or suppressing viruses by inhibiting viral replication. They do this by blocking polymerase enzyme which creates new viral components.
Immunoglobulins are a subclass of antiviral medications and are made of concentrated antibodies that can attack and destroy viruses. They may be nonspecific (e.g., human gammaglobulin) or specific (e.g., rabies immunoglobulin, varicella-zoster immunoglobulin) in their activity.
Antivirals types are plentiful but don’t get overwhelmed, focus on the endings… -CLOVIR, -AMIVIR and -DINE. Antivirals go on and go, memorizing the full generic names will cause madness, again focus on the endings only.
Indications for antivirals meds focus all forms locations of viral infections – systemic, throat, optic, STI, respiratory, GU, HIV/AIDS and hepatic. Again, they cover each and all body systems, don’t let the list overwhelm you. Focus on general concepts.
Contraindications focus in the word CAR and include CIDE-OFF-O-VIR (increases risk of renal failure), A-MAN-TA-DINE (causes teratogenic effects), RIB-A-VI-RIN (anemias can lead to heart attack).
Antiviral interactions include DAGA and include DI-DAN-O-SEEN, A-CY-CLO-VIR, GAN-CY-CLO-VER, A-MAN-TA-DINE. Again, big list of words, focus more in CRITICAL interactions such as neurotoxicity, ABX interactions and seizures risk increase. As a nurse, you focus on what can severely harm the patient or make drugs ineffective. Dianosine when given with itraconazole, ketoconazole or tetracyclines will decrease absorption sho should be given 2 hours apart. Acyclovir, when given with Zidovudine, will increase neurotoxicity risk. Ganciclovir, when given with Imipenem, will increase in seizures risks. And lastly, amantadine, when given with anticholinergic or CNS stimulants drugs, will increase their effects.
Alright, antiviral side effects are plentiful and extensive but I want you to focus on four systems, GI, CNS, hematologic and renal. Let’s review the possible side effects. Nausea, vomiting, diarrhea. pancreatitis. Headache, nervousness, seizures. Bone marrow suppression, anemia. Hypocalcemia, hypokalemia and renal failures.
Nursing concepts for antivirals include infection control and pharmacology.
The key points for antivirals include types: CLOVIR, -AMIVIR and -DINE. Indications for antivirals meds focus all forms locations of viral infections – systemic, throat, optic, STI, respiratory, GU, HIV/AIDS and hepatic. Again, they cover each and all body systems, don’t let the list overwhelm you. Focus on general concepts. Contraindications focus in the word CAR and include CIDE-OFF-O-VIR (increases risk of renal failure), A-MAN-TA-DINE (causes teratogenic effects),, RIB-A-VI-RIN (anemias can lead to heart attack). Antiviral interactions include DAGA and include DI-DAN-O-SEEN, A-CY-CLO-VIR, GAN-CY-CLO-VER, A-MAN-TA-DINE. Again, big list of words, focus more in CRITICAL interactions such as neurotoxicity, ABX interactions and seizures risk increase. As a nurse, you focus on what can severely harm the patient or make drugs ineffective. Side effects cover many body systems and include GI, CNS, hematologic and renal systems.
KRISTELLE
Concepts Covered:
- Cardiac Disorders
- Cardiovascular
- Circulatory System
- Nervous System
- Skeletal System
- Emergency Care of the Cardiac Patient
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Renal
- Respiratory
- Test Taking Strategies
- Note Taking
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Respiratory System
- Urinary System
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- Lower GI Disorders
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- EENT Disorders
- Central Nervous System Disorders – Brain
- Documentation and Communication
- Preoperative Nursing
- Disorders of the Adrenal Gland
- Disorders of the Thyroid & Parathyroid Glands
- Endocrine System
- Legal and Ethical Issues
- Adult
- Basics of NCLEX
- Communication
- Understanding Society
- Immunological Disorders
- Substance Abuse Disorders
- Studying
- Fetal Development
- Terminology
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Eating Disorders
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Anxiety Disorders
- Depressive Disorders
- Oncology Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Respiratory Emergencies
- Noninfectious Respiratory Disorder
- Basics of Chemistry
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Digestive System
- Behavior
- Postpartum Care
- Basic
- Integumentary Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Basics of Human Biology
- Postoperative Nursing
- Urinary Disorders
- Neurological Emergencies
- Prenatal Concepts
- Disorders of Thermoregulation
- Community Health Overview
- Neurological Trauma
- Renal Disorders
- Concepts of Mental Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Postpartum Complications
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Health & Stress
- Multisystem
- Proteins
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Endocrine and Metabolic Disorders
- Musculoskeletal Disorders
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Female Reproductive Disorders
- Basics of Sociology
- Neurological
- Intelligence and Language
- Labor and Delivery
- Reading
- Oncologic Disorders
- Bipolar Disorders
- Med Term Basic
- Peripheral Nervous System Disorders
- Infectious Disease Disorders
- Muscular System
- Central Nervous System Disorders – Spinal Cord
- Learning Pharmacology
- Prioritization
- Somatoform Disorders
- Writing
- Pediatric
- Emergency Care of the Respiratory Patient
- Sensory System
- State of Consciousness