Flu Preventive Medicine: What You Should Know About Flu Antiviral Drugs

13.08.202310.06.2023 by alexxlab

Can flu be treated? What are flu antiviral drugs? What should I do if I think I am sick with flu? Should I still get a flu vaccine? What are the benefits of antiviral drugs? When should antiviral drugs be taken for treatment? What antiviral drugs are recommended this flu season?

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Can Flu Be Treated?

Yes. There are prescription medications called “antiviral drugs” that can be used to treat flu illness. CDC recommends prompt treatment for people who have flu or suspected flu and who are at higher risk of serious flu complications, such as people with asthma, diabetes (including gestational diabetes), or heart disease.

What Are Flu Antiviral Drugs?

Flu antiviral drugs are prescription medicines (pills, liquid, an inhaled powder, or an intravenous solution) that fight against flu viruses in your body. Antiviral drugs are not sold over the counter. You can only get them if you have a prescription from a health care provider. Antiviral drugs are different from antibiotics, which fight against bacterial infections. Antiviral drugs for flu only work to treat flu. Flu antiviral drugs are different than antiviral drugs used to treat other infectious diseases such as COVID-19. Antiviral drugs prescribed to treat COVID-19 are not approved or authorized to treat flu.

What Should I Do If I Think I Am Sick with Flu?

If you get sick with flu, antiviral drugs are a treatment option. Check with your doctor promptly if you are at higher risk of serious flu complications (full list of higher risk factors) and you develop flu symptoms. Flu signs and symptoms can include feeling feverish or having a fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. However, not everyone with the flu has a fever. Your doctor may prescribe antiviral drugs to treat your flu illness.

Should I Still Get a Flu Vaccine?

Yes. Antiviral drugs are not a substitute for getting a flu vaccine. While flu vaccine can vary in how well it works, a flu vaccine is best way to help prevent seasonal flu and its potentially serious complications. Everyone 6 months and older should receive a flu vaccine every year. Antiviral drugs are a second line of defense that can be used to treat flu (including seasonal flu and variant flu viruses) if you get sick.

What Are the Benefits of Antiviral Drugs?

When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen fever and flu symptoms and shorten the time you are sick by about one day. They also may reduce the risk of complications such as ear infections in children, respiratory complications requiring antibiotics, and hospitalization in adults. For people at higher risk of serious flu complications, early treatment with an antiviral drug can mean having milder illness instead of more severe illness that might require a hospital stay. For adults hospitalized with flu illness, some studies have reported that early antiviral treatment can reduce their risk of death.

When Should Antiviral Drugs Be Taken for Treatment?

Antiviral treatment provides the greatest benefit when started soon after flu illness begins. Studies show that flu antiviral drugs work best for treatment when they are started within two days of getting sick. However, starting them later can still be beneficial, especially if the sick person is at higher risk of serious flu complications or is in the hospital with more severe illness. Follow instructions for taking these drugs. Follow your doctor’s instructions and the dose, frequency, and duration listed on the label instructions for taking these drugs.

What Antiviral Drugs Are Recommended This Flu Season?

There are four FDA-approved antiviral drugs recommended by CDC to treat flu this season:
– oseltamivir phosphate (available as a generic version or under the trade name Tamiflu®)
– zanamivir (trade name Relenza®)
– peramivir (trade name Rapivab®)
– baloxavir marboxil (trade name Xofluza®)

Generic oseltamivir and Tamiflu® are available as a pill or liquid suspension and are FDA approved for early treatment of flu in people 14 days and older. Zanamivir is a powdered medication that is inhaled and approved for early treatment of flu in people 7 years and older. (Note: Zanamivir (trade name Relenza®) is administered using an inhaler device and is not recommended for people with breathing problems like asthma or COPD.) Oseltamivir and zanamivir are given twice a day for five days.

Peramivir is given once intravenously by a health care provider and is approved for early treatment of flu in people 6 months and older. Baloxavir is a pill given as a single dose by mouth and is approved for early treatment of flu in children aged 5 years to less than 12 years who do not have any chronic medical conditions, and for all people aged 12 years and older. (Note: Baloxavir (trade name Xofluza®) is not recommended for treatment of flu in pregnant people, lactating people, or in outpatients with complicated or progressive illness because there is no information about use of baloxavir in these patients. Baloxavir is also not recommended for people with certain underlying medical conditions.)

