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55 Cards in this Set

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antivirals
acyclovir (Zovirax)
ganiciclovir (Cytovene)
other meds: interferon alfa-2b (Intron A)
lamivudine (Epivir)
Oseltamivir (Tamiflu)
ribavirin (Rebetol)
amantadine (Symmetrel)
boceprevir (Victrelis)
telaprevir (Incivek)
antiviral MOA
prevent reproduction of viral DNA and thus interrupts cell replication
acyclivir (antiviral)
treats herpes simplex and varicella zoster viruses
ganciclovir (antiviral)
treatment and prevention of cytomegaolvirus
prevention therapy using ganciclovir is also given for clients who have HIV/AIDS, organ transplants, and other immunocompromised states
interferon alfa-2b and lamivudine
used to treat hep b and c
oseltamivir
used to treat influenzae A and B
ribvirin
is used to treat respiratory syncytial virus and inflammation
boceprevir and telaprevir
used to treat hep C virus
acyclovir adverse
phlebitis and inflammation at site of infusion
nephrotoxicity
mild discomfort associated with oral terhapy
gaciclovir adverse
suppressed bone marrow, including leukocytes and thrombocytes
fever, headache, nausea, diarrhea
acyclovir contraindications
renal impairment, dehydration, nephrotoxic meds
gaciclovir contraindications
neutrophil count below 500 mm3 or platelet count less than 25000 mm 3
should be used cautiously in infants under 3 months, older adults, and clients who have dehydration, renal insufficiency, or malignant disorders
gaciclovir interactions
cytotoxic meds may increase toxicity
acyclovir interactions
probenecid may decrease elimination of acyclovir
concurrent use of zidovudine may cause drowsiness
acyclovir admin
put on rubber gloves to administer topical
administer IV infusion slowly over 1 hour or longer
ganciclovir admin
IV infusion slowly over at least 1 hr
administer oral med with food
intraocular for CMV retinitis
avoid getting ganciclovir solution or powder on skin
antiviral effectiveness
healed genital lesions, decreased inflammation or pain, improvement in vision
antiretroviral- fusion/entry inhibitors
proto: enfuvertide (Fuzeon)
subQ
antiretroviral MOA
decreases and limites the spread of HIV by blocking HIV from attaching to and entering CD4 T cell
enfuvirtide (Fuzeon) uses
treatment of HIV that is unresponsive to other antiretrovirals
enfuvirtide (Fuzeon) adverse
localized reaction at injection site
bacterial pneumonia
fever, chills, rash, hypotension
enfuvirtide contrainidcations
hypersensitivity
enfuvirtide admin
only administered subQ
enfuvirtide effectiveness
reduction of symptoms and remain free of opportunistic infection
antiretroviral-CCR5 antagonist
proto: maraviroc (selzentry)
maraviroc MOA
prevents HIV from entering lymphocytes by binding to CCR5 on cell membranes
maraviroc use
treats HIV infection in conjunction with other antiretroviral meds
maraviroc adverse
cough and upper respiratory tract infections
CNS effects
hepatotoxicity
maraviroc contraindications
first med to treat clients who have newly diagnosed HIV infection and also contraindicated with existing liver disease or during lactation
caution: existing cardiovascular disorders and older adults
maraviroc interactions
most protease inhibtors raise marviroc levels
rifampin, efavrienz, phenytoin, some anticonvulsants, St. John's Wort decreases maraviroc levels
maraviroc effectiveness
decrease in HIV manifestations and absence of opportunistic infection
NRTIs (antiretroviral)
zidovudine (Retrovir)
zidovudine (NRTI) MOA
reduces HIV symptoms by inhibiting DNA synthesis and thus viral replication
zidovudine (NRTI) use
first line antiretrovirals to treat HIV infection
zidovudine (NRTI) adverse
can cause suppressed bone marrow, resulting in anemia, agranulocytis, and thrombocytopenia
lactic acidosis
nausea, vomiting, diarrhea
hepatomegaly, fatty liver
zidovudine NRTI contraindications
liver disease, bone marrow depression
zidovudine (NRTI) interactions
probenecid, valproic acid, and methadone may increase zidovudine
ganciclovir
rifampin and ritonavir may reduce zidovudine levels
phenytoin may alter both med levels
zidovudine (NRTI) admin
monitor for bone marrow suppression
obtain baseline CBC and platelets at the start of therapy and monitor periodically as needed
anemia may be treated with epoetin alfa or infusions
neutropenia may be treated with colony-stimulating factors
zidovudine effectiveness
reduction of symptoms and remain free of opportunistic infection
antiretrovirals (NNRTIs)
proto: delavirdine (Rescriptor), efavirenz (Sustiva)
other: nevirapine (Viramune), etravirine, (Intelence)
delavirdine (NNRTIs) MOA
act directly on reverse transcriptase to stop HIV replication
delaviridine use
primary HIV-1 infection
used in combination with other antiretroviral agents to prevent med resistance
delaviridine adverse
rash, flulike symptoms, headache, fatigue, CNS manifestations
CNS manifestations, dizziness, drowsiness, insomnia, nightmares
NNRTI (efavirenz) contraindications
liver disease, hypersensitivity
NNRTI interactions
antacids may decrease absorption of delavirdine- allow one hour between medications
NNRTI may increase effects of benzodiazipines, antihistamines, calcium channel blockers, ergot alkaloids, quinidine, warfarin, and others
rifampin and phenytoin may cause decrease in levels of delavirine
didanosine may reduce both medicines absorption
NNRTIs may cause increase in slidenafil level
NNRTI administration
efavirernz must be given with a high-fat meal to increase absorption
NNRTI effectiveness
reduction of symptoms and remaining free of opportunistic infection
Protease inhibitors
ritonavir (Norvir)
protease inhibitors MOA
act against HIV 1 and HIV2 to alter and inactivate the virus by inhibiting enzymes needed for HIV replication
protease inhibitor use
HIV infections
ritonavir is usually given with other PIs to increase their effect
protease inhibitor adverse
bone loss-oseoporosis
DM-hyperglycemia
hypersensitivity
nausea and vomiting
elavated serum lipids
thrombocytopenia, leukocytopenia
protease inhibitor contraindications
liver disease
contraindicated in many medications
protease inhibitor interactions
raltegravir may be decreased with concurrent use of rifampin or the combination tipranavir/ritonavir
protease administration
raltegravir may decreased with concurrent use of rifampin or the combination tipranavir/ritonavir
raltegravir dosage may need to be increased
Protease inhibitor effectiveness
effectiveness may be evidenced by reduction of HIV manifestations and freedom of opportunistic infections