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Chapter 13

Chapter 13. Antivirals, Antiretrovirals and Antifungal Medications. Chapter 13 Lesson 13.1. Learning Objectives. Describe how antiviral and antiretroviral medications work List common medications used in treating AIDS and AIDS-related fungal infections

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Chapter 13

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  1. Chapter 13 Antivirals, Antiretrovirals and Antifungal Medications

  2. Chapter 13 Lesson 13.1

  3. Learning Objectives • Describe how antiviral and antiretroviral medications work • List common medications used in treating AIDS and AIDS-related fungal infections • Outline Standard Precautions the nurse takes in limiting exposure to AIDS

  4. HIV Infection Acquired immunodeficiency syndrome (AIDS) • Viral disease • High mortality rate High-risk populations include: • Homosexual and bisexual men • Intravenous drug users • People in prison • Female sexual partners of people in high-risk groups • Children born to mothers at risk

  5. Antivirals Action and Uses • Decrease symptoms of viral infection • Lessen the symptoms of viral illness in immunocompromised patients or adults and children at risk Adverse Reactions • Hepatotoxicity, nephrotoxicity, blood dyscrasias, peripheral neuropathies

  6. Antivirals (cont.) Nursing Implications and Patient Teaching • Medications do not cure • Follow specific storage instructions • Reporting adverse reactions • Administration • Encourage immunocompromised clients in areas with impure water supplies to drink bottled water only

  7. Antiretrovirals Action • Interfere with the ability of a retrovirus to reproduce or replicate • Two types: • Reverse transcriptase inhibitors • Act early in viral life cycle • Protease inhibitors • Act later in viral life cycle

  8. Antiretrovirals (cont.) Uses • Slow advance of AIDS • Maintain immunity • Prevention of HIV in infants born to HIV-infected mothers • Prevention of HIV in healthcare workers exposed to HIV Drug Interactions

  9. Antiretrovirals (cont.) Nursing Implications and Patient Teaching • Adherence is essential • Medications do not cure • Report all drugs and supplements used, including OTC and CAM • Signs and symptoms of pancreatitis • Signs and symptoms of peripheral neuropathy

  10. Antiretrovirals (cont.) Nursing Implications and Patient Teaching (cont.) • Routes of disease transmission • Need for social and financial support

  11. Antifungals Action • Fungistatic • Fungicidal Uses • Treat mycotic infections • Fungal-specific medications • Systemic medications

  12. Antifungals (cont.) Common Antifungal Medications: Ketoconazole (Nizoral) • Broad-spectrum fungistatic and fungicidal action • Used to treat oral thrush, candidiasis, histoplasmosis Nystatin (Mycostatin) • Antibiotic with fungistatic and fungicidal action • Used to treat intestinal, vaginal, and oral fungal infections caused by Candida strains

  13. Antifungals (cont.) Common Antifungal Medications (cont.) Amphotericin B (Amphotec) • Systemic drug Griseofulvin • Activity decreased with barbiturates Metronidazole (Flagyl) • Related drug for mixed fungal and bacterial or protozoa infections; interacts with alcohol

  14. Antifungals (cont.) Nursing Implications and Patient Teaching • Take all the medication as ordered; do not stop when symptoms disappear • Avoid alcohol • Report nausea, vomiting, and diarrhea; watch for easy bruising, sore throat, rash, or fever • Nystatin must be shaken thoroughly before use • Intolerance to the sun (photosensitivity) can occur with griseofulvin therapy • Cleanliness of hair, skin and nails will limit spread

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