Antivirals, Antimalarials, and Anthelmintics

These are more difficult to eradicate than most types of
bacteria.

It is an obligate intracellular organism that must reside within a living host cell to survive and reproduce.

Viruses enter healthy cells and use their ______ and ______ to generate more
viruses.

These live and reproduce when they are within living cells.

Examples of common viral infections

It is a highly contagious viral infection that affects the nose, throat, and lungs.

This virus is seasonal and more prevalent from fall to spring

Three antigen types of Influenza

Causes a moderate to severe infection.

causes mild illness in children

It is very rare in humans.

This viral infection is transmitted easily via contaminated droplets during coughing, sneezing, or talking.

Droplets enter into the _____ of the unaffected person and begin replication 24 hours before the appearance of symptoms.

Influenza has an abrupt onset with the first symptoms being
_____, ______, ______, and ________.

These are large viruses that cause infections.

Most familiar Herpesviruses

Usually associated with cold sores (vesicular lesions), which grow in neurons.

It is capable of latency (ability to maintain disease potential without signs and symptoms)

It is usually associated with vesicular lesions and small ulcerations on the genitalia (genital herpes).

The ______ remains dormant by traveling through the peripheral nerves to the sacral dorsal root ganglia. The virus can be transported back the nerve root
to the skin for reactivation at any time. While dormant, the virus continues to replicate.

Both ___ and ___ are capable of causing recurrent infections. Both viruses can replicate in the _______  and skin of the ________.

HSV-1 is spread by _____ from one individual to another.

Usually spread by intimate sexual contact, or an infected mother can transmit the virus to her infant during childbirth. When signs and symptoms are present, they usually include eruption of small pustules and vesicles; fever; headache; malaise; myalgia; as well as tingling, itching, and pain in the genital area.

Causes chickenpox and shingles.

It is a highly contagious viral infection that causes generalized pruritic vesicles and fever, which has become less common since a vaccine was developed.

Most commonly causes infectious mononucleosis, a condition manifested by fever, tonsillitis, and enlarged lymph nodes in the neck.

It is a very common infectious disease worldwide transmitted via body fluids, especially saliva or urine; by kissing, sexual contact, or sharing food; or by a pregnant patient to the fetus. In susceptible individuals, ___ infection can lead to fatal pneumonia or blindness (due to an infected retina).

It is a serious liver infection caused by the hepatitis B virus, which is transmitted via a needlestick, intimate sexual contact, or childbirth. It is found in all body fluids, including blood, semen, and vaginal fluid.

A _____ usually can be detected only after the
virus has replicated itself.

General signs and symptoms of an _______ include headache, low-grade fever (with a mildviral infection), nausea, vomiting, diarrhea, muscular pain,fatigue, and cough.

These are pharmacologic preparations that have been developed to provide immunity against and prevent diseases, such as smallpox, chickenpox, mumps, rabies, and influenza.

The influenza virus vaccine may change annually because _____ changes its genetic structure each year.

____ are used to produce the flu vaccine; therefore any allergies to ___ should be determined before flu vaccine is administered to the patient.

has been available for many years to detect influenza A; however, it does not
detect influenza B

Diagnostic tests that identify both influenza A and B using throat swabs, nasal swabs, or nasal aspiration. Results are available within 10 to 20 minutes.

These are used to prevent or delay the spread of a viral infection by inhibiting viral replication by interfering with viral nucleic acid synthesis in the cell.

_______ and ______, were used to treat type A influenza. Both these antivirals are nonclassified anti-virals.

Nonclassified antiviral used to treat CMV retinitis

Used to treat HIV retinitis and herpes simplex infection in patients with acquired immunodeficiency syndrome (AIDS) (immune disorder characterized by opportunistic diseases)

Used to treat herpesvirus

____ and ____, two drugs that inhibit the replication and spread of the influenza virus if given within 48 hours of symptoms.

Side effects and adverse reactions to amantadine include ______, such as insomnia, depression, anxiety, confusion, and ataxia; _______; _________, such as weakness, dizziness, and slurred speech; and __________, such as anorexia, nausea, vomiting, and diarrhea.

Three topical antiviral drugs used to treat herpes simplex viruses.

A group of drugs that decrease the release of the virus from infected cells, thus decreasing viral spread and shortening the duration of flu symptoms.

two neuraminidase inhibitors that should be taken within 48 hours of flu symptoms and are effective against type A and B influenza viruses.

It is rich in antibodies found in the blood and provides a passive form of immunity to a virus by blocking the penetration of the virus into the host cell.

Administered intramuscularly (IM). A single-dose injection protects for approximately 2 to 3 weeks; it may be repeated 2 to 3 weeks following the first dose. For patients who need an immediate increase in immune globulin levels, intravenous (IV) immune globulin (Gamimune N) may be administered.

The ______ is effective in interfering with the steps of viral nucleic acid (DNA) synthesis.

