DRUG STUDY ON

ANTIVIRAL
DRUGS

Prepared By:
Mia Karla Paula Z. Obispo
BSN-II-A
ACYCLOVIR(ZOVIRAX)
Indications:
 First and recurrent episodes of mucocutaneous herpes
simplex virus(HSV-1 and HSV-2)infections in
immunocompromised patients; severe first episodes of
genital herpes in patients who aren’t
immunocompromised.
 First genital herpes episode.
 Intermittent therapy for recurrent genital herpes.

Classification:
 Antiviral
 Long- term suppressive therapy for recurrent genital
herpes.
 Varicella(chickenpox) infections in
immunocompromised patients.
 Varicella infection in immunocompetent patients.
 Acute herpes zoster infection in immunocompetent
patients.
 Herpes simplex encephalitis.
 Neonatal herpes simplex virus infection.
Dosage:
 Adults and children age 12 and older:
 5mg/kg given I.V. over 1 hour q8 hours for 7 days.
Give for 5-7 days for severe first episode of genital
herpes.

 Children younger than age 12:

 10mg/kg given I.V. over 1 hour q8 hours for 7 days.
Action:
 Interferes with DNA synthesis and inhibits viral
multiplication.
Adverse Reactions:
 CNS: malaise, headache, encephalopathic changes,
(including lethargy, obtundation, tremor, confusion,
hallucinations, agitation, seizure, coma).
 GI: nausea, vomiting, diarrhea.
 GU: hematuria, acute renal failure.
 Hematologic: thrombocytopenia, leukopenia,
thrombocytosis.
 Skin: rash, itching, urticaria, inflammation or phlebitis
at injection site.
Contraindications:
 Contraindicated in patients hypersensitive to drug.
 Use cautiously in patients with neurologic problems,
renal disease, or dehydration, and in those receiving
other nephrotoxic durgs.
 Adequate studies haven’t been done in pregnant
women; use only if potential benefits outweigh risks to
fetus.
Nursing Considerations:
 Alert: Don’t give I.M. or subcutaneously.
 In patients with renal disease or dehydration and in
those taking other nephrotoxic drugs, monitor renal
function.
FAMCICLOVIR(FAMVIR)
Indications:
 Acute herpes zoster infection (shingles).
 Recurrent genital herpes.
 Suppression of genital herpes.
 Recurrent mucocutaneous herpes simplex infections in
HIV infected patients.
Classification:
 Antiviral
Dosage:
 Adults:

- 500mg P.O. q8 hours for 7 days.

 Adjust a dose:

- For patients with creatinine clearance of 40-

59ml/minute, give 500mg P.O. q12 hours; if clearance
is 20-39ml/minute, give 500mg P.O. q24 hours; and if
it is less than 20ml/minute, give 250mg P.O. q24 hours.
For hemodialysis patients, give 250mg P.O. after each
hemodialysis session.
Action:
 A guanosine nucleoside that is converted to
penciclovir, which enters viral cells and inhibits DNA
polymerase and viral DNA synthesis.
Adverse Reactions:
 CNS: headache, fatigue, fever, dizziness, paresthesia,
somnolence.
 EENT: pharyngitis, sinusitis.
 GI: diarrhea, nausea, vomiting, constipation, anorexia,
abdominal pain.
 Musculoskeletal: back pain, arthralgia.
 Skin: pruritus.
Contraindications:
 Contraindicated in patients hypersensitive to drug.
 Use cautiously in patients with renal or hepatic
impairment.
Nursing Considerations:
 Drug may be taken without regard to meals.
 Dosage adjustment may be needed in patients with
renal or hepatic impairment.
 Monitor renal and liver function tests in these patients.
VALACYCLOVIR(VALTREX)
Indications:
 Herpes zoster infection (shingles).
 First episode of genital herpes.
 Recurrent genital herpes in immunocompetent patients.
 Long- term suppression of recurrent genital herpes.
 Cold sores (herpes labialis).
 Long- term suppression of recurrent genital herpes in
HIV- infected patients with CD4 cell count of 100
cells/mm3 or more.
Classification:
 Antiviral
Dosage:
 Adults:

- 1g P.O. t.i.d. for 7 days.

 Adjust a dose:

- For patients with creatinine clearance of 30-

49ml/minute, give 1g P.O. q12 hours; if clearance 10-
29ml/minute, give 1g P.O. q24 hours; if clearance is
less than 10ml/minute, give 500mg P.O. q24 hours.
Action:
 Rapidly converts to acyclovir, which in turn becomes
incorporated into viral DNA, thereby terminating
growth of the DNA chain; inhibits viral DNA
polymerase, causing inhibition of viral replication.
Adverse Reactions:
 CNS: headache, dizziness, depression.
 GI: nausea, vomiting, diarrhea, abdominal pain.
 GU: dysmenorrhea.
 Musculoskeletal: arthralgia.
Contraindications:
 Contraindicated in patients hypersensitive to or
intolerant of valacyclovir, acyclovir, or components of
the formulation.
 Alert: Valacyclovir isn’t recommended for use in
patients with HIV infection or in bone marrow or renal
transplant recipients because of the occurrence of
thrombotic thrombocytopenic purpura and hemolytic
uremic syndrome in these patients at doses of 8g/day.
 Use cautiously in elderly patients, those with renal
impairment, and those receiving other nephrotoxic
drugs. Monitor renal function test results.
Nursing Considerations:
 Look alike-sound alike: Don’t confuse valacyclovir
(valtrex) with valganciclovir (valcyte).
 Although there are no reports of overdose,
precipitation of acyclovir in renal tubules may occur
when solubility (2.5mg/ml) is exceeded in the
intratubular fluid. With acute renal failure and anuria,
the patient may benefit from hemodialysis until renal
function is restored.
THANK YOU!