 Oseltamivir phosphate (available as a generic version or under the trade name Tamiflu)

 Zanamivir (trade name Relenza)

 Peramivir (trade name Rapivab)

 Baloxavir marboxil (trade name Xofluza)

Drug Classification Indication of Use Mechanism of Contraindication Side Effects Nursing Responsibilities
Action

Trade Name: Neuraminidase Influenza A or B Selective Contraindications: Frequent (10%–7%): Nausea, BASELINE ASSESSMENT
Tamiflu inhibitor inhibitor of Hypersensitivity vomiting, diarrhea. Obtain baseline laboratory tests as indicated.
influenza virus to oseltamivir. Confirm presence of influenza A or B virus.
Generic Name: Antiviral neuraminidase, Rare (2%–1%): Abdominal pain,
Oselmativir an enzyme Cautions: Renal bronchitis, dizziness, headache, INTERVENTION/EVALUATION
essential for impairment. cough, insomnia, fatigue, Monitor serum glucose, renal function in pts with
Availability and viral vertigo. influenza symptoms, diabetes.
doses: replication.
PATIENT/FAMILY TEACHING
Capsule: 30 Acts against ADVERSE EFFECTS/ TOXIC •  Begin as soon as possible from first
mg, 45 mg, 75 influenza A REACTIONS Colitis, appearance of flu symptoms (recommended
mg and B viruses. pneumonia, tympanic within 2 days from symptom onset). 
membrane disorder, fever
Suspension: Therapeutic •  Avoid contact with those who are at high risk
occur rarely.
6 mg/ml Effect: for influenza. 
Suppresses
Route: Oral spread of
infection
•  Not a substitute for flu shot.
within
respiratory
system,
reduces
duration of
clinical
symptoms.

Trade Name: Neuraminidase Treatment of Inhibits Treatment of Occasional (3%–2%):  BASELINE ASSESSMENT
Relenza inhibitor. uncomplicated influenza virus uncomplicated Diarrhea, sinusitis, nausea, Pts requiring an inhaled bronchodilator at same
acute ill- ness enzyme acute illness due bronchitis, cough, dizziness time as zanamivir should use the bronchodilator
Generic Name: Antiviral, anti- due to influenza neuraminidase, to influenza virus headache. before zanamivir administration.
Zanamivir influenza virus A and B in essential for A and B in adults,
Availability and adults, children 7 viral children 7 yrs and INTERVENTION/EVALUATION
Dose: yrs and older replication. older who have Provide assistance if dizziness occurs. Monitor
who have been been symptomatic Rare (Less Than 1.5%):  daily pattern of bowel activity, stool consistency.
Powder for symptomatic for Prevents viral for less than 2 Malaise, fatigue, fever,
Inhalation:  5 less than 2 days. release from days. Prevention abdominal pain, myalgia,
mg/blister. Prevention of infected cells of influenza A and arthralgia, urticaria. PATIENT/FAMILY TEACHING
influenza A and B B in adults and
in adults and children 5 yrs and ADVERSE EFFECTS/ TOXIC •  Follow manufacturer guidelines for use of
children 5 yrs and older. REACTIONS May produce delivery device. 
Route: older. neutropenia. Bronchospasm
Inhalation may occur in those with •  Avoid contact with those who are at high risk
history of COPD, bronchial for influenza. 
Frequency: asthma.
BID •  Continue treatment for full 5-day course. 
(Approximately Neuropsychiatric events (e.g.,
12 hours) confusion, seizures, •  Doses should be evenly spaced. 
hallucinations) have been
reported. •  In pts with respiratory dis- ease, an inhaled
bronchodilator should be readily available.