These drugs are effective in combating herpes simplex viruses (HSV-1, HSV-2), herpes zoster (shingles), varicella-zoster virus (chickenpox), and CMV.

prodrug of ganciclovir and is effective for treating CMV retinitis in patients with AIDS

Used to treat respiratory syncytial virus (RSV) in children and respiratory infections caused by the influenza A and B viruses in older adults. ____ is administered by aerosol.

Introduced as an antineoplastic drug and later was found to be effective against herpesvirus, especially HSV-2, but also against HSV-1, herpes zoster (shingles), and CMV (which can cause congenital defects

can increase the effect of acyclovir

If taken with acyclovir, the incidence of nephrotoxicity is increased.

_____ is converted to acyclovir, which has inhibitory activity against HSV-1, HSV-2, and varicella-zosteror herpes zoster viruses.

Effective in treating the herpesviruses and CMV yet has a serious adverse reactions such as thrombocytopenia and granulocytopenia so this should be prescribed primarily for severe systemic CMV infections for immunocompromised patients.

The retrovirus that is the cause of AIDS

Two classes of antiretroviral drugs:

Antiviral drugs classified as reverse transcriptase inhibitors which aid in inhibiting viral replication

The protease inhibitor group which inhibits the replication of retroviruses (HIV-1 and HIV-2) include

When a protease inhibitor is used in combination with a reverse transcriptase inhibitor, these drugs may greatly reduce the viral level to the point that
it is undetectable. The combination of drugs helps decrease ______.

caused by the protozoan parasites Plasmodium spp. carried by infected Anopheles mosquitoes, is still one of the most prevalent protozoan diseases.

Malaria is caused by the protozoan parasites ______ carried by infected Anopheles mosquitoes

Carrier of Plasmodium spp.

Two phases in which the protozoan Plasmodium spp. undergoes

The phase which produces no clinical symptoms in the human

The phase which causes symptoms of chills, fever, and sweating. The incubation period is 10 to 35 days, followed by flulike symptoms.

The only anti-malarial drug available from 1820 until the early 1940s

Type of Plasmodium species which is the most severe

commonly prescribed drug for malaria

Three methods used to eradicate malaria

examples of synthetic antimalarials

frequently used to treat an acute malarial attack

used to treat chloroquine-resistant P. falciparum

Chloroquine and hydroxychloroquine can be ___ to children and may even
cause death; therefore the drug dose should be closely monitored.

It is well absorbed from the GI tract. It is moderately protein-binding, and the drug has a long half-life. The first two doses have a loading dose effect. It is metabolized in the liver to active metabolites and excreted in the urine.

The duration of effect of Chloroquine HCl is very long—days to weeks. True or False?
True False

Chloroquine HCl inhibits the malaria parasite’s growth by interfering with its ____.

General side effects and adverse reactions to antimalarials

Quinine is an _____ drug, and quinidine is an _____ drug.

Lemon juice increases effects of Chloroquine HCl. True or False?
True False

Check patient for visual changes. Patients who take chloroquine and hydroxychloroquine should have frequent ophthalmic examinations. True or False?
True False

Assess patient’s hearing, especially if receiving quinine or chloroquine. These drugs may affect ____.

Advise patients traveling to malaria-infested countries to receive ____ doses of antimalarial drug before leaving, during the visit, and upon return.

Combination antimalarial drugs

For malaria infections that are both drug-sensitive and drug-resistant to Plasmodium falciparum. Acts by inhibiting nucleic acid and protein synthesis.

For oral prophylaxis and treatment of malaria. Effective for chloroquine-resistant strains.

large organisms (parasitic worms) that feed on host tissue.

Worm infection

most common site for helminthiasis (worm infestation)

Other sites for parasitic infestation

Groups of helminthes

These are segmented and enter the intestine via contaminated food. They have heads and hooks or suckers that attach to the tissue.

four species of cestodes

flat, nonsegmented parasites that feed on the host

Four types of trematodes

Five types of nematodes may feed on intestinal tissue

Two types of nematodes are tissue-invading

disease caused by ingestion of raw or inadequately cooked pork that contains larvae of the T. spiralis parasite which can be diagnosed by muscle biopsy

The common side effects of ____ (agents that destroy worms) include GI distress, which may manifest as anorexia, nausea, vomiting, and occasionally diarrhea and stomach cramps.

____ should be avoided if the patient has liver disease.

Anti-parasite medication used to treat head lice, onchocerciasis, strongyloidiasis, ascariasis, trichuriasis, and enterobiasis by disrupting their membrane or by entering inside to interact with intracellular components

Ivermectin should be taken on a full stomach with water. True or False?
True False

A polypeptide antibiotic that targets aerobic gram-negative bacteria. It is used to treat Pseudomonas aeruginosa, CRE, and Klebsiella and Shigella species.

___ and ___ both increase nephrotoxicity and/or ototoxicity.

Used to treat several parasitic worm infections such as schistosomiasis by causing severe spasms and paralysis of the worms' muscles

Used to treat pinworm infections by depolarizing neuromuscular blocking agent

Used to treat fascioliasis

Used to treat trichomoniasis and other bacterial infections by disrupting the bacterial DNA and inhibiting cell synthesis, causing cell death.