What You Should Know About Flu Antiviral Drugs

Can flu be treated?

What are flu antiviral drugs?

What should I do if I think I am sick with flu?

Should I still get a flu vaccine?

Yes. Antiviral drugs are not a substitute for getting a flu vaccine. While flu vaccine can vary in how well it works, a flu vaccine is best way to help prevent seasonal flu and its potentially serious complications. Everyone 6 months and older should receive a flu vaccine every year. Antiviral drugs are a second line of defense that can be used to treat flu (including seasonal flu and variant flu viruses) if you get sick.

What are the benefits of antiviral drugs?

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When should antiviral drugs be taken for treatment?

What antiviral drugs are recommended this flu season?

There are four FDA-approved antiviral drugs recommended by CDC to treat flu this season.

oseltamivir phosphate (available as a generic version or under the trade name Tamiflu®),
zanamivir (trade name Relenza®)
peramivir (trade name Rapivab®), and
baloxavir marboxil (trade name Xofluza®).

Generic oseltamivir and Tamiflu® are available as a pill or liquid suspension and are FDA approved for early treatment of flu in people 14 days and older.

Zanamivir is a powdered medication that is inhaled and approved for early treatment of flu in people 7 years and older. (Note: Zanamivir (trade name Relenza®) is administered using an inhaler device and is not recommended for people with breathing problems like asthma or COPD.) Oseltamivir and zanamivir are given twice a day for five days.

Peramivir is given once intravenously by a health care provider and is approved for early treatment of flu in people 6 months and older.

Baloxavir is a pill given as a single dose by mouth and is approved for early treatment of flu in children aged 5 years to less than 12 years who do not have any chronic medical conditions, and for all people aged 12 years and older. (Note: Baloxavir (trade name Xofluza®) is not recommended for treatment of flu in pregnant people, lactating people, or in outpatients with complicated or progressive illness because there is no information about use of baloxavir in these patients. Baloxavir is also not recommended for treatment of flu in hospitalized patients due to limited data.)

How long should antiviral drugs be taken?

To treat flu, oseltamivir or inhaled zanamivir are usually prescribed for five days, while one dose of intravenous peramivir or one dose of oral Baloxavir are usually prescribed. Oseltamivir treatment is given to hospitalized patients, and some patients might be treated for more than five days.

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What are the possible side effects of antiviral drugs?

Side effects vary for each medication. The most common side effects for oseltamivir are nausea and vomiting. Zanamivir can cause bronchospasm, and peramivir can cause diarrhea. Other less common side effects also have been reported. Your health care provider can give you more information about these drugs or you can check the Food and Drug Administration (FDA) website for specific information about antiviral drugs, including the manufacturer’s package insert.

Can children take antiviral drugs?

Yes, though this varies by medication. Oseltamivir is recommended by CDC for treatment of flu in children beginning from birth and the American Academy of Pediatrics (AAP) recommends oseltamivir for treatment of flu in children 2 weeks old or older.

Oseltamivir is available as an oral suspension for children.
Zanamivir is approved for early treatment of flu in people 7 years and older, though it is not recommended for use in children with underlying respiratory disease, including asthma and other chronic lung diseases.
Peramivir is approved for early treatment in people 6 months and older.
Baloxavir is available in a single dose tablet for children aged 5 years and older. While an oral Baloxavir suspension (liquid) medication is approved by FDA, this product is not available for the 2022-2023 flu season.

If your child’s health care provider prescribes oseltamivir capsules for your child and your child cannot swallow capsules, the prescribed capsules may be opened, mixed with a thick sweetened liquid, and given that way. Learn more here.

Can pregnant people take antiviral drugs?

Yes. Oral oseltamivir is recommended for treatment of pregnant people with flu because compared to other recommended antiviral medications, it has the most studies available to suggest that it is safe and beneficial during pregnancy. Baloxavir is not recommended for pregnant people or while breastfeeding, as there are no available efficacy or safety data.

Who should take antiviral drugs?

It’s very important that flu antiviral drugs are started as soon as possible to treat patients who are hospitalized with flu, people who are very sick with flu but who do not need to be hospitalized, and people who are at higher risk of serious flu complications based on their age or health, if they develop flu symptoms. Although other people with mild illness who are not at higher risk of flu complications may also be treated early with antiviral drugs by their doctor, most people who are otherwise healthy and not at higher risk for flu complications do not need to be treated with antiviral drugs.

