What are the nursing considerations when administering antiretroviral drugs?
Here are important nursing considerations when administering antiretroviral drugs: These are the important things the nurse should include in conducting assessment, history taking, and examination:
What Nursing Diagnoses can be formulated in the use of antiviral drugs?
Here are some of the nursing diagnoses that can be formulated in the use of these drugs for therapy: Disturbed sensory perception (kinesthetics) related to CNS effects of the drug These are vital nursing interventions done in patients who are taking antiviral agents for respiratory viruses:
What are the nursing interventions for antiviral treatment of respiratory virus infection?
Disturbed sensory perception (kinesthetics) related to CNS effects of the drug These are vital nursing interventions done in patients who are taking antiviral agents for respiratory viruses:
What are antiretroviral drugs and do they work?
Antiretroviral drugs are one of the major scientific breakthroughs of modern medicine, transforming a disease that was once thought to be a death sentence into a chronically managed condition. Even so, the drugs only work if you take them.
How is effectiveness of antiretroviral therapy measured?
Antiretroviral therapy effectiveness is determined by assessing virological response by measuring viral load, results having less than 400 copies/ml indicating an adequate response and results under 50 copies/ml indicating an optimal response.
What does the nurse understand is the goal of antiretroviral therapy?
Goals of therapy — The following are goals of antiretroviral treatment for HIV: Suppress HIV multiplication. The goal is to have no detectable virus in the blood for as long as possible. At this level, the virus is essentially "shut down."
What is the most accurate way of checking adherence to highly active antiretroviral therapy?
Adherence to HAART can be measured by a variety of methods. The most commonly used methods are pill counts, review of pharmacy records, self-reporting, and use of such electronic medication-monitoring devices as MEMS. No single method has been established as the “gold standard” for measuring adherence.
Which is usually the most important consideration in the decision to initiate antiretroviral therapy?
[17,18] Regardless of CD4 cell count, the decision to initiate ART should always include consideration of any co-morbid conditions, the willingness and readiness of the patient to initiate therapy, and the availability of resources.
What is the goal of antiretroviral therapy ART?
The primary goal of antiretroviral therapy (ART) is to prevent HIV-associated morbidity and mortality. This goal is accomplished by using effective ART to achieve and maintain a plasma HIV-1 RNA (viral load) below the quantification limits of commercially available assays.
Why is adherence important in antiretroviral therapy?
Why is medication adherence important? Taking HIV medicines every day prevents HIV from multiplying, which reduces the risk that HIV will mutate and produce drug-resistant HIV. Skipping HIV medicines allows HIV to multiply, which increases the risk of drug resistance and HIV treatment failure.
How do you measure adherence on antiretroviral therapy?
Common methods for measuring adherence to antiretroviral (ARV) medications involve using patient self-reports [8–10]; pill counts [11, 12]; pharmacy dispensing data [7, 13–15] and, primarily in research settings, electronic medication monitors [16–19].
How do you measure ART adherence?
A variety of methods have been proposed to measure ART adherence, including review of pharmacy refill records, self-reported adherence questionnaires, ART drug blood level monitoring, electronic monitoring devices, and pill count.
Which diagnostic test would the nurse prepare for the patient who is taking antiretroviral therapy?
Nucleic acid tests (NATs). These tests look for the actual virus in your blood (viral load). They also involve blood drawn from a vein. If you might have been exposed to HIV within the past few weeks, your health care provider may recommend NAT . NAT will be the first test to become positive after exposure to HIV .
What are the five goals of antiretroviral therapy?
Thus, once initiated, ART should be continued, with the following key treatment goals:Maximally and durably suppress plasma HIV RNA;Restore and preserve immunologic function;Reduce HIV-associated morbidity and prolong the duration and quality of survival; and.Prevent HIV transmission.
Is it a must for a patient to take antiretroviral treatment?
3-4 Should patients be asked whether they are ready for antiretroviral treatment? Yes. It is a major decision to start ART as these patients will have to take drugs every day for the rest of their life. The patients must be fully counselled and given time to consider all the implications.
What does a patient with acquired immunodeficiency syndrome (AIDS) tell the home care nurse?
A patient with acquired immunodeficiency syndrome (AIDS) tells the home care nurse, "I brought the disease upon myself." The patient tells the nurse, I stopped going to church and speaking with those who previously provided spiritual support." What would a priority goal related to spirituality during this terminal phase be?
What is the purpose of AIDS in the clinic?
A patient diagnosed with acquired immunodeficiency syndrome (AIDS) comes to the clinic to find out which tests would determine the prognosis of the syndrome. What information will the nurse provide? Select all that apply.
What is a nurse educator?
A nurse educator is teaching a group of nurses how to prevent health care-associated infections (HAI) in hospitals. Which bacteria are common culprits for the spread of health care-associated infections? Select all that apply.
How can a prognosis be assessed?
Prognosis can be assessed by viral load
When to prescribe broad spectrum antibiotics?
Prescribing broad-spectrum antibiotics when only first-line antibiotics are needed
Who reviews a plan of care for a patient who has sustained a deep laceration to an extremity?
The nurse reviews a plan of care for a patient who has sustained a deep laceration to an extremity. Which goal listed on the plan is inappropriate and should be questioned by the nurse ?
What is antiretroviral medicine?
Antiretroviral drugs are one of the major scientific breakthroughs of modern medicine, transforming a disease that was once thought to be a death sentence into a chronically managed condition.
How many classes of antiretroviral drugs are there?
