{"id":119,"date":"2019-09-22T17:54:06","date_gmt":"2019-09-22T17:54:06","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/3-14-antivirals\/"},"modified":"2025-01-16T22:25:11","modified_gmt":"2025-01-16T22:25:11","slug":"3-14-antivirals","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/3-14-antivirals\/","title":{"raw":"3.14 Antivirals","rendered":"3.14 Antivirals"},"content":{"raw":"Unlike the complex structure of fungi or protozoa, viral structure is simple. There are several subclasses of antiviral medications: antiherpes, antiinfluenza, antihepatitis, and antiretrovirals. Each subclass will be discussed in more detail below. See Figure 3.8[footnote]\u201cUnknown\u201d by CNX OpenStax<\/a> is licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-3-types-of-microorganisms<\/a>[\/footnote]<\/sup> for images of viruses.\n\n[caption id=\"\" align=\"aligncenter\" width=\"667\"]\"Photos Figure 3.8 Images of Viruses (a) Members of the Coronavirus family can cause respiratory infections like the common cold, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). Here they are viewed under a transmission electron microscope (TEM). (b) Ebolavirus, a member of the Filovirus family. (credit a: modification of work by Centers for Disease Control and Prevention; credit b: modification of work by Thomas W. Geisbert)[\/caption]\n

Subclass: Antiherpes<\/h2>\nMechanism of Action:<\/strong> Acyclovir causes termination of the DNA chain during the viral replication process. Acyclovir can be administered either topically or systemically, depending on the infection.[footnote]This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup>\n\nIndications: <\/strong>Acyclovir (Zovirax) and its derivatives are frequently used for the treatment and prevention of herpes and varicella virus infections, including genital herpes, chicken pox, shingles, Epstein-Barr virus infections, and cytomegalovirus infections.\n\nNursing Considerations:<\/strong> Acyclovir use may result in nephrotoxicity.\n\nSide Effects\/Adverse Effects: <\/strong>Common side effects may include gastrointestinal distress. Additional adverse effects may include renal impairment and decreased seizure threshold.\n\nHealth Teaching & Health Promotion:<\/strong> Clients who are being treated with antiviral therapy should be instructed about the importance of medication compliance. They may also experience significant fatigue, so periods of rest should be encouraged.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n

Subclass: Antiinfluenza<\/h2>\nMechanism of Action:<\/strong> Tamiflu prevents the release of virus from infected cells.\n\nThe influenza virus is one of the few RNA viruses that replicates in the nucleus of cells. Antivirals block the release stage. See Figure 3.9.[footnote]\u201cUnknown\u201d by CNX OpenStax<\/a> is licensed under CC BY 4.0<\/a> Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/6-2-the-viral-life-cycle<\/a>[\/footnote]<\/sup>\n\n[caption id=\"attachment_118\" align=\"aligncenter\" width=\"671\"]\"Illustration Figure 3.9 Influenza Virus Replication Stages[\/caption]\n\nIndications: <\/strong>Oseltamivir (Tamiflu) is used to target the influenza virus by blocking the release of the virus from the infected cells.\n\nNursing Considerations:<\/strong> This medication does not cure influenza but can decrease flu symptoms and shorten the duration of illness if taken within 48 hours of symptom onset. Clients are prescribed the medication for prophylaxis against infection, known exposure, or to lessen the course of the illness. If clients experience flu-like symptoms, it is critical that they start treatment within 48 hours of symptom onset.\n\nSide Effects\/Adverse Effects: <\/strong>Common side effects include GI upset. Adverse effects include serious skin hypersensitivity reactions or neuropsychiatric symptoms, especially in children. Use cautiously in clients with renal failure, chronic cardiac or respiratory diseases, or any medical condition that may require imminent hospitalization.\n\nHealth Teaching & Health Promotion:<\/strong> Clients who are being treated with antiviral therapy should be instructed about the importance of medication compliance. They may also experience significant fatigue, so periods of rest should be encouraged.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n

Subclass: Antihepatitis<\/h2>\nMechanism of Action:<\/strong> Antihepatitis medications inhibit translation of viral mRNA into viral proteins. This action impedes the replication of the hepatitis virus.\n\nIndications:<\/strong> Antihepatits medications like adefovir are used to treat chronic hepatitis and the hepatitis B virus and hepatitis C virus.\n\nNursing Considerations:<\/strong> The medication is used to maintain or improve liver function when active disease is present. Therapy is prolonged, typically greater than 1 year or indefinitely, based on the client's status.\n\nSide Effects\/Adverse Effects: <\/strong>Adverse effects of antihepatitis medications include severe acute exacerbations of hepatitis B, nephrotoxicity, lactic acidosis, and severe hepatomegaly.\n\nHealth Teaching & Health Promotion: <\/strong>Clients receiving treatment for antihepatitis medications should also be offered HIV testing to ensure that they do not have an unrecognized or untreated HIV infection. Antihepatitis medications may promote resistance to antiretrovirals in clients with chronic Hepatitis B infection. Clients must understand that they should not stop taking medication unless directed by a health care provider. Monitor hepatic function several months after stopping therapy.\n

