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Pharmacology Viruses Drug therapy

front 1 What are the two types of herpes infections and their signs/symptoms?	back 1 Herpes Simple Virus (HSV) - fever, blisters, cold sores, genital herpes Cytomegalovirus (CMV retinitus) - affects retina of the eye, so blurry vision and decreased visual acuity
front 2 What is the topical drug used for herpes simple virus?	back 2 acyclovir
front 3 What does acyclovir do?	back 3 it interrupts viral DNA synthesis
front 4 What do we use acyclovir for?	back 4 to treat herpes simple virus and genital herpes (decreases duration, pain, and viral shedding (ability to spread))

front 5 How would you, as a nurse, apply acyclovir to a patient?	back 5 topically with gloved hands and any other PPE
front 6 There is also an IV form of acyclovir. What is it called?	back 6 Encaphylopathy
front 7 What is a drug used to treat Cytomegalovirus?	back 7 ganciclovir
front 8 How does ganciclovir work?	back 8 it inhibits viral DNA synthesis

front 9 What are some nursing considerations for ganciclovir?	back 9 it can cause renal impairment
front 10 Ganciclovir has 2 BBWs. What are they?	back 10 granulocytopenia (neutropenia), thrombocytopenia maintain contraceptive precautions during and 90 days after use.
front 11 What is the oral version of ganciclovir?	back 11 valganciclovir (Valcyte)
front 12 What would you tell a patient who is just starting valganciclovir?	back 12 take with a high fat meal to increase absorption

front 13 What is respiratory syncytial virus (RSV)?	back 13 respiratory illness that's more severe in babies
front 14 What is a symptom of RSV?	back 14 cyanosis
front 15 What drug would you give to treat RSV?	back 15 ribavirin
front 16 What does ribavirin do?	back 16 interferes with DNA/RNA replication

front 17 Who would you use ribavirin for?	back 17 in children experiencing RSV
front 18 How would you give ribavirin?	back 18 via inhalation (monitor for nasal flaring (indicator of respiratory distress))
front 19 Ribavirin has a BBW. What is it?	back 19 teratogenic
front 20 What are some signs and symptoms of influenza (the flu)?	back 20 muscle aches, pains, fatigue, fever, nausea, vomiting, diarrhea, headache, shivering, can be deadly

front 21 What drug is used to treat influenza?	back 21 oseltamivir phosphate
front 22 How oseltamivir phosphate work?	back 22 doesn't allow for new viruses to escape cell
front 23 Who would you use oseltamivir phosphate for?	back 23 patients above 1 years old who have influenza
front 24 What are some nursing considerations for oseltamivir phsophate?	back 24 you can take it prophylactally (for prevention) and has similar symptoms to the flu, so take with food to lower GI upset

front 25 Describe how you can get hepatitis A, B, and C and if untreated, what it could cause.	back 25 A - fecal-oral route, close contact with infected person. B - contaminated bodily fluids (esp. blood) C - same as B can lead to cirrhosis, liver cancer, liver failure, and death. Hepatitis A and B have a vaccine.
front 26 What drug would you give for hepatitis?	back 26 Lamivudine
front 27 How does Lamivudine work?	back 27 it incorporates itself into viral DNA and terminates it
front 28 Who would you use Lamivudine for?	back 28 patients with chronic hepatitis B and HIV

front 29 What are some nursing considerations of Lamivudine?	back 29 It can cause pancreatitis (severe upper abdominal pain)
front 30 There is a BBW for Lamivudine. What is it?	back 30 it can cause lactic acidosis (musculoskeletal pain) and hepatomegaly with steatosis (fatty liver)
front 31 What is HIV known as?	back 31 a retrovirus (RNA -> DNA) that binds to and destroys CD4 cells (T lymphocytes) that normally help to regulate immune function and can progress to AIDS if left untreated
front 32 Describe the steps of HIV to AIDS.	back 32 virus integrates itself on receptors on host cell membrane Virus uncoats itself an releases RNA into the cell Reverse transcriptase converts virus's RNA to DNA (necessary for viral replication) DNA codes for protein synthesis and produces immature viral particles Enzyme protease assembles immature viral particles into mature virus Mature viruses are released from the host cell

front 33 What are the HIV clinical manifestations?	back 33 Initial phase - flu like symptoms that last weeks Immune response - decreases in viral reproduction. Pt is asymptomatic but infectious Immune system damaged - increased viral reproduction Illness progresses to AIDS - once viral load reaches high level. Serious opportunistic infections occur.
front 34 What is the goal of HIV treatment?	back 34 to limit viral load and prevent progression to AIDs and transmission to others.
front 35 What is PrEP (Truvada)?	back 35 daily pill patients who do NOT have HIV but are at high risk for it take to prevent HIV. Pt must take it consistently or the effects will decrease. It only protects against HIV NOT STDs/STIs.
front 36 What drugs would you use to treat HIV?	back 36 nucleoside reverse transcriptase inhibitors (NRTI) and nonnucleoside reverse transcriptase inhibitors (NNRTI)

front 37 What is the prototype drug for nucleoside reverse transcriptase inhibitors (NRTI)?	back 37 Zidovudine
front 38 How does zidovudine work?	back 38 it incorporates itself into viral DNA and terminates it (prevents step 3-4)
front 39 Who would you give zidovudine to?	back 39 pregnant mothers with HIV to prevent HIV transmission to fetus
front 40 Zidovudine has a BBW. What is it?	back 40 granulocytopenia, pancytopenia, lactic acidosis, hepatomegaly

front 41 What is the prototype drug for non nucleoside reverse transcriptase inhibitors (NNRTIs)?	back 41 efavirenz
front 42 How do efavirenz work?	back 42 incorporates into viral DNA and terminates it (prevents 3-4). has synergy with zidovudine (nucleoside reverse transcriptase inhibitors).
front 43 What is efavirenz used to treat?	back 43 HIV
front 44 What are some nursing considerations with efavirenz?	back 44 don't give to patients with hepatic impairment, has a potential for Steven Johnson Syndrome, and has a CNS effect (so take it at night)