Drug Classes. Combination antiretroviral therapy works by blocking several stages of the HIV life cycle. There are currently six classes of antiretroviral drugs, each classified by the stage of the cycle they inhibit: Entry/attachment inhibitors. Nucleoside reverse transcriptase inhibitors (NRTIs)
How many antiretroviral pills are needed per day?
Drug resistance takes far longer to develop, while dosing requires as few as one pill per day.
What happens if one antiretroviral drug is unable to suppress a certain mutation?
If one antiretroviral drug is unable to suppress a certain mutation, the other one or two drugs usually can by blocking a different stage of the cycle.
How much did combination therapy reduce HIV?
Within two short years, the introduction of combination therapy resulted in a remarkable 60% drop in HIV-related deaths. 3 This revelation ushered in what would come to be known as the age of HAART (highly active antiretroviral therapy). 2
How many shots of Cabenuva are needed?
There is now even an injectable option, called Cabenuva (cabotegravir + rilpivirine), that requires two shots once monthly rather than having to take pills every day. 4
When will the FDA approve extended release drug regimens for adults living with HIV?
FDA approves first extended-release, injectable drug regimen for adults living with HIV. January 21, 2021. U.S. Department of Health and Human Services. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents.
What is the nurse assessing?
The nurse is assessing a child with short stature and malnutrition. The medical history of the child also indicates oral candidiasis. Which condition does the nurse suspect in the child?
What is prescribed for a child with severe immunodeficiency?
A child is prescribed hematopoietic stem cell transplantation for severe combined immunodeficiency disease. What is administered to the child to improve the humoral immunity until the transplant is performed?
Which binds to the envelope glycoprotein gp41 and prevents viral fusion to the CD4 T?
Fusion inhibitors bind to the envelope glycoprotein gp41 and prevent viral fusion to the CD4 T-cells.
How does HAART help with HIV?
Improve immune function. Reducing the transmission of HIV-1 to others is a primary goal of HAART. With the use of HAART, a reduction of HIV-1 RNA levels has been shown to reduce the risk of sexual transmission to partners to nearly zero in some studies, even among couples that engaged in condomless sexual acts.
How many different types of HIV medications are there?
For the treatment of HIV, there are more than 25 different medications in six different classes, for which a detailed discussion will follow in further sections.
Is lamivudine a monotherapy?
Some NRTIs, lamivudine, and tenofovir, are also indicated in the treatment of hepatitis B (HBV). Monotherapy is unlikely to be sufficient to treat chronic HBV ; therefore, a combination of nucleoside/nucleotide analogs and interferon-alpha is generally recommended.
Is HAART used for HIV?
HAART is also utilized in the treatment of HIV -2, though currently, there is no specific guideline of recommendations for HI V-2 treatment. Instead, HIV-2 management is under HIV-1 guidelines with some modifications. Genetic differences render HIV-2 intrinsically resistant to certain HAART medication classes (non-nucleoside reverse transcriptase inhibitors) and decrease the efficacy of others (protease inhibitors and fusion inhibitors). Research is ongoing to determine the best initial treatment for patients infected with HIV-2 or dually infected with HIV-1/2. [17][18]
How do antiretrovirals work?
How Antiretrovirals Works. Antiretroviral drugs do not kill HIV; rather, they block different stages in the virus's life cycle —from the time it attaches to a cell to the time it creates new copies of itself to infect other cells.
How does antiretroviral treatment help HIV?
The strategy, known as treatment as prevention, aims to reduce the "community viral load" within a population , making it more difficult to spread infection. 9.
How much is antiretroviral therapy reduced?
Moreover, when antiretroviral therapy is started early, the risk of severe HIV-associated diseases and non-HIV-associated illnesses (like cancers and heart disease) is reduced by as much as 72% , according to research published in the New England Journal of Medicine. 11 .
How many shots of Cabenuva are needed?
While antiretrovirals typically require daily dosing, an injectable option called Cabenuva (cabotegravir + rilpivirine) was approved by the FDA in 2021, requiring only two shots once monthly to keep the virus fully suppressed. 8 . Complete List of Approved HIV Drugs.
What is PREP in HIV?
The strategy, known as pre-exposure prophylaxis (PrEP), is currently recommended for people at high risk of infection, including serodiscordant (mixed-status) couples, injecting drug users, and those who engage in protected anal or vaginal sex. 13 . High vs. Low Risk Activities for HIV Transmission.
What happens if one drug is unable to suppress a certain viral type?
By keeping the viral population fully suppressed ( undetectable ), there are fewer circulating viruses in the bloodstream and fewer opportunities for the virus to mutate into a drug-resistant variant.
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Introduction
In response to the HIV/AIDS pandemic, the WHO launched the ‘3 × 5’ initiative in 2003 [1].
Methods
The study population consisted of employees attending workplace-based ART clinics at two gold mining sites in South Africa. The programme has been described elsewhere [6].
Results
Of the 676 ART-naive individuals with baseline CD4 data, 423 (63%) remained in the programme and on ART 12 months after commencing treatment. Two individuals were excluded who had switched to second-line therapy before the 12-month visit, both due to virologically defined treatment failure.
Discussion
Our study shows that both clinical and CD4 criteria are insensitive in detecting virological treatment failure in this routine programme setting in South Africa.
Acknowledgements
We thank all the staff of Anglogold Health Services and Aurum Institute for their work in collecting the data used in this study and assistance in its preparation, in particular Mr Michael Eisenstein and Dr Lindiwe Pemba. We are grateful to Dr Jenny Whetham and Dr Mampedi Bogoshi for providing data on outpatient TB episodes and hospital admissions.