Antivirals for influenza: Nursing pharmacology

The influenza virus causes seasonal influenza, commonly called “the flu”, which is one of the most common infectious diseases.

There are several antiviral medications that can be used either in the prevention of influenza for high-risk clients, or in the acute treatment of severe cases of influenza.Alright, so, the most commonly used antivirals for influenza include neuraminidase inhibitors, such as oseltamivir, peramivir, and zanamivir; as well as endonuclease inhibitors like baloxavir marboxil.

Also, there are additional antivirals that are currently not recommended, including adamantanes, such as amantadine and rimantadine.

Most of these antivirals are taken orally, except for peramivir, which is given intravenously, and zanamivir, which comes in a powder form that is inhaled by mouth.Once administered, each class of antiviral act through a different mechanism of action.

Neuraminidase inhibitors, as their name implies, bind and inhibit the viral enzyme neuraminidase, thereby preventing the release of new viruses.

Endonuclease inhibitors, on the other hand, inhibit, you guessed it, a viral enzyme called endonuclease, ultimately stopping the transcription of viral RNA.

Finally, adamantanes act by inhibiting the viral protein M2, which prevents viruses from replicating inside the host cell.

Ultimately, all of these antivirals help stop viral replication and the release of new influenza viruses.However, these medications also come with side effects.

Luckily, these are usually mild, and they mainly refer to gastrointestinal disturbances, such as nausea, vomiting, stomach pain, and diarrhea.

Less commonly, antiviral medications for influenza can cause neuropsychiatric symptoms, such as delirium, delusions, and hallucinations.

In addition, some clients can develop serious hypersensitivity reactions, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme.

Finally, clients taking zanamivir can present with bronchospasms.Now, antivirals for influenza should be used with caution during pregnancy and breastfeeding, as well as with infants, children, and elderly clients, as well as clients with underlying respiratory disease, such as asthma or chronic obstructive pulmonary disease.

Additional precautions should be taken in clients with severe renal or hepatic disease. Now, when your client with influenza is prescribed oseltamivir, perform a baseline physical assessment, including vital signs and their current symptoms such as fever, chills, cough, congestion, fatigue, body aches, and ask when they first noticed their symptoms.

Lastly, check your client’s laboratory test results such as rapid antigen testing or reverse transcription polymerase chain reaction or RT-PCR for short.Moving on to client education, explain that the medication helps reduce the severity and duration of influenza symptoms by stopping the spread of the virus in their body.

Let them know that the medication doesn’t prevent the spread of the virus to others, so they should follow infection prevention guidelines like frequent hand hygiene, practicing cough etiquette, and staying home from work, school, or crowded environments.

Encourage your client to get plenty of rest and fluids to promote their recovery. Then, instruct your client to take their medication twice daily, with or without food for a total of 5 days, and emphasize the importance of taking their first dose as soon as possible, since it is most effective if started within 48 hours of symptom onset.Finally, be sure to talk to your client about some of the side effects they could experience, such as headache, nausea, vomiting, and diarrhea.

Also instruct them to contact their healthcare provider if they notice dermatological symptoms like blistered, swollen, or peeling skin; or behavioral symptoms, including confusion, tremors, or seeing things or hearing voices that do not exist.

Also, encourage them to get the influenza vaccine every year before the influenza season begins. Finally, monitor your client for side effects and evaluate for the therapeutic effect of reduced flu symptoms.Alright, as a quick recap… The influenza virus causes seasonal influenza, or “the flu”, which is one of the most common infectious diseases.

There are several antiviral medications that can be used to either prevent or treat influenza, including neuraminidase inhibitors, such as oseltamivir, peramivir, and zanamivir as well as endonuclease inhibitors like baloxavir marboxil.

These medications work by inhibiting different viral enzymes required for replication. Antivirals usually only cause mild side effects, including gastrointestinal disturbances, like nausea and vomiting; but they can cause neuropsychiatric symptoms as well, such as delirium, delusions, and hallucinations.

Some clients can also develop serious hypersensitivity reactions, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme.

When caring for clients taking antiviral medications, nursing considerations include performing a baseline assessment, and educating the client on safe self-administration and recognition of side effects, as well as evaluating the desired therapeutic effect of the