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23 Cards in this Set
- Front
- Back
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Immunoglobulins
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Concentrated antibodies that can attack & destroy viruses
Isolated & pooled from human & animal blood Nonspecific (human gamma globulin) & specific (rabies immunoglobin, varicella-zoster immunoglobin) May be considered antivirals but are more commonly considered immunizing drugs |
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Viruses controlled by current antiviral therapy
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Cytomegalovirus (CMV)
Hepatitis viruses Herpes viruses Human immunodeficiency virus (HIV) Influenza viruses (the “flu”) Respiratory syncytial virus (RSV) |
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amantadine (Symmetrel)
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Narrow antiviral spectrum; active only against influenza A
2008 CDC guidelines do not recommend use for treatment or prevention of flu CNS effects: insomnia, nervousness, lightheadedness GI effects: anorexia, nausea, others Contraindicated in lactating women, babies< 12 months & eczematous rash |
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rimantadine (Flumadine
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Same spectrum of activity, mechanism of action, & indications as amantadine
Fewer CNS adverse effects Causes GI upset |
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acyclovir (Zovirax)
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Synthetic nucleoside analog
Used to suppress replication of: HSV-1, HSV-2, VZV Drug of choice for treatment of initial & recurrent episodes of these infections Oral, topical, parenteral forms |
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ganciclovir (Cytovene)
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Synthetic nucleoside analog
Used to treat infection with cytomegalovirus (CMV) Oral, parenteral forms CMV retinitis Ophthalmic form surgically implanted Ocular injection (fomivirsen) |
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oseltamivir (Tamiflu) & zanamivir (Relenza)
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Active against influenza types A & B
Reduce duration of illness Oseltamivir: causes nausea & vomiting Zanamivir: causes diarrhea, nausea, sinusitis Treatment should begin within 2 days of influenza symptom onset |
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Ribavirin
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Synthetic nucleoside analog
Given orally, or oral or nasal inhalation Inhalation form (Virazole) used for hospitalized infants with respiratory syncytial virus (RSV) infections Recently oral forms have become available for treatment of hepatitis C |
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Four Stages of HIV Infection*
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Stage 1: asymptomatic infection but may have persistent, generalized lymphadenopathy; normal CD4
Stage 2: early, general symptoms of disease; seroconversion @ 3 wks to 3 months after exposure. Individual is considered HIV + Stage 3: moderate symptoms; opportunistic infections begin; CD4 begins to drop & HIV antibodies rise. Often first presenting signs Stage 4: (formerly called full-blown AIDS)severe symptoms, often leading to death. Increasing destruction of T cells & CD4 falls below 200 |
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ELISA (enzyme-linked immunosorbent assay)
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Detects HIV exposure based on presence of human antibodies to the virus in the blood
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Antiretroviral Drugs
5 classes |
Reverse transcriptase inhibitors (RTIs)
Protease inhibitors (PIs) Fusion inhibitors Entry inhibitor-CCR5 coreceptor antagonists; CCR5receptors are located on CD4 & are used by HIV virion to gain entry to cell HIV integrase strand transfer inhibitors-inhibits catalytic activity of integrase & integration of proviral gene into human DNA |
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zidovudine (Retrovir)
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First anti-HIV medication
Nucleoside reverse transcriptase inhibitor Can be given to pregnant HIV-positive women & newborn babies to prevent maternal transmission of HIV Major dose-limiting adverse effect: bone marrow suppression |
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Protease inhibitors (PIs)
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Inhibit the protease retroviral enzyme, preventing viral replication
amprenavir (Agenerase) indinavir (Crixivan) nelfinavir (Viracept) ritonavir (Norvir) |
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Fusion inhibitors
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Inhibit viral fusion, preventing viral replication
A newer class of antiretroviral drugs Example: enfuvirtide (Fuzeon) |
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CCR5 antagonist
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maraviroc (Selzentry)
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HIV integrase strand transfer inhibitor
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raltegravir (Isentress)
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Avian Flu, H1N1 meds
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zanamivir & oseltamivir
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Diagnosis of Tuberculosis
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Tuberculin skin test (Mantoux test)
If skin test is positive, chest x-ray If chest x-ray shows signs of TB, then culture of sputum* or stomach secretions |
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Purified protein derivative (PPD):
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dx injection to detect exposure to TB. A positive test is induration at the site of injection.
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Bacille Calmette-Guerin (BCG):
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a vaccine derived from an inactivated strain of Mycobacterium bovis. Not normally distributed in the US, it is used outside US to vaccinate young children against TB. It reduces active TB by 60 to 80% & is more effective in preventing severe cases with dissemination throughout the body.
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Initial regime for TB
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isoniazid, rifampin, pyrazinamide (PZA), & ethambutol or streptomycin. Together = 95% effective
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Isoniazid (INH)
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Drug of choice for TB
Resistant strains of Mycobacterium emerging Metabolized in the liver through acetylation—watch for “slow acetylators” Used alone or in combination with other drugs Contraindicated with liver disease |
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TB : Nursing implications
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Perform liver function studies in patients who are to receive isoniazid or rifampin
Therapy may last for up to 24 months Remind patients they are contagious during initial period of illness No alcohol Rifampin causes oral contraceptives to be ineffective Pyridoxine may be needed to combat neurologic adverse effects associated with INH therapy |