Treating Flu With Antiviral Medicines: Relenza & Tamiflu

Written by WebMD Editorial Contributors

What Are Antiviral Drugs?
When Are Antiviral Drugs Recommended?
How Are Antivirals Used in Preventing Flu?
Which Antiviral Drugs Are Recommended for Both Treatment and Prevention of the Flu?
Do Antiviral Drugs for Flu Have Side Effects?
When Do I Call the Doctor About Flu Antiviral Drugs?
More

Antiviral drugs are prescription medications that may help prevent flu complications or shorten the severity and duration of flu once you have it. Here are the latest antiviral drug recommendations. After you read this, talk to your doctor to see if antiviral drugs can help you feel better.

Antiviral drugs are medicines that decrease the ability of flu viruses to reproduce. When used as directed, antiviral drugs may help reduce the duration of flu symptoms in otherwise healthy children and adults and may reduce the severity of common flu symptoms.

Antiviral drugs are recommended for both treatment and prevention of flu. Antiviral drugs work best when taken within 48 hours of onset of flu symptoms, but they may still offer benefits when taken later. These medications may reduce the duration of flu by one to two days and prevent severe flu complications.

Your doctor may prescribe an antiviral if you come in close contact with family members or others who have the flu and you want to try to avoid getting sick. However, the CDC discourages this as a routine practice, as it can lead to drug-resistant strains of the virus. Instead, the CDC recommends that people at risk of severe flu — such as pregnant women or people with asthma, diabetes, or heart disease — begin antiviral treatment as soon as flu symptoms appear. Others at high risk for complications from the flu include infants, the elderly, those with chronic illness, Native Americans and Alaskan Natives

It’s important, however, to remember that vaccination is the most effective way to prevent flu.

The CDC recommends the antiviral drugs baloxavir marboxil (Xofluza), oseltamivir (Tamiflu), and zanamivir (Relenza) for both flu prevention and treatment..

Baloxavir marboxil is taken orally and is approved for use in treatment of children 12 years of age and older.

Oseltamivir, which is taken by mouth, is approved for treating flu in those over 2 weeks of age and preventing flu in people one year of age and older.

Peramivir, given in one intravenous dose, is approved for people over the age of 2 for treatment only.

Zanamivir (Relenza) is approved for treating flu in people 7 years and older and for preventing flu in people 5 years and older. Relenza is inhaled through the mouth.

All four antivirals are most effective when given within 48 hours of the onset of flu symptoms, although they may still prevent severe flu complications when given more than 48 hours after symptoms appear.

For in-depth information, see WebMD’s Flu Prevention Strategies.

Side effects of antivirals may include nausea, vomiting, runny nose, stuffy nose, cough, diarrhea, and behavioral changes. Zanamivir is not recommended for individuals who have asthma, chronic obstructive pulmonary disease (COPD), or other lung disease. Based on your individual health status, your doctor will prescribe the antiviral drug that’s safest for you.

Ideally, you should talk to your doctor about the flu vaccine and antiviral drugs, including side effects, before the flu season begins.

When you do get flu symptoms, it’s important to call your doctor soon after symptoms appear. Flu drugs are most effective when taken within the first 48 hours of flu symptoms, although they may help prevent severe disease when taken later.

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Prevention of influenza – recommendations to citizens – Prevention of diseases and healthy lifestyle – Budgetary institution of the Khanty-Mansiysk Autonomous Okrug – Yugra

Prevention of influenza – advice to citizens

Some people get the flu for several days, while others last longer and with severe complications. In total, there are three types of influenza virus, which

is characterized by infinite variability, while protecting yourself from the flu and its consequences is in the power of everyone.

What is influenza and what is its danger?

Influenza is an infectious disease that can affect anyone. Influenza is caused by a virus that

from infected people enters the nasopharynx of others.

Most people get flu for only a few days, but some get more severe, possibly severe,

up to deaths.

Influenza exacerbates existing chronic diseases, in addition, the flu has an extensive list of possible complications:

Pulmonary complications (pneumonia, bronchitis). Pneumonia is the cause of most influenza deaths.

