Please enable JavaScript.

Coggle requires JavaScript to display documents.

ANTIVIRAL DRUGS (INFLUENZA A AND RESPIRATORY VIRUSES DRUGS (SIDE EFFECTS…

- - - - Assess for contraindications such as drug allergies, hepatorenal impairment, pregnancy and lactation to prevent any untoward complications.
      - Perform a thorough physical assessment (other medications taken, orientation and reflexes, vital signs, etc.)
        
        to establish baseline data before drug therapy begins, to determine effectiveness of therapy
        
        and to evaluate for occurrence of any adverse effects associated with drug therapy.
    - - Acute pain related to GI, CNS, or GU effects of the drug
      - Disturbed sensory perception (kinesthetics) related to CNS effects of the drug
    - - Administer drug as prescribed as soon after exposure to the virus is possible
      - Administer influenza A vaccine before the flu season begins, if at all possible
      - Instruct the patient about the appropriate dosage scheduling regimen; safety precautions, changing position slowly and avoiding driving
      - Educate client on drug therapy to promote understanding and compliance
    - - Monitor patient response to therapy (prevention of respiratory flu-like symptoms and alleviation of flu-like symptoms).
      - Monitor for adverse effects (e.g. changes in orientation and affect, blood pressure, urinary output, liver or renal function test changes, etc).
      - Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
      - Monitor patient compliance to drug therapy.
- - - - Assess for contraindications such as drug allergies, hepatorenal impairment, pregnancy and lactation, severe CNS disorders, etc
      - Evaluate renal function tests to determine baseline function of the kidneys and to assess adverse effects on the kidney and need to adjust the dose of the drug.
      - Perform a thorough physical assessment (other medications taken, orientation and reflexes, skin color, temperature, and lesions, etc.)
    - - Acute pain related to GI, CNS, or local effects of the drug
      - Disturbed sensory perception (kinesthetics) related to CNS effects of the drug
    - - Administer drug as prescribed as soon after exposure to the virus is possible to enhance effectiveness and decrease the risk of complications due to viral infection.
      - Ensure good hydration to decrease the toxic effects on the kidneys.
      - Ensure patient takes the complete course of the drug regimen to improve effectiveness and decrease the risk of emergence of resistant viruses.
      - Wear protective gloves when applying the drug topically to decrease the risk of exposure to the drug and inadvertent absorption.
      - Provide safety precautions (e.g. use of side rails, appropriate lighting, orientation, assistance) if CNS effects occur to protect the patient from injury.
      - Monitor renal function tests periodically during treatment to ensure prompt detection and early intervention should renal toxicity develop.
      - Educate client on drug therapy to promote understanding and compliance.
      - Provide the following patient teaching:
        
        Avoid sexual intercourse if genital herpes is being treated because these drugs do not cure the disease.
        
        Wear protective gloves when applying topical agents.
        
