Unit 5: Immunity & Infection PathoPharmacology - Viral Infections, HIV, and AIDS

Foundational vocabulary and key concepts for antiviral and antiretroviral pharmacology, covering major drug classes, prototypes, mechanisms, and nursing considerations.

Viral Infections

Occur when viruses enter host cells and hijack cellular machinery to replicate.

Dormant Viruses

Viral states that are not affected by antiviral therapy because replication is not actively occurring.

Antiviral Medications

Medications that interrupt viral replication by inhibiting viral DNA/RNA synthesis or viral enzymes required for replication.

Suppress Replication

The action of antivirals which inhibits the virus from multiplying but does not eradicate it from the host.

Acyclovir

An antiviral prototype that inhibits viral DNA synthesis, used specifically for herpes simplex and varicella-zoster.

Ganciclovir

An antiviral prototype used for the treatment and prevention of CMV, especially in immunocompromised clients.

Phlebitis

An adverse effect associated with the administration of IV acyclovir.

Acyclovir Nephrotoxicity

A potential kidney-related adverse effect that can be reduced by ensuring adequate hydration.

Ganciclovir Bone Marrow Suppression

A serious adverse effect of ganciclovir characterized by decreased WBC and platelets.

Acyclovir IV Administration

A nursing consideration requiring the drug to be administered slowly over a period of $\ge 1\,\text{hr}$.

Ganciclovir Pregnancy/Lactation

Situations in which ganciclovir is strictly contraindicated.

HIV (Human Immunodeficiency Virus)

A chronic viral infection that attacks CD4 T cells.

AIDS

Advanced HIV infection characterized by severe immune suppression and opportunistic infections.

Reverse Transcriptase

An enzyme HIV uses to convert viral RNA into DNA before integrating into host DNA.

HIV Viral Load

The amount of virus in the blood; the goal of antiretroviral therapy is to suppress this value.

HAART (Highly Active Antiretroviral Therapy)

A combination treatment for HIV consisting of 3 or more antiretroviral agents to reduce resistance and disease progression.

HIV Therapy Adherence

A requirement for lifelong, strict compliance to prevents resistance and treatment failure.

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

A class of antiretrovirals, including Zidovudine, that inhibit DNA synthesis to prevent viral replication.

Zidovudine

An NRTI prototype indicated as a first-line agent for HIV infection.

Zidovudine Lactic Acidosis

A serious adverse effect of zidovudine, with an increased risk for clients who are pregnant.

Zidovudine and Ganciclovir Interaction

A drug-drug interaction that increases the risk of bone marrow suppression.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

A class of antiretrovirals, including Efavirenz, that directly inhibit the reverse transcriptase enzyme.

Efavirenz

An NNRTI prototype used for HIV-1 infection in combination therapy.

Efavirenz CNS Effects

Adverse effects including dizziness, insomnia, and nightmares.

Stevens-Johnson Syndrome

A severe, potentially life-threatening rash that is a risk for clients taking Efavirenz or Raltegravir.

Efavirenz Administration Timing

Instruction to take the medication on an empty stomach at bedtime.

Efavirenz and Barrier Contraception

Required because Efavirenz reduces the effectiveness of hormonal contraceptives.

Integrase Inhibitors

A class of antiretrovirals, including Raltegravir, that prevent the integration of viral DNA into host DNA.

Raltegravir

An integrase inhibitor prototype used as first-line HIV therapy.

Raltegravir Mental Status Monitoring

Nursing requirement to monitor for suicidal ideation or mood changes.

CCR5 Antagonists

A class of antiretrovirals, including Maraviroc, that prevents HIV entry by blocking specific cell receptors.

Maraviroc

The prototype CCR5 antagonist used in HIV combination therapy.

Maraviroc Hepatotoxicity

A potential liver injury often preceded by a rash; requires immediate provider notification.

Maraviroc Orthostatic Hypotension

An adverse effect requiring education on slow position changes.

Maraviroc Renal Impairment

A clinical condition where the use of Maraviroc is contraindicated.

Protease Inhibitors (PIs)

A class of antiretrovirals, including Ritonavir, that inhibit enzymes required for the final stages of viral replication.

Ritonavir

A Protease Inhibitor prototype often used to boost the levels of other PIs.

Ritonavir Metabolic AEs

Side effects including hyperglycemia and hyperlipidemia.

Fat Redistribution

A physical adverse effect associated with Protease Inhibitors like Ritonavir.

Ritonavir and Grapefruit Juice

A specific dietary contraindication that can lead to toxic medication levels.

Fusion/Entry Inhibitors

A class of antiretrovirals, including Enfuvirtide, that blocks HIV attachment and entry into CD4 cells.

Enfuvirtide

An entry inhibitor prototype indicated for HIV resistant to other antiretroviral therapies.

Enfuvirtide Route

The medication is administered strictly via the subcutaneous route only.

Enfuvirtide Bacterial Pneumonia

A specific respiratory adverse effect associated with fusion inhibitor therapy.

Echinacea

A complementary therapy that may suppress immune function in HIV clients.

Garlic Interaction

A complementary herb known to decrease the levels of protease inhibitors.

St. John's Wort Interaction

An herbal supplement that decreases the overall effectiveness of antiretroviral therapy.

Probenecid DDI

An agent that decreases the elimination of Acyclovir and increases levels of Zidovudine.

Opportunistic Infections

Infections that occur more frequently or are more severe in people with weakened immune systems, characteristic of AIDS.

HIV Transmission Prevention

A critical educational component for all clients on antiviral and antiretroviral therapy.