- Body system
- Anti-infectives
- Name stem
- -ciclovir, -vir
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Valacyclovir, Famciclovir, Oseltamivir, Ganciclovir, Nirmatrelvir-ritonavir, Remdesivir.
How antivirals work
Most block viral DNA or RNA synthesis (acyclovir, valacyclovir, remdesivir) or viral release and enzymes (oseltamivir, protease inhibitors).
Uses
- Herpes simplex and herpes zoster
- Influenza (oseltamivir, ideally within 48 hours of symptoms)
- Cytomegalovirus (ganciclovir)
- COVID-19 (nirmatrelvir-ritonavir, remdesivir)
- HIV and hepatitis B and C (antiretrovirals and direct-acting antivirals)
Adverse effects
- Nausea, diarrhea and headache
- Nephrotoxicity and phlebitis (IV acyclovir)
- Bone marrow suppression (ganciclovir)
- Many drug interactions (ritonavir-boosted regimens)
Nursing considerations
- Hydrate well and infuse IV acyclovir over at least 1 hour.
- Adjust doses for kidney function.
- Ganciclovir is a hazardous drug: follow handling precautions.
Patient teaching
- Start herpes treatment at the first sign of an outbreak.
- Antivirals do not prevent all transmission.
- Take oseltamivir as soon as possible after flu symptoms begin.
Antivirals NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which nursing action helps prevent kidney injury during IV acyclovir therapy?
Show answer
Answer B: Ensure adequate hydration and infuse slowly Acyclovir can crystallize in the renal tubules; hydration and slow infusion reduce the risk.
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A patient with genital herpes asks if acyclovir will cure it. What is the correct response?
Show answer
Answer A: No, it shortens and lessens outbreaks but does not eliminate the virus Herpes viruses remain latent; antivirals suppress replication but do not cure.
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When is oseltamivir most effective?
Show answer
Answer A: Started within 48 hours of flu symptoms Neuraminidase inhibitors work best when started within 48 hours of symptom onset.
Frequently asked questions
What are antivirals?
Antivirals suppress viral replication but rarely cure the infection. Acyclovir and its relatives treat herpes viruses; IV acyclovir needs hydration to protect the kidneys.
How do antivirals work?
Most block viral DNA or RNA synthesis (acyclovir, valacyclovir, remdesivir) or viral release and enzymes (oseltamivir, protease inhibitors).
What are examples of antivirals?
Acyclovir, Valacyclovir, Famciclovir, Oseltamivir, Ganciclovir, Nirmatrelvir-ritonavir and Remdesivir.
What are the nursing considerations for antivirals?
Hydrate well and infuse IV acyclovir over at least 1 hour. Adjust doses for kidney function.