Viral Infections, Hiv & Aids

Front 1

What do antiviral medications do?

Back 1

Antiviral medications act by altering viral reproduction, they are only effective during viral replication - antiretroviral agents may act by preventing the virus from from entering the cells (fusion inhibitors)

Front 2

What kind of virus is HIV?

Back 2

HIV is a retrovirus, a retrovirus must attach to a host cell in order to replicate, RNA is changed into DNA using the enzyme reverse transcriptase

Front 3

What is HAART?

Back 3

Highly active antiretroviral therapy involves using 3-4 HIV medications in combination with other antiretroviral medications to reduce medication resistance, adverse effects and dosages

Front 4

What medication class is Acyclovir (Zovirax)?

Back 4

Antiviral

Front 5

What medication class is Ganiciclovir (Cytovene)?

Back 5

Antiviral

Front 6

What other examples of antiviral medications?

Back 6

-Interferon alfa-2b
-Lamivudine (Epivir)
-Ostelmivir (Tamiflu)
-Ribavirin (Rebetol)
-Amantidine (Symmetrel)

Front 7

What is the expected pharmacological action of Acyclovir and Ganiciclovir?

Back 7

Prevent the synthesis of viral DNA and thus interrupts cell replication

Front 8

What is Acyclovir used to treat?

Back 8

Herpes simplex and varicella-zoster infections

Front 9

What is Ganiciclovir used to treat?

Back 9

Used in the treatment and prevention of CMV (cytomegalovirus) - prevention therapy using Ganiciclovir is for clients who have HIV/AIDS, organ transplants and other immunocompromised states

Front 10

What is Interferon alfa 2-b and Lamivudine used to treat?

Back 10

Hepatitis

Front 11

What is Oseltamivr used for?

Back 11

Used in the treatment and prevention of infections from type A or B influenza

Front 12

What is Ribavarin used for?

Back 12

Used to treat respiratory syncytial virus (RSV)

Front 13

What is Amantadine used for?

Back 13

Used for treatment and prevention of infections of type A influenza viruses

Front 14

What are the possible adverse reactions for Acyclovir?

Back 14

-Phlebitis, inflammation at the site of infusion (when given IV)
-Nephrotoxicity (provide adequte hydration)
-Mild discomfort associated with oral therapy (burning and stinging with topical applications are transient, notify PCP if getting worse)

Front 15

What are the possible adverse reactions in Ganiciclovir?

Back 15

-Thrombocytopenia (obtain CBC and platelet count)

Front 16

If a client has renal impairment, what medications should be used cautiously?

Back 16

IV Acyclovir

Front 17

How do you administer Acyclovir topically?

Back 17

Apply while wearing rubber gloves to avoid transfer of viruses to other areas of the body

Front 18

How do you care for the lesions caused by Herpes?

Back 18

Wash affected area with soap and water 3-4 times a day, and to keep the lesions dry after washing

Front 19

Do you administer Ganiciclovir with or without food?

Back 19

Give with food, to prevent GI upset

Front 20

What are entry/fusion inhibitors?

Back 20

Decreases and limits the spread of HIV by blocking HIV from attaching to and entering the CDC4 T cell

Front 21

What is an example of an entry/fusion inhibitors?

Back 21

Enfuvirtide (Fuzeon)

Front 22

How is Enfuvirtide administered?

Back 22

Subcutaneous

Front 23

What are some possible side effects that may occur with Enfuvirtide?

Back 23

-Localized reaction at injection site
-Bacterial pneumonia (fever, cough, SOB)
-Fever, chills, rash and hypotension

Front 24

What are nucleoside reverse transcriptase inhibitors?

Back 24

Reduce HIV symptoms by inhibiting DNA synthesis and thus viral replication - can also be used to treat HIV infection

Front 25

What is an example of nucleoside reverse transcriptase inhibitors?

Back 25

Zidovudine (Retrovir)

Front 26

What are some possible adverse reactions of nuceloside reverse transcriptase inhibitors?

Back 26

-Bone marrow suppression resulting in anemia, agranulocytosis and thrombocytopenia
-Lactic acidosis (hyperventilation, nausea and abdominal pain)
-Nausea, vomiting diarrhea
-Hepatomegaly (fatty liver)

Front 27

How do we monitor for bone marrow suppression?

Back 27

Monitor CBC and platelets at the start of therapy and every 4 weeks

Front 28

Can you give epoetin alfa for anemia?

Back 28

Yes, to treat anemia, to help prevent bone marrow suppression

Front 29

What are non-nucleoside reverse transcriptase inhibitors?

Back 29

Act directly on reverse transcriptase to STOP HIV replication, used primarily in HIV-1 infection - this drug can also be used to prevent medications resistance - this drug can be given with another antiretroviral to reduce the risk of medication resistance

Front 30

What is an example of a non-nucleoside reverse transcriptase inhibitors?

Back 30

Efavirenz (Sustiva)

Front 31

What are some possible adverse reactions of non-nuceloside reverse transcriptase inhibitors?

Back 31

-Rash, which may become serious and lead to Steven-Johnson syndrome (monitor for rash, treat with Benadryl)
-Flu like symptoms
-Headache
-Fatigue

Front 32

What are non-nucleoside reverse transcriptase inhibitors used cautiously in?

Back 32

Patients who have liver disease

Front 33

Do you give Efavirenz with or without food?

Back 33

Give with high fat meal to increase absorption

Front 34

What are protease inhibitors (PI)?

Back 34

Act against HIV-1 and HIV-2 to alter and inactivate the virus by INHIBITING enzymes needed for HIV replication - can be used with another antiretroviral medication to reduce medication resistance

Front 35

What are some examples of protease inhibitors?

Back 35

-Ritonavir (Norvir)
-Indinavir (Crixivan)

Front 36

What are some possible side effects that may occur with protease inhibitors?

Back 36

-DM, hyperglycemia (monitor serum glucose)
-Nausea & vomiting
-Elevated serum lipids (monitor for hyperlipidemia, may need to assist clients with diet modification)
-Thrombocytopenia, leukopenia (fever, sore throat, bruising, blood in stool)

Front 37

Do you give protease inhibitors with or without food?

Back 37

Give with food to increase absorption