Complications from the upper respiratory tract and ENT organs (otitis media, sinusitis, rhinitis, tracheitis).

Complications of the cardiovascular system (myocarditis, pericarditis).

Complications of the nervous system (meningitis, meningoencephalitis, encephalitis, neuralgia, polyradiculoneuritis).

To avoid possible complications, it is important to prevent influenza in a timely manner and treat the disease itself correctly.

Influenza usually starts suddenly. The causative agents of influenza, viruses types A and B, are characterized by aggressiveness and exceptionally high speed

reproduction, therefore, in a matter of hours after infection, the virus leads to deep lesions of the mucous membrane of the respiratory tract, opening

opportunities for bacteria to penetrate into it.

Influenza symptoms include fever, temperature 37.5-39°C, headache, muscle and joint pain, chills, fatigue, cough, runny nose or

stuffy nose, sore and sore throat.

Influenza can be confused with other diseases, so a doctor must make a clear diagnosis, he also prescribes treatment tactics.

What should I do if I have the flu?

The patient himself, at the first symptoms, needs to stay at home, so as not only not to infect others, but also to start treatment in time,

for which you must immediately consult a doctor. To prevent further spread of the infection – the sick person must be isolated

from healthy individuals, it is desirable to allocate a separate room.

Important!

Parents! In no case do not send sick children to kindergarten, school, cultural events.

In influenza, it is extremely important to observe bed rest, as the disease increases the load on

cardiovascular, immune and other body systems.

Self-medication for influenza is unacceptable, and it is the doctor who must diagnose and prescribe the necessary treatment,

corresponding to the condition and age of the patient.

For proper treatment, it is necessary to strictly follow all the recommendations of the attending physician and take medicines in a timely manner.

In addition, it is recommended to drink plenty of water – it can be hot tea, cranberry or lingonberry juice,

alkaline mineral waters. You need to drink more often and as much as possible.

Important!

At a temperature of 38 – 39 ° C, call the local doctor at home or the ambulance team.

When coughing and sneezing, the patient should cover their mouth and nose with a handkerchief or tissue.

The room where the patient is located should be regularly ventilated and wet cleaned as often as possible,

preferably with disinfectants that act on viruses.

Contact with a sick person should be limited, and when caring for him, use a medical mask or gauze bandage.

How to protect yourself from the flu?

According to the position of the World Health Organization, the most effective remedy against influenza is vaccination, because it is the vaccine that provides protection against those types of influenza virus that are the most relevant in this epidemiological season and are part of it.

The introduction of a vaccine into the body cannot cause disease, but by producing protective antibodies it stimulates the immune system to fight infection. The effectiveness of the flu vaccine is incomparably higher than all non-specific medicines that can be taken during the winter months, for example, immunomodulators, vitamins, homeopathic remedies, traditional medicine, and so on.

Vaccination is recommended for all population groups, but is especially indicated for children from 6 months of age, people suffering from chronic diseases, pregnant women, and people at occupational risk groups – medical workers, teachers, students, workers in the service sector and transport.

Vaccination should be carried out 2-3 weeks before the onset of an increase in the incidence, vaccination can only be done in a medical institution by specially trained medical personnel, and a doctor’s examination is mandatory before vaccination.

There are few contraindications to influenza vaccination. Influenza vaccination should not be done in acute febrile conditions, during an exacerbation of chronic diseases, with an increased sensitivity of the body to egg white (if it is part of the vaccine).

Having been vaccinated against influenza, you protect your body from the attack of the most dangerous viruses – influenza viruses, but there are still more than 200 types of viruses that are less dangerous to humans, but can also cause SARS. Therefore, during the period of the epidemic rise in the incidence of acute respiratory viral infections and influenza, it is recommended to take non-specific preventive measures.

Flu prevention rules:

Get your flu shot before flu season.

Reduce your time in crowded places and public transport.

Wear a mask in crowded places.

Avoid close contact with people who show signs of illness, such as sneezing or coughing.

Wash your hands thoroughly with soap and water regularly, especially after street and public transport.

Flush the nasal cavity, especially after the street and public transport

Ventilate the room you are in regularly.

Regularly wet clean the room you are in.

Humidify the air in the room you are in.

Eat as many foods containing vitamin C as possible (cranberries, lingonberries, lemon, etc.).

