C H A P T E R 1 0
Antiviral agents
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Contraindications and cautions
Locally active antiviral drugs are not absorbed system-
ically, but caution must be used in people with known
allergic reactions to any topical drugs.
Adverse effects
Because these drugs are not absorbed systemically,
the adverse effects most commonly reported are local
burning, stinging and discomfort. These effects usually
occur at the time of administration and reduce and dis-
appear over time.
KEY POINTS
■■
Some antiviral agents are available only for the local
treatment of viral infections, including warts and eye
infections.
■■
Topical antiviral agents should not be applied
to open wounds; local reactions can occur with
administration.
CHAPTER SUMMARY
■■
Viruses are particles of DNA or RNA surrounded
by a protein coat that survive by injecting their own
DNA or RNA into a healthy cell and taking over its
functioning.
■■
Because viruses are contained within human cells, it
has been difficult to develop drugs that are effective
antiviral agents and yet do not destroy human cells.
Antiviral agents are available that are effective
against only a few types of viruses.
■■
Influenza A and respiratory viruses cause the signs
and symptoms of the common cold or “flu”. The
drugs that are available to prevent the replication of
these viruses are used for prophylaxis against these
diseases during peak seasons and to treat disease
when it occurs.
■■
Herpes viruses and CMV are DNA viruses that
cause a multitude of problems, including cold sores,
encephalitis, infections of the eye and liver, and
genital herpes.
■■
Helper T cells are essential for maintaining a vigilant,
effective immune system. When these cells are
decreased in number or effectiveness, opportunistic
infections occur. AIDS and ARC are syndromes of
opportunistic infections that occur when the immune
system is depressed.
KEY POINTS
TABLE 10.5
DRUGS IN FOCUS Locally active antiviral agents
Drug name
Usual indications
ganciclovir (Vitrasert)
Implanted for treatment of CMV in people with AIDS
imiquimod (Aldara)
Local treatment of genital and perianal warts
Care considerations for people receiving
locally active antiviral agents
Assessment: history and examination
■
■
Assess for history of allergy to antiviral agents
to avoid allergic response to these drugs.
■
■
Perform a physical assessment
to establish
baseline data for evaluating the effectiveness of
the drug and the occurrence of any adverse effects
associated with drug therapy
.
■
■
Assess the infected area, including location, size
and character of lesions.
■
■
Evaluate for signs of inflammation at the site of
infection.
Implementation with rationale
■
■
Ensure proper administration of the drug
to
improve effectiveness and decrease risk of adverse
effects.
■
■
Stop the drug if severe local reaction occurs or if
open lesions occur near the site of administration
to prevent systemic absorption and adverse effects.
■
■
Instruct the person about the drug being used
to enhance knowledge about drug therapy and to
promote compliance.
Include as a teaching point
the fact that these drugs do not cure the disease but
should alleviate discomfort and prevent damage to
healthy tissues.
■
■
Encourage the person to report severe local
reaction or discomfort.
Evaluation
■
■
Monitor person’s response to the drug (alleviation
of signs and symptoms of viral infection).
■
■
Monitor for adverse effects (local irritation and
discomfort).
■
■
Evaluate the effectiveness of the teaching plan
(person can name the drug, the dosage, proper
administration technique, and adverse effects to
watch for and report to a healthcare provider).
■
■
Monitor the effectiveness of comfort and safety
measures and compliance with the regimen.
