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antiviral drugs ((ANTIRETROVIRAL DRUGS ((PROTEAS INHIBITORS ((MECHANISM OF…
antiviral drugs
ANTIRETROVIRAL DRUGS
PROTEAS INHIBITORS
MECHANISM OF ACTION
Proteas inhibitors compete for the cleavage site on the proteas enzyme blocking the cleavage of the polyproteins and thus the maturation of new viral particles is blocked.
INDICATIONS
Treatment of HIV-1 infections with other antiretroviral agents.
NAME
Indinavir
NURSING CONSIDERATIONS
CONTRAINDICTIONS
Not recommended with atazanavir due to increased risk of hyperbilirubinamia. also contraindicated with alprazolam, triazolam, midazolam, amiodarone, simvastatin and argot alkaloids.
SIDE EFFECTS
Nephrolithiasis, flank pain, haematuria, heamolytic anemia hyperbilirubinamia and back pain
ROUTE OF ADMINISTRATION
It is administered orally as a capsule.
STORAGE CONDITIONS
stored at 15-30 degrees Celsius at room temperature
HIV INTAGRASE-STRAND TRANSFER INHIBITOR
MECHANISM OF ACTION
It targets integrase an HIV enzyme that intergrates the viral genetic material into human chromosomes, a critical step in the pathogenesis of HIV. the drug is metabolised away via glucoronidation.
INDICATIONS
It is used for individuals whose infection has proven resistant to other antiretroviral drugs. It is used to treat HIV infection
NAME
Raltegravir ( isentress)
NURSING CONSIDERATIONS
SIDE EFFECTS
ROUTE OF ADMINISTRATION
It is administered orally as a pill.
CONTRAINDICATIONS
Patients with liver problems and history of muscle disorder called rhabdomyolysis or myopathy. if a patient is on kidney dialysis treatment.
STORAGE CONDITIONS
store at 20-25 degrees Celsius at room temperature
NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
MECHANISM OF ACTION
It act allosterivally by binding to a distinct site away from the active site known as the NNRTI pocket, EFV is not affective against HIV-2 because its pocket has a different structure, which confers intrinsic resistance to the NNRTI. NRTI and EFV have different binding sites so cross-resistance is unlikelly.
INDICATIONS
It is used to treat patients with HIV/AIDS and prevention after needle stick injury and other potential exposure
NAME
Efevirenz (EFV)
NURSING CONSIDERATION
SIDE EFFECTS
Neuropsychiatric effects such as disturbed sleep, dizziness, headaches, vertigo, blurred vision, anxiety, cognitive impairment and depression. euphoria, rash, nausea and convulsions
ROUTE OF ADMINISTRATION
It is administered by mouth as a tablet and oral solution
CONTRAINDICATIONS
To patients who have taken EFV before and experienced an allergic reaction. hypersensitive patients eg. steven-johnson syndrome
STORAGE CONDITIONS
stored at 20-25 degrees Celsius at room temperature.
ENTRY INHIBITORS-CCR5 CO-RECEPTOR ANTAGONIST
MECHANISM OF ACTION
Its an antagonist which selectively binds to human cytokine receptor CCR5 preventing tropic HIV-1 virus from entering the cells. It works by attaching to a protein on the surface of the immune cells. The protein called CCR5 co-receptor, when it attaches to the CCR5 co-receptor certain strains of HIV called R5 tropic virus cannot attach to enter or infect the cell.
INDICATIONS
CCR5 tropic HIV-1 infection with other retroviral agents
NAME
Selzentry (Maraviroc)
NURSING CONSIDERATION
SIDE EFFECTS
Infections such as herpes, esophageal candida, influenza and upper respiratory tract infection. fever,cough, rhinitis, sinusitis, rash, pruritus,mylagia, artralgia, postural hypotention, syncope, dizziness, myocardial infarction
ROUTE OF ADMINISTRATION
It is administered orally as a tablet
CONTRAINDITIONS
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STORAGE CONDITIONS
Stored at 20-25 degrees Celsius at room air.
antiviral drugs
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NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
MECHANISM OF ACTION
It works selectively by inhibiting HIV's reverse transcriptase, the enzyme that the virus uses to make a DNA copy of its RNA. Reverse transcription is necessary for production of HIV's double-stranded DNA, which would be subsequently intergrated into the genetic material of the infected cell. cellular enzymes convert AZT into the effective 5'-triphosphate form. termination of HIV's forming DNA chains is the specific factor in the inhibitory effect.