Eat as many meals as possible with garlic and onions.

Use immune-boosting drugs and products as recommended by your doctor.

In case of occurrence of flu cases in the family or work team, start taking antiviral drugs for prophylactic purposes (as agreed with the doctor, taking into account contraindications and according to the instructions for using the drug).

Maintain a healthy lifestyle, get enough sleep, eat a balanced diet and exercise regularly.

Based on materials from the site http://rospotrebnadzor.ru/

measures to prevent influenza, SARS and viral diseases in adults

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Season of respiratory infections: how to protect yourself and your loved ones?

Prevention of influenza, SARS and coronavirus is a single set of measures aimed at preventing morbidity. The words of Hippocrates are relevant today: “It is easier to prevent a disease than to cure it.” Compliance with preventive measures helps protect against infection, reduce the risks of a large-scale spread of infection, and save people’s lives.

With the advent of the pandemic, the importance of preventing respiratory infections has been felt around the world. COVID-19 has forced humanity to take a fresh look at ways to maintain health. In the same row with coronavirus infection are influenza and SARS, which people face in autumn and spring. As practice shows, seasonal diseases sometimes cause no less severe complications than covid. Prevention of influenza and SARS, developed by epidemiologists, helps to protect yourself from infection and its consequences. Read about the features of respiratory viruses, means and methods of protection against infection in our article. 9Respiratory viruses are a large family of ultramicroscopic intracellular parasites. Some of them are noticeably activated in the demi-season, causing epidemics of SARS (acute respiratory viral infection). These are paramyxoviruses, picornaviruses, adenoviruses, coronaviruses, parainfluenza, influenza A, B, C viruses. The main method of infection is aerogenic or airborne. Viral particles fly through the air with droplets of liquid that escape from the mouth of a sick person when sneezing, coughing. The second way of infection is contact-household. The direct way is through a handshake with the carrier of the infection, the indirect way is through contaminated (infected) surfaces. Having picked up the virus on the hands, it is easy to bring it into the nose, the mouth is the “entrance gate” of SARS.

Means for the prevention of SARS and influenza

Preventive measures against acute respiratory infections are divided into specific and non-specific. Specific prevention is vaccination. In the Russian Federation, the population is being immunized against influenza and coronavirus. For other viruses, of which medical virology has more than two hundred, there is no vaccine. Non-specific methods include drug protection of the body, home remedies to strengthen immunity, rules for the prevention of influenza and SARS recommended by WHO.

Non-specific prophylaxis

Two types of pharmacological preparations have been developed to prevent influenza and SARS:

• Direct-acting drugs. Block enzymes on the surface of the virus. Because of this, the infectious agent loses the ability to reproduce its RNA and proteins.
• Agents that stimulate the production of protective interferons to increase the body’s resistance to infections.

Antiviral drugs are available in the form of tablets, capsules, powders. For children, syrups, suspensions, drops are provided, which are convenient to take.

TOP-5 drugs include:

• Arbidol. Active against most pathogens of SARS, including influenza viruses. For prevention, take twice a week, for treatment – 4 times a day. In the form of a powder, it is allowed for children from 2 years old, in the form of tablets – from 6 years old.
• Ergoferon. Fast-acting immunomodulator with proven efficacy against respiratory viruses. Tablets for sublingual administration are prescribed: on day 1, 5 pcs. within 2 hours, in the following days – 1 pc. three times.
• Ingavirin. An innovative antiviral agent with high anti-inflammatory activity. Used for all types of SARS, including coronavirus infection. In pediatrics, they have been used since 7 years. To achieve the result, 1 capsule per day is enough.
• Kagocel. A powerful immunostimulant that causes the synthesis of interferons by all cells of the body that are involved in the antiviral response. Allowed for children from 3 years. Prevention is carried out in cycles: 2 days for 2 tablets – 5 days break – 2 days for 2 tablets.
• Anaferon. Increases the production of interferon, is prescribed for the prevention and treatment of acute respiratory viral infections. In pediatrics, a specially designed children’s version of the drug is used.

Unlike antibiotics, antivirals are available without a prescription.

