Drug Guide
Vidarabine
Classification
Therapeutic: Antiviral
Pharmacological: Nucleoside analog
FDA Approved Indications
- Herpes simplex virus (HSV) infections of the eye
Mechanism of Action
Vidarabine is a nucleoside analog that inhibits viral DNA synthesis by competing with natural nucleotides, leading to chain termination during viral DNA replication.
Dosage and Administration
Adult: Apply 1% ophthalmic ointment to the affected eye every 3 hours during the day and every 4 hours during the night, for 7-14 days.
Pediatric: Same as adult dosing; dosages are based on the severity of the infection and patient response.
Geriatric: No specific adjustments; follow standard dosing unless renal or hepatic impairment present.
Renal Impairment: Use with caution; no specific dose adjustment provided, but monitor renal function.
Hepatic Impairment: Use with caution; no specific dose adjustment provided.
Pharmacokinetics
Absorption: Poor oral absorption; topical administration for ocular use.
Distribution: Limited systemic absorption; mostly localized effect.
Metabolism: Metabolized by deamination.
Excretion: Primarily renally excreted.
Half Life: Approximately 20-25 minutes systemically; topical ocular half-life varies.
Contraindications
- Hypersensitivity to vidarabine or any component
Precautions
- Use with caution in immunocompromised patients.
- Potential for neurotoxicity if used systemically.
Adverse Reactions - Common
- Local irritation, burning, or stinging of the eye (Frequent)
- Conjunctivitis or eyelid inflammation (Occasional)
Adverse Reactions - Serious
- Neurotoxicity (e.g., seizures, altered consciousness) if systemically absorbed (Rare)
Drug-Drug Interactions
- None well-documented; check for other ocular medications.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of ocular irritation or allergic reactions.
Diagnoses:
- Risk for infection related to impaired ocular integrity.
Implementation: Apply ointment as prescribed; ensure proper eye hygiene.
Evaluation: Assess resolution of infection and monitor for adverse effects.
Patient/Family Teaching
- Use medication exactly as prescribed.
- Avoid touching the tip of the tube to any surface.
- Report any eye pain, vision changes, or Allergic reactions.
Special Considerations
Black Box Warnings: N/A
Genetic Factors: None specified.
Lab Test Interference: None known.
Overdose Management
Signs/Symptoms: Local ocular irritation or systemic neurotoxicity in case of significant systemic absorption.
Treatment: Discontinue drug; provide symptomatic and supportive care.
Storage and Handling
Storage: Store at room temperature, protected from light.
Stability: Stable as per manufacturer; discard after expiration.