Chapter 21 Drug Therapy for Viral Infections

1. A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication?

1. A)  Decreased testosterone production
2. B)  Decreased libido
3. C)  Decreased viral shedding
4. D)  Decreased bacterial replication

Ans: C
Feedback:
Acyclovir is used to treat genital herpes, in which it decreases viral shedding and the duration of skin lesions and pain. Acyclovir does not decrease testosterone or libido. Acyclovir is used to treat viral, not bacterial, infections.

2. A patient suffers from an autoimmune disorder. Which of the following represents a potential result of a viral infection in a patient with an autoimmune disorder?

1. A)  Lymphocytes recognize the host’s tissue as foreign.
2. B)  Erythrocytes destroy the T cells in the host.
3. C)  The involution of the thymus gland increases infection cause.
4. D)  The differential decreases the sedimentation rate.

Ans: A Feedback:

Autoimmune diseases may be caused by viral alteration of host cells so that lymphocytes recognize the host’s own tissues as being foreign.

3. An 80-year-old patient with chronic renal failure is admitted to the hospital with herpes simplex. The acyclovir (Zovirax) is to be administered parenterally. When preparing to administer this medication, what would the nurse expect in regard to the dose?

1. A)  The dose is smaller due to the herpes simplex.
2. B)  The dose is smaller based on the patient’s kidney function.
3. C)  The dose is higher in treating genital herpes.
4. D)  The dose is higher if the creatinine is above 4.0 mg/dL.

Ans: B

Feedback:

Oral and IV acyclovir are excreted in the urine, and the dose should be decreased in patients who are older or have renal impairment. The dose is not smaller due to herpes simplex. The dose is not higher in treating genital herpes. The dose should be lower if the creatinine level is above 4.0 mg/dL.

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4. A patient who has been diagnosed with human immune deficiency syndrome is given ganciclovir (Cytovene) to prevent cytomegalovirus. The patient develops granulocytopenia. How long will it take for the granulocytes to regenerate after the ganciclovir is discontinued?

1. A)  5 days
2. B)  7 days
3. C)  10 days
4. D)  14 days

Ans: B
Feedback:
Ganciclovir causes granulocytopenia and thrombocytopenia in 20% to 40% of recipients, often during the first 2 weeks of therapy. If severe bone marrow depression occurs, ganciclovir should be discontinued; recovery usually occurs within a week of stopping the drug. Five days after discontinuing the drug is too soon to see a change in granulocytopenia. Ten to fourteen days is too long for change to occur. It should have occurred within 1 week.

5. A patient has been diagnosed with cytomegalovirus (CMV). Which of the following drugs would be ineffective in the treatment of this disease?

1. A)  Ribavirin (Rebetol)
2. B)  Ganciclovir (Cytovene) IV
3. C)  Foscarnet (Foscavir) IV
4. D)  Valganciclovir hydrochloride (Valcyte)

Ans: A
Feedback:
Ribavirin is administered to treat respiratory syncytial virus. Ganciclovir, foscarnet, and valganciclovir are used in the treatment of CMV.

6. A 21-year-old male is being started on zidovudine (AZT) for treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching?

1. A)  “AZT inactivates the virus and prevents recurrence of the disease.”
2. B)  “AZT therapy may result in the development of AZT-resistant strains.”
3. C)  “AZT slows the progression of the disease but does not cure it.”
4. D)  “AZT prevents the occurrence of opportunistic infections.”

Ans: C

Feedback:

Zidovudine slows the progression of the disease but does not cure the disease. Zidovudine does not inactivate the virus. Zidovudine does not result in resistant strains. Zidovudine does not prevent the occurrence of opportunistic infections.