Organization of home prevention of SARS and influenza includes:

• Nutrition correction. Foods with a high content of ascorbic acid help stimulate the formation of interferon – vegetables, wild berries, fruits, greens. Protein is the building material for immune cells, so the diet should contain a sufficient amount of meat, fish, dairy products, cereals (millet, oats, buckwheat). The main assistant to immunity is vitamin D. It is found in egg yolk, seaweed, cod liver.
• Hardening, physical activity. Hardening procedures are recommended to start in the summer – before the onset of seasonal epidemics. Sports activities saturate the blood with oxygen, accelerate hemodynamics, increase blood supply to organs. This allows you to maintain the efficiency of the cells of the immune system for the production of interferons.

• The use of folk remedies. Products with antimicrobial action (garlic, ginger, onion), as well as plants with immunostimulating properties (ginseng root, rosehip, echinacea, sage, lemon balm) help protect against seasonal diseases.

To prevent ailments, it is important to adhere to a rational regime of work and rest. Doctors recommend getting enough sleep, walking daily, avoiding conflict situations that lead to stress, and taking vitamin and mineral supplements.

Influenza and its dangers

In addition to the coronavirus, the influenza virus is considered the most dangerous causative agent of acute infections. It differs from its respiratory “relatives” in high virulence – the ability to quickly spread throughout the body, cause severe complications – up to lethality. The risk group includes elderly people, small children, patients with chronic cardiological and pulmonary pathologies.

The influenza virus provokes infectious and inflammatory diseases of the heart, nervous system, and brain. With a severe viral load, intoxication quickly develops, the permeability of the vascular walls increases, hemodynamics are disturbed, the lungs lose their ability to absorb oxygen, and respiratory failure occurs, threatening a fatal outcome. The most effective prevention of influenza is the introduction of an influenza vaccine before the start of the epidemic season. Children are vaccinated from 6 months of age.

Immunity strengthening vitamins

Special blood tests help determine which vitamins are lacking in the body. Normal indicators of vitamin D hormone are considered to be the main marker of the stable functioning of the immune system. It enters the body with food, is synthesized by skin cells under the influence of sunlight. Given the shortage of ultraviolet radiation in most Russian regions, it is recommended to take the vitamin hormone in the form of dietary supplements. To prevent respiratory diseases, the immune system needs B vitamins, ascorbic acid, fat-soluble vitamins A, E.

Products containing vitamins for the prevention of SARS and influenza

Ascorbic acid (vitamin C):

sauerkraut
bell pepper
citrus
cranberry
currant
wild rose

Group B:

nuts
milk
Legumes
Greek
oats
tomatoes

Tocopherol (E):

sea buckthorn
spinach
broccoli
bran
eggs
vegetable oils

Retinol (A):

carrot
green onion
parsley
peaches
apricots
melon

Replenishing the vitamin reserve with food alone is an impossible task. To maintain the immune system in a state of alert, an additional source is needed – pharmacy vitamin complexes:

• Supradin Immuno Forte;
• Doctor More;
• Multi-tabs Immuno Plus;
• Pediakid Syrup;
• Superum Echinacea Complex with Vitamin C.

The most modern and effective means to strengthen the immune system can be ordered with home delivery.

What to do in case of illness?

Fever, weakness, perspiration, lacrimation are early signs of infection. When they appear, it is not recommended to leave the house. Firstly, so as not to spread viruses, and secondly, so as not to worsen your well-being. A call to a therapist or pediatrician can be made by phone. In case of extreme temperatures, it is better to call an ambulance. Before the doctor arrives, the sick person should be put to bed, given warm tea (fruit drink). It is advisable to put on a medical mask for the patient, give him a separate room, dishes, hygiene items. To prevent complications, it is important to follow medical prescriptions – take medicines, drink plenty of fluids, ventilate the room, eat foods rich in vitamins, phytoncides, and protein. In the first days of the disease, bed rest must be observed. With the flu, physical activity can trigger the development of acute respiratory distress syndrome, an extremely life-threatening condition.

Influenza prevention rules

WHO insists on vaccination, especially for the elderly. For the formation of anti-influenza immunity, the body needs 3-5 weeks. Vaccination is recommended to be done in September-October.

During the influenza and SARS season, doctors call:

• Take care of yourself and those around you. Don’t visit public places unnecessarily. If communication with others is unavoidable, keep your distance. Sneeze gently into pre-prepared paper tissues. Wear medical masks, treat your hands with antiseptics, use disposable gloves.