        Avoid driving and hazardous tasks if dizziness or drowsiness occurs.
    - - Monitor patient response to therapy (alleviation of signs and symptoms of herpes or CMV).
      - Monitor for adverse effects (e.g. orientation and affect, GI upset and renal function).
      - Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
      - Monitor patient compliance to drug therapy.
- - - - Binding directly to HIV reverse transcriptase to block both RNA- and DNA-dependent DNA polymerase activities..
      - They prevent the transfer of information that would allow the virus to carry on the formation of viral DNA.
      - Consequently, replication becomes impossible
    - - Oral route of administration
    - - Treatment of patients with documented AIDS or ARC who have decreased numbers of helper T cells and evidence of increased opportunistic infections in combination with other antiviral drugs.
    - - Pregnancy- No adequate studies of nonnucleoside reverse transcriptase inhibitors so use should be limited only in which benefits clearly outweigh any risks.
      - Children Safety for the use of delavirdine is not established.
    - - CNS: dizziness, blurred vision, headache
      - GI: dry mouth, constipation or diarrhea, nausea, abdominal pain, dyspepsia
      - Flu-like syndrome may occur but this may also be because of the underlying disease.
  - - - These nucleosides, however, lack a substance needed to extend the DNA chain.
      - Consequently, chain cannot lengthen and insert itself into the host DNA.
      - Competing with the naturally occurring nucleosides within the cell that the virus would use to build DNA chain.
    - - Intravenous route of administration
      - Oral route of administration
    - - Lamivudine as an oral solution can be used in treatment of chronic hepatitis B
      - Zidovudine is used in prevention of maternal transmission of HIV.
      - Combination therapy for the treatment of adults and children with HIV
    - - Pregnancy-No adequate studies of NRTIs so use should be limited, except for zidovudine, which has been proven to be safe.
      - Hepatic dysfunction, severe renal impairment-Caution with use of tenofovir, zidovudine, and emtricitabine.
      - Bone marrow suppression-Can be aggravated by zidovudine.
    - - Abacavir: serious-to-fatal hypersensitivity reactions (fever, chills, rash, fatigue, GI upset, flu-like symptoms) can occur and drug must be discontinued immediately and listed with the Abacavir Hypersensitivity Registry
      - Didanosine: serious pancreatitis, hepatomegaly, and neurological problems
      - Emtricitabine, tenofovir: severe and fatal hepatomegaly with steatosis
      - Zidovudine: severe bone marrow suppression
      - Tenofovir: changes in body fat distribution, with loss of fat from arms, legs, and face and deposition of fat on the trunk, neck, and face.
    - - store out of reach of children
  - - - Rendering the virus immature and noninfective by blocking protease which is essential for the maturation of an infectious virus.
      - As a result, the virus is unable to fuse with and inject itself into a cell.
    - - Combination therapy for the treatment of HIV infections.
    - - Pregnancy, lactation-Only saquinavir is not teratogenic. However, it can cross into breast milk.
      - Hepatic dysfunction- Increased toxicity especially with fosamprenavir and darunavir
      - Patients taking antidiabetic drugs : Darunavir can cause diabetes mellitus and/or hyperglycemia; dose adjustment is required.
      - Darunavir is associated with mild to severe dermatologic reactions including Steven Johnson syndrome.
      - Safety of indinavir for use in children younger than 12 years has not been established.
      - Darunavir should not be used in children younger than 3 years of age because of the potential for toxic effects.
    - - GI: nausea, vomiting, diarrhea, anorexia, changes in liver function (elevated cholesterol and triglyceride)
      - Skin: rashes, pruritus, Steven Johnson syndrome
    - - Oral route of administration
    - - stay away from direct sunlight and store out of reach of children
  - - - Preventing the fusion of the virus with the human cellular membrane, thereby preventing entry of HIV-1 virus into the cell.
    - - Combination therapy for the treatment of adults and children older than 6 years who have evidence of HIV-1 replication despite ongoing antiretroviral therapy.
    - - Subcutaneous route of administration
    - - Pregnancy and lactation- Potential adverse effects to the fetus and neonate.
      - Known hypersensitivity to the drug.
    - - CNS: insomnia, depression, peripheral neuropathy
      - GI: nausea, diarrhea
      - Local: injection-site reactions
      - Respiratory: pneumonia
    - - store away from direct sunlight
  - - - Blocking the receptor site on the cell membrane to which the HIV virus needs to interact to enter the cell.
    - - Combination therapy with other antivirals
    - - Oral route of administration
    - - Pregnancy, lactation, known hypersensitivity to drugs.
      - Renal impairment. Increased risk of toxicity.
      - Safety of use for children not established.
    - - CNS: dizziness, changes in consciousness
      - Severe hepatotoxicity has been reported with maraviroc, often preceded with systemic allergic reaction with eosinophilia and rash.
    - - store away from sunlight
      - store away from children
  - - - Inhibiting the activity of the virus-specific enzyme integrase, an encoded enzyme needed for replication.
      - Blocking integrase prevents the formation of HIV-1 provirus leading to decreased viral load and increased active CD4 cells.
    - - Reserved for use in patients who have been treated with other antivirals and have evidence of a return to viral replication.
    - - Oral route of administration
    - - It is contraindicated with known hypersensitivity to any component of the drug, as initial treatment for adults, for use in children, and for nursing mothers.
      - Caution should be used if the patient is at risk for rhabdomyolysis or myopathy and during pregnancy.
    - - CNS: headache, dizziness
      - Musculoskeletal: rhabdomyolysis, myopathy
    - - store away from children
      - store away from direct sunlight
  - - - Assess for contraindications such as drug allergies, hepatorenal impairment, pregnancy and lactation to prevent any untoward complications.
      - Perform a thorough physical assessment
        
