Antiviral Agents

Antiviral Agents

Viruses That Respond to Antiviral Therapy

  • Influenza A and some respiratory viruses
  • Herpes viruses
  • Cytomegalovirus (CMV)
  • Human immunodeficiency virus (HIV) that causes acquired immune deficiency syndrome (AIDS)
  • Some viruses that cause warts and certain eye infections

Antivirals Across the Lifespan

Antivirals Across the Lifespan

Antivirals Across the Lifespan

Characteristics of Common Viruses

  • Viral replication
    • A virus cannot replicate on its own
      • It must attach to and enter a host cell
      • It then uses the host cell’s energy to synthesize protein, DNA, and RNA
  • Viruses are difficult to kill because they live inside our cells
    • Any drug that kills a virus may also kill our cells

Stages of Virus Replication

Stages of Virus Replication

Stages of Virus Replication

Characteristics of Antiviral Drugs

  • Able to enter the cells infected with virus
  • Interfere with viral nucleic acid synthesis and/or regulation
  • Some agents interfere with the ability of the virus to bind to cells
  • Some agents stimulate the body’s immune system

Common Respiratory Viruses

  • Influenza A
  • Influenza B
  • Respiratory syncytial virus

Signs & Symptoms of Respiratory Viruses

  • Cough
  • Fever
  • Inflammation of the nasal mucosa
  • Inflammation of the mucosa of the respiratory tract

Signs and Symptoms of Herpes Virus

  • Painful vesicles that often occur in clusters on skin, cornea, or mucous membranes
  • Usual course of primary disease is 2 weeks
  • Duration of recurrences varies

Signs and Symptoms of CMV

  • May be asymptomatic
  • Fatigue
  • Nausea
  • Jaundice
  • If contracted during pregnancy, can result in stillbirth, brain damage, or birth defects

Signs and Symptoms of HIV/AIDS

  • Attach helper T cells
  • Acute infection: fever, rash, and myalgia
  • Asymptomatic infection: follows acute infection; duration varies
  • Persistent generalized lymphadenopathy: adenopathy persists more than 3 months
  • Constitutional symptoms: fever lasting more than a month, involuntary weight loss, chronic fatigue
  • Neurologic disease: dementia
  • Secondary infections: pneumocystis carinii and disseminated herpes simplex

Influenza A & Respiratory Viruses

  • Action: prevent shedding of the viral protein coat
  • Pharmacokinetics: administered orally and excreted unchanged in the urine
  • Contraindications: allergy, pregnancy, and lactation
  • Adverse reactions: dizziness, insomnia, nausea, orthostatic hypotension
  • Drug-to-drug interactions: anticholinergic agents

Herpes & Cytomegalovirus

  • Action: inhibit viral DNA replication by competing with viral substrates to form shorter, noneffective DNA chains
  • Pharmacokinetics: administered orally, IV, or topically; excreted unchanged in the urine
  • Contraindications: pregnancy and lactation
  • Adverse reactions: nausea, vomiting, headache, rash, and hair loss
  • Drug-to drug-interactions: nephrotoxic drugs and zidovudine

Drugs Used to Treat HIV/AIDS

  • Reverse transcriptase inhibitors
  • Protease inhibitors
  • Nucleosides
  • Fusion inhibitors

Reverse Transcriptase Inhibitors

  • Action: bind directly to HIV reverse transcriptase, blocking both RNA- and DNA-dependent DNA polymerase activities
  • Pharmacokinetics: given orally, metabolized in the liver, and excreted in the urine
  • Contraindications: pregnancy and lactation
  • Adverse reactions: headache, nausea, vomiting, rash, chills, fever, and diarrhea

Protease Inhibitors

  • Action: block protease activity within the HIV virus
  • Pharmacokinetics: agents are teratogenic except for saquinavir
  • Contraindications: pregnancy and lactation

Nucleosides

  • Action: interfere with HIV replication by inhibiting cell protein synthesis
  • Pharmacokinetics: given orally or IV, metabolized in the liver, and excreted in the urine
  • Adverse reactions: HA, insomnia, dizziness, nausea, diarrhea, fever, and rash

Fusion Inhibitors

  • Action: prevent the fusion of the virus with the human cellular membrane
  • Pharmacokinetics: given sub-q, metabolized in the liver, recycled in the tissues, and not excreted
  • Contraindication: no true contraindication
  • Adverse reactions: HA, dizziness, myalgia, nausea, vomiting, and diarrhea
  • Drug-to-drug interactions: pimozide, rifampin, triazolam, midazolam, and oral contraceptives

Locally Active Antiviral Agents

  • Action: act on viruses by interfering with normal viral replication and metabolic processes
  • Pharmacokinetics: not absorbed systemically
  • Contraindication: allergy to the drug
  • Adverse reactions: local burning, stinging, and discomfort

Prototype of Respiratory Antiviral Agents

Rimantadine

Rimantadine

Prototype of Herpes and Cytomegalovirus Agents

Acyclovir

Acyclovir

Prototype of HIV/AIDS Antiviral Agents

Nevirapine

Nevirapine

 

Zidovidine

Zidovidine

Nursing Considerations for Respiratory Antiviral Therapy

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Herpes Virus and Cytomegalovirus

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for HIV/AIDS Antiviral Therapy

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Locally Active Antiviral Agents

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation
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One Response to “Antiviral Agents”

  1. I guess having herpes/HIV/HPV is not the end of the world. I’m living with HIV positive for 2 years. I was upset at the beginning.
    A std support site Positivemate,,com helps me find useful, up-to-date information for cure..meet lots of warm-hearted people..No rejection or discrimination. We’re not alone.

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