Contraindications: 1-10%
Trade Name: Neuraminidase Indicated for Elicits antiviral Known serious BASELINE ASSESSMENT:
Rapivab inhibitor treatment of activity by hypersensitivity Assess for the mentioned cautions and
Diarrhea (8%)
acute inhibiting or anaphylaxis to contraindications (e.g. drug allergies, hepatorenal
Generic Name: Antiviral uncomplicated influenza virus peramivir or any Neutrophils <1 x 10^9/L (8%) impairment, pregnancy and lactation, etc.) to
influenza in neuraminidase, component of the prevent any untoward complications.
Peramivir patients aged ≥2 an enzyme product; severe Increased serum glucose (>160
years who have that releases allergic reactions mg/dL) (5%) Perform a thorough physical assessment (other
Availability and been viral particles have included medications taken, orientation and reflexes, vital
dose: symptomatic for from the anaphylaxis, signs, etc.) to establish baseline data before drug
Creatine phosphokinase (≥6 x therapy begins, to determine effectiveness of
no more than 2 plasma erythema ULN) (5%) therapy, and to evaluate for occurrence of any
days membrane of multiforme, and
IV solution adverse effects associated with drug therapy
infected cells Stevens-Johnson
Constipation (4%)
Syndrome
200mg/20mL INTERVENTION/EVALUATION:
(10mg/mL) Insomnia (3%) Administer drug as prescribed as soon after
exposure to the virus is possible to enhance
600 mg IV as a AST and ALT increased (3%) effectiveness and decrease the risk of
single dose Cautions: complications due to viral infection.
Hypertension (2%)
Serious skin Administer influenza A vaccine before the flu
Infuse diluted season begins, if at all possible, to decrease the
IV over 15-30 reactions
reported including risk of contracting the flu and decrease the risk of
minutes complications.
erythema
multiforme and
Monitor patient response to therapy (prevention
Stevens-Johnson
of respiratory flu-like symptoms and alleviation of
syndrome
flu-like symptoms).

Monitor for adverse effects (e.g. changes in

 orientation and affect, blood pressure, urinary
output, liver or renal function test changes, etc).

Evaluate patient understanding on drug therapy

by asking patient to name the drug, its indication,
and adverse effects to watch for.

Monitor patient compliance to drug therapy.

PATIENT/FAMILY TEACHING:
Instruct the patient about the appropriate dosage
scheduling regimen; safety precautions, including
changing position slowly and avoiding driving and
hazardous tasks that should be taken if CNS
effects occur; the need to report any adverse
effects such as difficulty walking or talking to
enhance the patient knowledge about drug
therapy and to promote compliance.

Educate client on drug therapy to promote

understanding and compliance.

Baloxavir Baloxavir XOFLUZA is Adverse events reported in at

Brand Name: marboxil is an marboxil is an Baloxavir contraindicated in least 1% of adult and
Xofluza antiviral antiviral inhibits the patients with a adolescent subjects treated
medication medication used endonuclease history of with XOFLUZA included
Generic Name: used to treat to treat the flu activity of the hypersensitivity diarrhea (3%), bronchitis (2%),
Baloxavir the flu (influenza) if your polymerase to baloxavir nasopharyngitis (1%),
Marboxil (influenza) if symptoms acidic (PA) marboxil or any of headache (1%) and nausea
your started less than protein, an its ingredients. (1%).
symptoms 48 hours ago. It influenza
started less helps make the virus-specific
Availability and enzyme in the
than 48 hours symptoms (such
Dose: viral RNA
ago. It helps as stuffy nose,
make the cough, sore polymerase
Tablets: 20 mg complex
symptoms throat,
and 40 mg (3) required for
(such as stuffy fever/chills,
nose, cough, aches, tiredness) viral gene
sore throat, less severe and transcription,
fever/chills, may shorten the resulting in
aches, recovery time by inhibition of
tiredness) less 1 to 2 days. influenza virus
severe and Baloxavir replication.
 may shorten marboxil works
the recovery by stopping the
time by 1 to 2 flu virus from
days. Baloxavir growing. It will
marboxil not treat other
works by kinds of infection
stopping the besides the flu
flu virus from virus.
growing. It will
not treat other
kinds of
infection
besides the flu
virus.