Transcript PowerPoint Chapter 13

Chapter 13
Antivirals, Antiretrovirals and Antifungal
Medications
Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
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Chapter 13
Lesson 13.1
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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
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HIV Infection
Acquired immunodeficiency syndrome (AIDS)
– Viral disease
– High mortality rate
High-risk populations include:
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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
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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
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Antivirals (cont.)
Nursing Implications and Patient Teaching
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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
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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
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Antiretrovirals (cont.)
Uses
– Slow advance of AIDS
– Maintain immunity
– Prevention of HIV in infants born to HIVinfected mothers
– Prevention of HIV in healthcare workers
exposed to HIV
Drug Interactions
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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
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Antiretrovirals (cont.)
Nursing Implications and Patient Teaching
(cont.)
• Routes of disease transmission
• Need for social and financial support
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Antifungals
Action
– Fungistatic
– Fungicidal
Uses
– Treat mycotic infections
• Fungal-specific medications
• Systemic medications
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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
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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
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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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