Subclass: Antiretrovirals<\/h2>\nViruses with complex life cycles, such as HIV, can be more difficult to treat. These types of viruses require the use of antiretroviral medications that block viral replication, often referred to as antiretroviral therapy (ART). (See Figure 3.10 to view the viral replication process of HIV.)[footnote]This work is a derivative of \u201cHIV Virus Replication Cycle<\/a>\u201d by NIAID<\/a> is licensed under CC BY 2.0<\/a>[\/footnote]<\/sup>\u00a0<\/span>Additionally, antiretrovirals fall under the class of antiviral medications.\n\n[caption id=\"attachment_118\" align=\"aligncenter\" width=\"526\"]\"Illustration Figure 3.10 HIV attaches to a cell surface receptor of an immune cell and fuses with the cell membrane. Viral contents are released into the cell, where viral enzymes convert the single-stranded RNA genome into DNA and incorporate it into the host genome[\/caption]\n\nMechanism of Action:<\/strong> Antiretrovirals impede virus replication.\n\nIndications:<\/strong> Antiretrovirals such as lamivudine-zidovudine are used for the treatment of illnesses like HIV.\n\nNursing Considerations:<\/strong> Many antiretrovirals may impact renal function; therefore, the client's urine output and renal labs should be monitored carefully for signs of decreased function.\n\nSide Effects\/Adverse Effects: <\/strong>Adverse side effects of antiretroviral medications include lactic acidosis and severe hepatomegaly. Clients should cease medication immediately if pancreatitis occurs.\n\nHealth Teaching & Health Promotion:<\/strong> Clients who are being treated with antiviral therapy should be instructed about the importance of antiretroviral compliance. They may also experience significant fatigue, so periods of rest should be encouraged.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nNow let's take a closer look at the medication grids for the subclasses of antivirals in Tables 3.14a-d.[footnote]This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the\u00a0Public Domain<\/a>. [\/footnote]\u00a0<\/sup>\n\nTables 3.14a Acyclovir Medication Grid\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing <\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals: Antiherpes<\/th>\nacyclovir<\/a><\/td>\nCheck for allergies\n\nRoute: PO, IV, or topical; do not give IM or subcutaneously\n\nGive with food if GI upset occurs\n\nIV: Give IV infusion over at least 1 hour to prevent renal tubular damage\n\nUse cautiously if renal impairment, neurological problems, or dehydration\n\nStart therapy as early as possible after signs or symptoms occur\n\nEncourage fluid intake\n\nAvoid sexual contact while genital lesions are present<\/td>\nDrug is not a cure for herpes but improves signs and symptoms of herpes lesions if started early\n\nCan be prescribed at lower doses for long-term for prevention of outbreaks<\/td>\nGI distress\n\nMonitor renal function in long-term use, especially if renal impairment\n\nLowers seizure threshold<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nTables 3.14b Oseltamivir Medication Grid\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing\u00a0<\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals:\n<\/strong>Antiinfluenza Agents<\/strong><\/th>\noseltamivir<\/a><\/td>\nCheck for allergies\n\nRoute: PO\n\nMust be given within 48 hours of onset of symptoms\n\nAdminister with food to avoid GI distress\n\nDoes not replace need for annual influenza vaccination<\/td>\nReduce duration of influenza symptoms<\/td>\nGI distress\n\nSerious skin\/ hypersensitivity reactions; discontinue immediately\n\nMonitor for neuropsychiatric symptoms\n\nUse cautiously in clients with renal failure, chronic cardiac or respiratory diseases, or any medical condition that may require imminent hospitalization<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nTables 3.14c Adefovir Medication Grid\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing\u00a0<\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals:\n<\/strong>Antihepatitis Agents<\/strong><\/th>\nadefovir<\/a><\/td>\nRoute: PO\n\nProlonged therapy (greater than 1 year or indefinitely) based on client status\n\nOffer HIV testing; may promote resistance to antiretrovirals in clients with chronic HBV infection who also have unrecognized or untreated HIV infection\n\nDo not stop taking medication unless directed. Monitor hepatic function several months after stopping therapy<\/td>\nMaintain or improve liver function when active disease is present<\/td>\nSevere acute exacerbations of hepatitis B\n\nNephrotoxicity\n\nLactic acidosis\n\nSevere hepatomegaly<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nTables 3.14d Lamuvadine-Zidovudine Medication Grid\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing\u00a0<\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals: <\/strong>Antiretrovirals\n<\/strong>Nucleoside\u2013N<\/strong>ucleotide Reverse Transcriptase Inhibitors<\/strong><\/th>\nlamivudine- zidovudine<\/a><\/td>\nCheck for allergies\n\nLamivudine used to treat HIV-1 infection contains a higher dose of the active ingredient than the lamivudine used to treat chronic HBV infection. Clients with HIV-1 infection should receive only dosing forms appropriate for HIV-1 treatment\n\nUse cautiously in clients with renal impairment\n\nInform client that drug doesn't cure HIV infection, that opportunistic infections and other complications of HIV infection may still occur, and that transmission of HIV to others through sexual contact or blood contamination is still possible. Taking these medications, along with practicing safer sex and making other lifestyle changes, may decrease the risk of transmitting (spreading) the HIV or hepatitis B virus to other people\n\nTeach clients to report symptoms of pancreatitis such as sudden abdominal pain, nausea, or yellowish tinge of the skin or eyes<\/td>\nDecreases chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer<\/td>\nLactic acidosis\n\nSevere hepatomegaly\n\nStop treatment immediately if pancreatitis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

