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NON-RETROVIRAL USES- influenza A, influenza B, respiratory syncytial virus, varicella, herpes zoster, hepatitis C, cytomegalovirus, herpes simplex MOA-

blocks polymerase enzyme which impairs replication does not eliminate virus from body Zovirax (acyclovir)genital herpes, SE- n&v diarrhea, HA, orths. Hypotension Famciclovir (famvir)herpes zoster, shingles, recurrent genital herpes Foscavircytomegalovirus; highly toxic to kidneys, in children b/c can affect bone development, used in immunocompressed pts. Cytovene (gancicilovir)longterm treatment & prevention of CMV, can be carcinogenic, can cause bone marrow suppression, SE- n&v HA anorexia seizures TamifluRelenzaInfluenza A & B Symmetrel- effective against A but not B SE-nervousness, insomnia, lightheaded, anti-cholinergic effects, anorexia, nausea, orthos. Hypotension Lamivudine (epivir)hepatitis; AE- fat accumulation in live, lactic acidosis makes my bones ache

Nursing assessmentvarious viral illness, immunization deficits, renal & hepatic status, risk factors Interventions- infection prevention & control measures, avoid AE, pt. teaching, monitor AE provide immunizations Evaluation- monitor change in S/S; monitor compliance; monitor SE; review immunization ANTI-RETROVIRAL MOANRTI&NNRTI- block RNA & DNA activity PROTEASE INHIBITORS- prevent maturation ENTRY INHIBITORSprevent the entry of the virus into the cell wall Combination drugsCombivir Kaletra Trizivir - intolerable toxicity, drug allergy Goal - reduce viral load; <50 is considered undetectable; improve tcell counts, incidence of opportunistic infections, mortality Retrovir- very 1st approved for AIDs, given to females and newborns to prevent maternal transmission, bone marrow suppression Zerit- extended release, incidence of peripheral neuropathy Viread- used in salvage therapy for drug failure

Sustiva- NNRTI, used in combo w/NRTI; Viramune- liver toxicity Crixivan- PI, best absorbed in an acidic gastric environment, presence of high-protein high-fat food absorption, should be admin. in fasting state Viracept- PI, metabolized in liver, good for pts. with renal impairment, dru-drug: antidysrhythmics, sedative-hypnotics Fuzeon- entry inhibitor, newest med, injection only, peripheral neuropathy Maraviroc- entry inhibitors Assessment- note age (renal & hepatic functioning); monitor lab work WBC RBC BUN creatinine liver function, medical hx, vitals Diagnosis- acute pain, risk for injury, deficient knowledge, activity intolerance, risk for impaired tissue integrity, altered sexuality patterns, social isolation Planning- client is free of symptoms of viral infection, client remains compliant, client experiences improved injury level & appetite, client experiences minimal AE of antiviral drug therapy Interventionshandwashing, gloves, IV over 1 hr- renal damage; hydration, nutrition; pain; mouth care; saliva

substitutes; observe for liver toxicity; weigh weekly; analgesia for pain relief; safety; aerosol generators; ventilators

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