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Anti-infective Medications: Antivirals

Session Objectives:

By the end of this session, you will be able to:

● Identify the major types of antivirals and their target pathogens.

● Understand the mechanisms by which antivirals work to eradicate pathogens.
● Identify nursing considerations relevant to antivirals and their use.
● Understand the difference between antiviral medications and vaccinations against viral
infections.

Points of Emphasis:

1. Viruses are obligate intracellular parasites. They cannot live on their own outside of a host cell.
2. Viruses do not have a metabolic mechanism of their own for survival and replication.
3. Viruses must invade a host cell and use the host enzymes to replicate.
4. The difficulty is in obtaining “selective toxicity” against viruses, meaning that an antiviral must
kill the viral cells but not the host's cells.
5. Every step in viral life cycle engages host functions.
6. Antiviral side effects are common and often are more damaging to the host than the virus itself.
7. Viruses are opportunistic.
8. A well-functioning immune system will eliminate or effectively destroy the replication of most
viruses.
9. Key characteristics of antiviral drugs:
• Must be able to enter the host cell infected by the virus
• Works synergistically with host to stimulate the immune system
• Interferes with DNA or RNA replication of the virus
• Interferes with ability of virus to bind to host cells, preventing infection
• Kills healthy cells, resulting in serious toxicities
• May be used as single drug therapy or HAART
10. Two Main Types of Antiviral Drugs:
• Antiviral Drugs: Antivirals (Non-antiretrovirals): used to treat non-HIV viral infections
• Anti-retrovirals: used to treat HIV
11. Prior to therapy, assess underlying disease, history, allergies, assess baseline VS, nutritional
status, and lab values.

12. During therapy, assess for adverse S/E (drug specific) and conditions that indicate cautious use
and potential drug interactions.

13. Monitor for signs of opportunistic diseases (e.g. Kaposi’s Sarcoma, Pneumocystis carinii,
Pneumocystis jiroveci, oral thrush, etc).
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14. Immunocompromised patients have frequent viral infections.
Resources:

Get Smart Program: https://www.cdc.gov/getsmart/ a national effort to improve antibiotic prescribing

and use in both outpatient and inpatient settings.

References:

Adisasmito W, Chan PK, Lee N, Oner AF, Gasimov V, Aghayev F, et al. Effectiveness of antiviral treatment
in human influenza A(H5N1) infections: analysis of a Global Patient Registry. The Journal of
infectious diseases. 2010;202(8):1154-60. Epub 2010/09/14. doi: 10.1086/656316. PubMed PMID:
20831384.

Advisory Committee on Immunization Practices; Centers for Disease Control and Prevention.
Immunization of health-care personnel: recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR Recommendations and reports : Morbidity and mortality
weekly report Recommendations and reports. 2011;60(Rr-7):1-45. Epub 2011/11/24. PubMed
PMID: 22108587.Centers for Disease Control (n.d.) Antibiotic Resistance Map. Antibiotic
Resistance Investments; Retrieved from: https://wwwn.cdc.gov/arinvestments?s_cid=dhqp_004

Kaplan (n.d.) NCLEX-RN Content Review Guide, 3rd Edition. (March 2017). New York, NY.

Report of the NIH Panel to Define Principles of Therapy of HIV Infection. (n.d.). Retrieved January 06,
2018, from https://www.cdc.gov/mmwr/preview/mmwrhtml/00052295.htm