Critical Thinking Activity 3.14\"Image<\/h2>\n<\/header>\n
\n\nUsing the above grid information, consider the following clinical scenario question:<\/strong>\n\nA client is prescribed oseltamivir (Tamiflu) for influenza symptoms. The client states to the nurse, \u201cI hope this medication works quickly! I have felt awful for the past five days!\u201d What is the nurse's next best response?\n\nNote: Answers to the Critical Thinking activities can be found in the \u201cAnswer Key<\/a>\u201d section at the end of the book.\n\n<\/div>\n<\/div>","rendered":"

Unlike the complex structure of fungi or protozoa, viral structure is simple. There are several subclasses of antiviral medications: antiherpes, antiinfluenza, antihepatitis, and antiretrovirals. Each subclass will be discussed in more detail below. See Figure 3.8[1]<\/sup><\/a><\/sup> for images of viruses.<\/p>\n

\"Photos
Figure 3.8 Images of Viruses (a) Members of the Coronavirus family can cause respiratory infections like the common cold, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). Here they are viewed under a transmission electron microscope (TEM). (b) Ebolavirus, a member of the Filovirus family. (credit a: modification of work by Centers for Disease Control and Prevention; credit b: modification of work by Thomas W. Geisbert)<\/figcaption><\/figure>\n

Subclass: Antiherpes<\/h2>\n

Mechanism of Action:<\/strong> Acyclovir causes termination of the DNA chain during the viral replication process. Acyclovir can be administered either topically or systemically, depending on the infection.[2]<\/sup><\/a><\/sup><\/p>\n

Indications: <\/strong>Acyclovir (Zovirax) and its derivatives are frequently used for the treatment and prevention of herpes and varicella virus infections, including genital herpes, chicken pox, shingles, Epstein-Barr virus infections, and cytomegalovirus infections.<\/p>\n

Nursing Considerations:<\/strong> Acyclovir use may result in nephrotoxicity.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Common side effects may include gastrointestinal distress. Additional adverse effects may include renal impairment and decreased seizure threshold.<\/p>\n

Health Teaching & Health Promotion:<\/strong> Clients who are being treated with antiviral therapy should be instructed about the importance of medication compliance. They may also experience significant fatigue, so periods of rest should be encouraged.[3]<\/sup><\/a><\/sup><\/p>\n

Subclass: Antiinfluenza<\/h2>\n

Mechanism of Action:<\/strong> Tamiflu prevents the release of virus from infected cells.<\/p>\n

The influenza virus is one of the few RNA viruses that replicates in the nucleus of cells. Antivirals block the release stage. See Figure 3.9.[4]<\/sup><\/a><\/sup><\/p>\n

\"Illustration
Figure 3.9 Influenza Virus Replication Stages<\/figcaption><\/figure>\n

Indications: <\/strong>Oseltamivir (Tamiflu) is used to target the influenza virus by blocking the release of the virus from the infected cells.<\/p>\n

