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29 Cards in this Set
- Front
- Back
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**What is the antiviral spectrum of Acyclovir ? |
Herpes simplex, varicella zoster, & cytomegalovirus (CMV) |
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Mechanism of action? |
Inhibits viral replication by suppressing synthesis of viral DNA, inhibits viral DNA polymerase and further growth |
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How does virus gain resistance? |
(1) Decreases production of thymidine kinase, (2) no longer converts acyclovir to acyclo-GMP & (3) alters viral DNA polymerase so it is less sensitive to inhibition |
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Therapeutic uses? |
Mucocutaneous Herpes Simplex infections: oral of infections in the gums or prophylactically for recurrent cold sore, IV for immunocompromised Varicella-Zoster: oral for (herpes zoster) shingles & chicken pox (varicella) IV for immunocompromised Herpes simplex Genitalis |
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How is it eliminated? Doses should be reduced in what type of pt.? |
Primarily renal as an unchanged drug Pt. with kidney disease |
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Adverse effects? |
IV: phlebitis, inflammation and reversible to nephrototoxicity (minimized by infusing over 1 hour slowly and hydration Neurologic toxicity: agitation, tremors, delirium, hallucinations, and myoclonus |
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In what preperations may it be administered? |
Oral in capsules & suspension, topical in cream & ointment, also IV |
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Is it safe during pregnancy? When given IV you must adequately hydrate the pt. when? |
Yes During the infusion & 2 hours after |
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How is CMV (cytomegalovirus) transmitted? What are the common sites of infection? |
Person to person through saliva, urine, blood, tears, breast milk, semen, and other body fluids. Lungs, eyes and GI tract |
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**Therapeutic use of Interferon Alfa? |
Hepatitis C |
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Mechanism of action? |
It binds to receptors on host cell membranes and the drug blocks the viral entry into the host cell. |
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How often must drug be administered if the pt. is taking the conventional vs. the long acting? |
At least 3 times a week vs. once a week |
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How does it affect chronic hepatitis C? |
It normalizes serum ALT in 40-50% of pt.'s and HCV-RNA become undetectable, but half of these pt,'s relapse when treatment is stopped |
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Adverse effects? |
Flu-like syndrome: fever, fatigue, malaise, headache & chills Neuropsychiatric: depression Prolonged high dose: fatigue, thyroid dysfunction, heart damage & bone marrow suppression GI effects (vomitting, nausea, diarrhea) Injection site reaction (inflammation, bruising, itching, irritation) |
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What route is it administered? |
Subcut |
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XXXWhat is the mechanism of action of Ganciclovir? |
Must be activated to Ganciclovir triphosphate, then suppresses replication of DNA by inhibiting viral DNA polymerase and incorporation of the growing DNA chain which can cause premature chain termination |
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How is it excreted? When should dosage be lowered? |
Unchanged in the urine. When pt. has kidney disease |
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Therapeutic uses? |
Only to prevent & treat CMV infection in immunocompromised pt.'s |
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Adverse effects? (Pregnancy) |
Hematologic effects: granulocytopenia (decrease in a type of WBC), and thrombocytopenia (decrease in clotting factors) result from bone marrow suppression Teratogenic: avoid pregnancy during therapy & for 90 days after ending treatment Nausea, fever, rash, anemia, liver dysfunction & confusion |
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In what preperations may it be administered? |
Powder to be reconstituted for IV infusion, Oral tablets, Ocular implant (vision blurred for 2-4 weeks after procedure & replaced every 5-8 months), & lastly as ocular gel |
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XXRibavirin is combined with what for what therapeutic use? |
With Peginterferon Alfa for HCV infection |
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How long is its half-life? |
6-12 days |
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Adverse effects? |
Hemolytic anemia: Hb level below 10, can worsen heart disease avoid if pt. has it Fetal injury: contraindicated, rule out pregnancy before start, test every month and for 6 months after treatment stops. Use 2 reliable forms of birth control Sever depression, hemolytic anemia, autoimmune disorders, infections, pancreatitis, neutropenia, & injury to eyes/lungs |
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In what preperations may it be administered? (When it is Ribavirin & Peginterferon) What does the dose depend on? Do you administer it with food? |
Capsule, tablets and oral solution for PO Pt. weight and strain of Hep C Yes |
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**Inactivated vaccine is administered by what routes? & what about live attenuated vaccine? |
IM or intradermal injection & live is intranasal |
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When does protection begin and last for how many months? |
1-2 weeks after vaccinnation, last for 6 months or longer |
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Inactivated may cause what? Live may cause what? |
Soreness at injection site, fever, myalgia, malaise, GBS (paralytic illness) Anaphylaxis, GBS, Bell's palsy, runny nose, nasal congestion, cough, headache, vomitting, muscle ache, and fever. |
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When should vaccination be withheld for later? Contraindicated in what pt.'s? Who should be vaccinated? |
In acute febrile illness Hypersensitivity to eggs Ages 6 & older |
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When is the best time to get vaccinated? |
October or November |