        to determine effectiveness of therapy,
        
        to establish baseline data before drug therapy begins,
        
        to evaluate for occurrence of any adverse effects associated with drug therapy.
      - Evaluate hepatic and renal function tests to determine baseline function of the kidneys and liver.
      - Check results of CBC with differential
        
        to monitor bone marrow activity and helper T cell number to determine the severity of the disease
        
        and indicate the effectiveness of the drugs.
    - - Acute pain related to GI, CNS, or dermatological effects of the drug
      - Disturbed sensory perception (kinesthetics) related to CNS effects of the drug
      - Imbalanced nutrition: less than body requirements related to GI effects of the drug
    - - Monitor renal and hepatic function before and during therapy to detect changes requiring dose adjustments.
      - Ensure patient takes the complete course of the drug regimen and takes all drugs included in a particular combination
      - Administer the drug round the clock, if indicated, to provide the critical concentration needed for the drug to be effective.
      - Stop drug if sever rash occurs, especially if accompanied by blisters, fever, and other signs, to avert potentially serious reactions.
      - Provide safety precautions (e.g. use of side rails) If CNS effects occur, to protect patient from injury.
      - Educate client on drug therapy to promote understanding and compliance.
    - - Monitor patient response to therapy (alleviation or reduction of signs and symptoms of AIDS or ARC and maintenance of helper T cell levels).
      - Monitor for adverse effects (e.g. changes in orientation and affect, GI upset, renal and hepatic function, skin, levels of blood components, etc)
      - Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
      - Monitor patient compliance to drug therapy.
- - - - allergy to drugs, to prevent hypersensitivity reactions; lactation
      - to prevent potential toxicity to the infant; renal and liver impairment, because of increased risk of toxicity.
    - - pregnancy, hepatitis B, and HIV infections, as safety is not established.
  - - - Anti-hepatitis B: should not be stopped immediately because of potential risk of hepatitis B exacerbation
      - CNS: headache, dizziness, nausea
      - GI: diarrhea, elevated liver enzymes, severe hepatomegaly with steatosis
      - GU: lactic acidosis and renal impairment
    - - CNS: headache, fatigue
      - GI: nausea, diarrhea
      - Immunological: bone marrow suppression, severe skin reactions
  - - - Assess for the mentioned cautions and contraindications (e.g. drug allergies, hepatorenal impairment, pregnancy and lactation, etc.) to prevent any untoward complications.
      - Perform a thorough physical assessment
        
        to determine effectiveness of therapy,
        
        and to evaluate for occurrence of any adverse effects associated with drug therapy.
        
        to establish baseline data before drug therapy begins,
      - Evaluate hepatic and renal function tests to determine baseline function of the kidneys and liver.
    - - Acute pain related to GI and CNS effects of the drug
      - Imbalanced nutrition: less than body requirements related to GI effects of the drug
    - - Monitor renal and hepatic function before and during therapy to detect changes requiring dose adjustments or additional treatment as needed.
      - Withdraw the drug and monitor the patient if he or she develops signs of lactic acidosis or hepatotoxicity because these adverse effects can be life threatening.
      - Caution patient to not run out of this drug but to take it continually because acute exacerbation of hepatitis B can occur when the drug is stopped.
      - Advise patients that these drugs do not cure the disease and there is still a risk of transferring the disease, so the patient should continue to take appropriate steps to prevent transmission of hepatitis B.
      - Provide the following patient teachings:
        
        Have regular blood tests and medical follow-up.
        
        Realize that GI upset, with nausea and diarhea, is common with this drug
        
        Report severe weakness, muscle pain, palpitations, yellowing of the eyes or skin, and trouble breathing.
        
        Educate client on drug therapy to promote understanding and compliance.
    - - Monitor patient response to therapy (decreased viral load).
      - Monitor for adverse effects (e.g. liver or renal dysfunction, headache, nausea, diarrhea, etc).
      - Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
      - Monitor patient compliance to drug therapy.