INDICATIONS
used to treat patients with HIV/AIDS. used after needle stick injury or other potential exposure, post-exposure prophylaxis and treatment of mother-to-child transmission. it is also used to prevent likelihood of HIV resistance
NAME
Zidovudine (ZDV) OR Azidothymide (AZT)
NURSING CONSIDERATIONS
SIDE EFFECTS
Nausea, vomiting, acid or heartburn, headache, cosmetic reduction in abdominal body fat, light sleeping, loss of appetite, feint discoloration of fingernails and toenails, mood elevation, occasional tingling or numbness of the hands or feet and minor skin discoloration, anamea, neutropenia, hepatotoxicity, cardiomyopathyand myopathy
ROUTE OF ADMINISTRATION
It is administered orally, it is injectable and also administered as a suppository
CONTRAINDICATIONS
It is not recommended with ribavirin or stavudine due to potential exacerbation of anaemia. there is an increased risk of neutropenia if given with paracetamol. it contraindicated in patients with an abnormally low neutrophil count or abnormally low haemoglobin
STORAGE CONDITIONS
If refrigerated stored at 2-8 degrees Celsius. if stored at room temperature at 20-25 degrees Celsius.
FUSION INHIBITORS
MECHANISM OF ACTION
Fusion inhibitors specifically binds to virus proteins outside the cell thus stopping it from penetrating the cell.
INDICATIONS
Treatment for HIV-1 infection with other antiretrotroval agents and patients previously treated with antiretrovirals which were ineffective.
NAME
Enfuvirtide (Fuzeon)
NURSING CONSIDERATIONS
SIDE EFFECTS
Pain on injection site, erhythemia, induration, nodules, cysts, pruritus, ecchymosis, skin infection, cellulitis, abscess formation. sepsis, acne, bacterial pneumonia, cough, rhinitis, nasal congestion, sinusitis and hypersensitivity.
ROUTE OF ADMINISTRATION
It is injected subcutanously
CONTRAINDICATION
It is contraindicated in patients with pneumonia and hypersensitive patients
STORAGE CONDITIONS
Stored at 4-20 degrees Celsius at room temperature
INFLUENZA
NEURAMINIDASE INHIBITOR
MECHANISM OF ACTION
It is a competitive inhibitor of influenza''s nueramidase enzyme. the enzyme cleaves the sialic acid which is found on the glycoproteins on the surface of human cells and helps new virions to exit them. thus oseltamivir prevents new viral particles from being released.
INDICATIONS
It is used for the prevention and treatment of influenza caused by influenza A and B viruses
NAME
Oseltamivir (tamflu)
NURSING CONSIDERATIONS
CONTRAINDICATIONS
It is contraindicated in psychiatric patients, pregnant women and patients with kidney problems
SIDE EFFECTS
Nausea and vomiting, headaches diarrhoea, abdominal pain. it may induce serious heart rhythm problems, insomnia, fatigue. liver inflammation, elevated liver enzymes, rash, allergic reaction,toxic epidermal necrosis, seizures, confusion and aggraviation of diabetes.
ROUTE OF ADMINISTRATION
It is administered by mouth or orally as a pill( capsule) and a liquid ( oral suspension)
STORAGE CONDITIONS
Store at 25 degrees Celsius and if refrigerated it must be at 2-8 degrees Celsius. do not freeze
M2 INHIBITOR
MECHANISM OF ACTION
It intereferes with the viral protein, M2 a protein channel. after entry of the virus into cells via endocytosis it is localised in acidic vacoules, the M2 channell functions in transporting proteins with the gradient from the vacuolar space into interior of the varion. acidification of the interior results in disassociation of ribonucleoproteins and the onset of viral replication
INDICATIONS
It is indicated for patients with influenza ( type A) and patients with Parkinson,s disease
NAME
Amantandine
NURSING CONSIDERATIONS
SIDE EFFECTS
Nervousness, anxiety, aggitation, insomnia, difficulty concentrating ,exacerbation and severe skin rashes
ROUTE OF ADMINISTRATION
It is administered orally as a capsule
CONTRAINDICATIONS
Patients with a history of seizures and psychiatric patients
STORAGE CONDITIONS
Store at 20-25 degrees Celsius.
HEPATIC DRUGS
GUANOSINE ANALOG ( NUCLEOSIDE INHIBITOR)
MECHANISM OF ACTION
It is a prodrug which when metabolised resembles purine RNA nucleotide. In this fprm it inteferes with RNA metabolism required fpr viral replication. RNA viruses ribavirin's carboxamide group can make the native nucleoside drug resemble adenosine and guanine, depending on its rotation for this reason when ribavirin is incoparated into RNA as a base analog of eithr adenine or guaninethus inducing mutations in RNA- dependent replication in rna viruses.
INDICATIONS
It is used to treat hepititis C and viral haemorrhagic fevers. used in patients co-infected with hepititis B and HIV. It is olso used as treatment for herpes simplex virus
NAME
Ribavirin( Tribavirin)
NURSING CONSIDERATIONS
SIDE EFFECTS
Felling tired, headache, nausea, fever, muscle pains and irritable moods. Red blood cell breakdown liver problems and allergic reactions.
ROUTE OF ADMINISTRATION
It is administered orally as a capsule or tablet
CONTRAINDICATIONS
In pregnancy, should not be given with zidovudine because of increased risk of anemia and concurrent use with didanosine should be avoided because of increased risk of mitochondrial toxicity
STORAGE CONDITIONS
Stored at 20-25 degrees Celsius at room temperature