Nursing Considerations:<\/strong> This medication does not cure influenza but can decrease flu symptoms and shorten the duration of illness if taken within 48 hours of symptom onset. Clients are prescribed the medication for prophylaxis against infection, known exposure, or to lessen the course of the illness. If clients experience flu-like symptoms, it is critical that they start treatment within 48 hours of symptom onset.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Common side effects include GI upset. Adverse effects include serious skin hypersensitivity reactions or neuropsychiatric symptoms, especially in children. Use cautiously in clients with renal failure, chronic cardiac or respiratory diseases, or any medical condition that may require imminent hospitalization.<\/p>\n

Health Teaching & Health Promotion:<\/strong> Clients who are being treated with antiviral therapy should be instructed about the importance of medication compliance. They may also experience significant fatigue, so periods of rest should be encouraged.[5]<\/sup><\/a><\/sup><\/p>\n

Subclass: Antihepatitis<\/h2>\n

Mechanism of Action:<\/strong> Antihepatitis medications inhibit translation of viral mRNA into viral proteins. This action impedes the replication of the hepatitis virus.<\/p>\n

Indications:<\/strong> Antihepatits medications like adefovir are used to treat chronic hepatitis and the hepatitis B virus and hepatitis C virus.<\/p>\n

Nursing Considerations:<\/strong> The medication is used to maintain or improve liver function when active disease is present. Therapy is prolonged, typically greater than 1 year or indefinitely, based on the client’s status.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Adverse effects of antihepatitis medications include severe acute exacerbations of hepatitis B, nephrotoxicity, lactic acidosis, and severe hepatomegaly.<\/p>\n

Health Teaching & Health Promotion: <\/strong>Clients receiving treatment for antihepatitis medications should also be offered HIV testing to ensure that they do not have an unrecognized or untreated HIV infection. Antihepatitis medications may promote resistance to antiretrovirals in clients with chronic Hepatitis B infection. Clients must understand that they should not stop taking medication unless directed by a health care provider. Monitor hepatic function several months after stopping therapy.<\/p>\n

Subclass: Antiretrovirals<\/h2>\n

Viruses with complex life cycles, such as HIV, can be more difficult to treat. These types of viruses require the use of antiretroviral medications that block viral replication, often referred to as antiretroviral therapy (ART). (See Figure 3.10 to view the viral replication process of HIV.)[6]<\/sup><\/a><\/sup>\u00a0<\/span>Additionally, antiretrovirals fall under the class of antiviral medications.<\/p>\n

\"Illustration
Figure 3.10 HIV attaches to a cell surface receptor of an immune cell and fuses with the cell membrane. Viral contents are released into the cell, where viral enzymes convert the single-stranded RNA genome into DNA and incorporate it into the host genome<\/figcaption><\/figure>\n

Mechanism of Action:<\/strong> Antiretrovirals impede virus replication.<\/p>\n

Indications:<\/strong> Antiretrovirals such as lamivudine-zidovudine are used for the treatment of illnesses like HIV.<\/p>\n

Nursing Considerations:<\/strong> Many antiretrovirals may impact renal function; therefore, the client’s urine output and renal labs should be monitored carefully for signs of decreased function.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Adverse side effects of antiretroviral medications include lactic acidosis and severe hepatomegaly. Clients should cease medication immediately if pancreatitis occurs.<\/p>\n

Health Teaching & Health Promotion:<\/strong> Clients who are being treated with antiviral therapy should be instructed about the importance of antiretroviral compliance. They may also experience significant fatigue, so periods of rest should be encouraged.[7]<\/sup><\/a><\/sup><\/p>\n

Now let’s take a closer look at the medication grids for the subclasses of antivirals in Tables 3.14a-d.[8]<\/sup><\/a>\u00a0<\/sup><\/p>\n

Tables 3.14a Acyclovir Medication Grid<\/p>\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing <\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals: Antiherpes<\/th>\nacyclovir<\/a><\/td>\nCheck for allergies<\/p>\n

Route: PO, IV, or topical; do not give IM or subcutaneously<\/p>\n

Give with food if GI upset occurs<\/p>\n

IV: Give IV infusion over at least 1 hour to prevent renal tubular damage<\/p>\n

Use cautiously if renal impairment, neurological problems, or dehydration<\/p>\n

Start therapy as early as possible after signs or symptoms occur<\/p>\n

Encourage fluid intake<\/p>\n

Avoid sexual contact while genital lesions are present<\/td>\n

Drug is not a cure for herpes but improves signs and symptoms of herpes lesions if started early<\/p>\n

Can be prescribed at lower doses for long-term for prevention of outbreaks<\/td>\n

