Antiviral Drugs

Virus- are strands of genetic material wrapped in a protein coating that prevents the ability of the virus to
sustain itself independently.
- Live and reproduce when they are within the living cells
- To multiple they attach the cell membrane and enter the cell nucleus where there is DNA or RNA
covered with a protein capsule
- Replication is complete – SIGNS & SYMPTOMS
Work by preventing the virus from entering the body or by interrupting replication of the virus.
CLASSIFICATION:
1. Non-HIV drugs- prevent or delay the spread of a viral infection ( influenza A & B, herpes species,
cytomegalovirus)
a. amantadine HCl, rimantadine HCl- for flu
b. cidofovir
c. foscarnet
d. vidarabine
2. HIV Antiviral – reduce HIV levels in the plasma slowing the loss of immune function & prolonging life.
- triple-drug regimen or called COCKTAIL
- NRTI’s nucleotide reverse transcriptase inhibitors – preventing the helper T-cells in the body from
becoming infected with HIV

DRUGS TO TREAT MALARIA

Malaria- characterized by high fever, with recurrent chills, severe sweating, and jaundice- involvement of
the LIVER-microbes enter the liver
- by mosquito Anopheles.
- Prophylactic 1-2 weeks before travel and 6 weeks after after.
- Choloroquine is the drug of choice
- Quinine with adjunctive drugs used to treat choloroquine-resistant microbes

Antiseptics- agents applied to living tissue to clean wounds or prepare skin for surgery.
Disinfectants- applied to inanimate objects to reduce bacterial growth
Iodine preparations
Alcohol
Hexachlorophene
Hydrogen peroxide
Silver preparation – silver nitrate
Mercury preparation

ANTI-CANCER DRUGS
Cancer- uncontrolled division of abnormal cells reproducing faster than the normal cells
- no useful function but can cause dysfunction
- rapid metabolic rate
- increases in size, normal cells does not receive the necessary nutrition or blood supply &
decrease in number loss of normal body function
- original site PRIMARY SITE, metastasize  SECONDARY SITE
Antineoplastic agents – “neo’ new formation also called CHEMOTHERAPEUTIC agents
- kill tumor cells directly
- interrupt cell replication of normal and abnormal cells
- shrink the tumor and provide palliation & cure
EARLY STAGE- drug is more effective  Ca cells are in active growth cell than normal cells there is inc.
blood supply
ADVEANCED STAGE- not effectivedecrease blood supply

CHEMOTHERAPY
- difficult to be selective in killing the tumor cells than normal cells
- large dose kill malignant cells & normal cells are killed also
 - symptoms disappear thought malignant cells are eradicated but 1M Ca cells are still present.
DRUG RESISTANCE
- too infrequent intake or location limits the effectiveness of the drug
- brain tumors respond poorly due to inability to cross the blood brain barrier
- Ca cells mutate as they grow
COMBINATION CHEMOTHERAPY
- ENHACE TUMORECIDAL EFFECTS
- DECREASE DRUG RESISTANCE
- INCREASE DESTRUCTION
- DECREASE DRUG TOXICITY
SIDE EFFECTS:
1. Bone marrow- suppression –infection (no fresh materials, restrict visitors), bleeding (report s/sx,
less invasive procedures, sharp objects, padded), anemia (position slowly).
2. GI- loss of epithelial cells- stomatitis (oral care), diarrhea (cannot absorbed water-constipating-
cheese, hydration, avoid hot, high fiber foods.), loss of appetite, n/v.
3. ALopeica
4. Reproductive- teratogenic, irreversible sterility
5. Wt. loss
CLASSIFICATION OF ANITINEOPLASTIC DRUGS
1. Alkylating drugs – injure the cells by binding to DNA and inhibiting DNA & RNA synthesis
- client well hydrated to prevent hemorrhagic cystitis (severe bladder distention)
2. Antimetabolites- disrupt the metabolic process necessary for normal cell growth and reproduction.
3. Antitumor metabolites- inhibit the synthesis of RNA & DNA thus causing fragmentation.
-given parenterally (poorly absorbs in the GI)
4. Mitotic Inhibitors- prevent the chromosome from dividing and migrating tot eh end of the cells to
stop further replication.
- vincristine, vinblastine, vinorelbine
- alopecia is not common
5. Hormones or Hormone Antagonist- acts through specific hormone receptor and are highly
selective.
- Glucocorticoids – toxic to malignancies of lymphoid organs
- Tamoxifen- for breast cancer but can increase the risk of endometrial cancer- safe use
- Estrogen – for prostate cancer & breast cancer
-Androgen- premenopausal women with breast cancer

ANTI-INFLAMMATORY AGENTS
1. Osteoporosis – caused by excess resorption of bone resulting to deterioration in bone mass.
Causes: decreased estrogen, decreased Ca. intake, decreased physical exercise
Effects: loss of Ht., chronic back pain, spinal deformities-kyphosis
Medication:
A. Biphosphates – suppress bone resorption- (alendronate, risedronate, ibandronate )- take with
empty stomach with 6-8 oz. of water, remain in upright position for at least 30-60 min.
B. Calcitonin salmon inhibitors-
C. Teriparatide- parathyroid hormone stimulate new bone formation
2. Arhritis- characterized by joint pain and limitation of movement in the joint.
A. Osteoarthritis- degenerative, cartilage in the joint gradually becomes thinner as the body loses
its ability to keep pace with the need fro replacement.
- dull, aching pain and joint soreness & stiffness with little limitation of movement.
- Crepitus, loss of joint stability, dec. ROM, inc. in pain bone enlarges, deforms the joints.
B. Rheumatoid Arthritis- autoimmune disease, progressive disease that begins with stiffness &
fatigue to ankylosis or permanent fusion of the joint.
- synovitis overgrowth of tissuescarstiffness
Goal of Treatment:- relieve pain, inflammation, stiffness, maintain joint function & ROM, prevent
joint deformity
Medication:
 1. NSAID’s- salicylate (aspirin), quickly relieves symptoms, do not prevent the progression.
Toxicity- report tinnitus
2. Glucocorticoids- provide rapid relief, do not prevent the progression (prednisone, prednisolone,
“sone” family)
3. Cox-2 inhibitors- suppress inflammation (celecoxib, meloxican, mobic)
4. Immunosuppressants- reduce the body’s own autoimmune response
a. DMARD’s – methotrexate- DOC
b. Azathioprine
c. Gold salts- reduce synovitis
d. Hydroxychloroquine – anti-malarial- reserved for patients who do not respond to other
treatment.
3. Gouty Arthritis- inborn error in uric acid metabolism causing hyperuricemia
Factors: obesity, alcohol use, hypertension, exposure to lead.
Results: acute pain, swelling, redness, warmth, tenderness of joints (big toe, ankle, knee, elbow,
inc. temp, uric acid crystals on skin)
Avoid: oatmeal, red meat, tomatoes, alcohol, shellfish, fatty foods.
Medications:
a. Colchicine- decrease the migration of neutrophiuls to the joints- decreasing inflammation.
b. Allopurinol, - decrease the production of uric aicd.
c. Probenecid- excretion of uric acid, not for acute attack- it precipitate (inc. OFI- prevent
crystallization)
d. Sulfinpyrazone- for chronic gout attacks