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

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
- A virus cannot replicate on its own
- 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

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
Prototype of Herpes and Cytomegalovirus Agents
Prototype of HIV/AIDS Antiviral Agents


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
One reply on “Antiviral Agents”
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