Term
| What are the therapeutic uses of Acyclovir(Zovirax) ? |
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Definition
1.Herpes simplex genitalis—Caused by type 2 HSV; for initial infection, topical acyclovir used to reduce duration of viral shedding, but it does not accelerate healing; topical not effective for recurrent; oral acyclovir is superior for initial and recurrent infections
2.Mucocutaneous herpes simplex infections—Affects face and oropharynx; usually caused by HSV-2; oral acyclovir for immunocompetent and for prophylactic treatment to prevent episode of recurrent herpes labialis; immunocompromised may need IV
3.Varicella-zoster infections—High-dose oral acyclovir is effective for adults (shingles) and children (chickenpox) if begun within 24 hours of rash; use IV for immunocompromised patients |
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Term
| What response should be expected by treatment of herpes? |
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Definition
| Reduce # of days w/ symptoms, reduce symptoms, reduce outbreaks, can’t cure |
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Term
| What are the adverse effects of Acyclovir? |
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Definition
i. IV generally well tolerated; phlebitis and inflammation at site of infusion is common; can get reversible nephrotoxicity (hydrate during and after infusion and administer acyclovir over 1 hour); neurologic toxicity (agitation, tremors, delirium, hallucination) in patients with renal impairment
ii. Oral therapy devoid of serious adverse effects, some mild effects (NVD, HA, vertigo); safe to use during pregnancy
iii. Topical may cause burning and stinging |
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Term
| Precautions, Warnings, and Contraindications for Acyclovir are: |
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Definition
| Use IV form with caution in patients with dehydration or renal impairment and in those taking other nephrotoxic drugs. |
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Term
| Nursing Implications for Acyclovir include: |
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Definition
i. Preadministration Assessment: Renal function, hydrate and give over 1 hr.
ii. Administration: can be administered topically, orally (tablets, capsules, suspension), and IV
iii. Monitoring: Monitor for therapeutic efficacy and adverse effects & # of outbreaks. |
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Term
| What drug is like Acyclovir and what are the adverse effects? |
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Definition
| Valacyclovir (Valtrex) — Prodrug form of acyclovir; approved for oral therapy of herpes zoster (shingles), genital herpes, and herpes labialis; rapid absorption; can cause thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in immunocompromised patients; other adverse effects include NVD, HA, vertigo (same as acyclovir) |
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Term
| Therapeutic Uses of Ganciclovir (Cytovene) are: |
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Definition
| Prevention and treatment of CMV retinitis (inflammation of eye) in immunocompromised patients, treatment of CMV pneumonitis, Treatment of acute CMV colitis, prevention of CMV infection in transplant patients, preemptive treatment patients with CMV viremia. |
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Term
| What are the adverse effects of Ganciclovir? |
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Definition
i.Bone marrow suppression leading to Granulocytopenia (40%) and thrombocytopenia (20%) – low WBC and bleeding dysfunction
ii.Reproductive toxicity—Teratogenic and embryotoxic in lab animals and maybe in humans; avoid pregnancy during treatment and up to 90 days after treatment
iii.Other adverse effects—Nausea, fever, rash, anemia, liver dysfunction, and CNS symptoms |
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Term
| Ganciclovir is contraindicated in some instances, what are they? |
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Definition
| during pregnancy or patients with low neutrophil or platelet counts. |
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Term
| What should be monitored when giving Ganciclovir? |
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Definition
| CBC, WBC, platelets, BUN, Creatinine |
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Term
| Therapeutic Uses for Amantadine: |
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Definition
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Term
| Adverse effects of Amantadine are? |
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Definition
| CNS effects in 10%–30% of patients CNS effects include: dizziness, nervousness, insomnia, and difficulty concentrating. Rarely heart failure; orthostatic hypotension, seizures |
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Term
| What patients are contraindicated with Amantadine? |
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Definition
| Use caution with epilepsy or psychosis or HF. Don't use in pregnancy! |
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Term
| Theraputic uses for Oseltamivir (Tamiflu): |
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Definition
: Prevention and treatment of influenza; has activity against influenza A and influenza B. Will reduce severity of symptoms. Useful for prevention of influenza when patient was exposed to the virus.
i. If started within 12 hours of signs and symptoms of flu, symptom duration reduced by 3 days
ii. If started within 24 hours, symptom duration reduced by 2 days
iii. If started within 36 hours, symptom duration reduced by 29 hours. |
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Term
| Adverse effects of Oseltamivir (Tamiflu): |
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Definition
| Generally well tolerated, can see nausea and vomiting; psychiatric adverse effects have been reported in kids taking Tamiflu including delirium and hallucinations |
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Term
| What are the primary difference b/n Amantadine & Oseltamivir (Tamiflu)? |
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Definition
Amantadine treats only Influenza A, Oseltamivir treats A & B.
Amantadine cannot be given in pregancy, Oseltamivir can. |
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