GI distress<\/p>\n

Monitor renal function in long-term use, especially if renal impairment<\/p>\n

Lowers seizure threshold<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Tables 3.14b Oseltamivir Medication Grid<\/p>\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing\u00a0<\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals:
\n<\/strong>Antiinfluenza Agents<\/strong><\/th>\n		oseltamivir<\/a><\/td>\nCheck for allergies<\/p>\n

Route: PO<\/p>\n

Must be given within 48 hours of onset of symptoms<\/p>\n

Administer with food to avoid GI distress<\/p>\n

Does not replace need for annual influenza vaccination<\/td>\n

Reduce duration of influenza symptoms<\/td>\nGI distress<\/p>\n

Serious skin\/ hypersensitivity reactions; discontinue immediately<\/p>\n

Monitor for neuropsychiatric symptoms<\/p>\n

Use cautiously in clients with renal failure, chronic cardiac or respiratory diseases, or any medical condition that may require imminent hospitalization<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Tables 3.14c Adefovir Medication Grid<\/p>\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing\u00a0<\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals:
\n<\/strong>Antihepatitis Agents<\/strong><\/th>\n		adefovir<\/a><\/td>\nRoute: PO<\/p>\n

Prolonged therapy (greater than 1 year or indefinitely) based on client status<\/p>\n

Offer HIV testing; may promote resistance to antiretrovirals in clients with chronic HBV infection who also have unrecognized or untreated HIV infection<\/p>\n

Do not stop taking medication unless directed. Monitor hepatic function several months after stopping therapy<\/td>\n

Maintain or improve liver function when active disease is present<\/td>\nSevere acute exacerbations of hepatitis B<\/p>\n

Nephrotoxicity<\/p>\n

Lactic acidosis<\/p>\n

Severe hepatomegaly<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Tables 3.14d Lamuvadine-Zidovudine Medication Grid<\/p>\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/<\/strong>Generic<\/strong><\/th>\nNursing\u00a0<\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antivirals: <\/strong>Antiretrovirals
\n<\/strong>Nucleoside\u2013N<\/strong>ucleotide Reverse Transcriptase Inhibitors<\/strong><\/th>\n		lamivudine- zidovudine<\/a><\/td>\nCheck for allergies<\/p>\n

Lamivudine used to treat HIV-1 infection contains a higher dose of the active ingredient than the lamivudine used to treat chronic HBV infection. Clients with HIV-1 infection should receive only dosing forms appropriate for HIV-1 treatment<\/p>\n

Use cautiously in clients with renal impairment<\/p>\n

Inform client that drug doesn’t cure HIV infection, that opportunistic infections and other complications of HIV infection may still occur, and that transmission of HIV to others through sexual contact or blood contamination is still possible. Taking these medications, along with practicing safer sex and making other lifestyle changes, may decrease the risk of transmitting (spreading) the HIV or hepatitis B virus to other people<\/p>\n

Teach clients to report symptoms of pancreatitis such as sudden abdominal pain, nausea, or yellowish tinge of the skin or eyes<\/td>\n

Decreases chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer<\/td>\nLactic acidosis<\/p>\n

Severe hepatomegaly<\/p>\n

Stop treatment immediately if pancreatitis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\n
\n

Critical Thinking Activity 3.14\"Image<\/h2>\n<\/header>\n
\n

Using the above grid information, consider the following clinical scenario question:<\/strong><\/p>\n

A client is prescribed oseltamivir (Tamiflu) for influenza symptoms. The client states to the nurse, \u201cI hope this medication works quickly! I have felt awful for the past five days!\u201d What is the nurse’s next best response?<\/p>\n

Note: Answers to the Critical Thinking activities can be found in the \u201cAnswer Key<\/a>\u201d section at the end of the book.<\/p>\n<\/div>\n<\/div>\n

  1. \u201cUnknown\u201d by CNX OpenStax<\/a> is licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-3-types-of-microorganisms<\/a> ↵<\/a><\/li>
  2. This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a> ↵<\/a><\/li>
  3. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  4. \u201cUnknown\u201d by CNX OpenStax<\/a> is licensed under CC BY 4.0<\/a> Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/6-2-the-viral-life-cycle<\/a> ↵<\/a><\/li>
  5. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  6. This work is a derivative of \u201cHIV Virus Replication Cycle<\/a>\u201d by NIAID<\/a> is licensed under CC BY 2.0<\/a> ↵<\/a><\/li>
  7. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  8. This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the\u00a0Public Domain<\/a>. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":83,"menu_order":13,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-119","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":82,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/119","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/users\/83"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/119\/revisions"}],"predecessor-version":[{"id":120,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/119\/revisions\/120"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/82"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/119\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/media?parent=119"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=119"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/contributor?post=119"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/license?post=119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}