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NURS 251 (Pharmacology 1) > Biological Response-Modifiers and Antirheumatic Drugs > Flashcards

Biological Response-Modifiers and Antirheumatic Drugs Flashcards

1
Q

What are biological response modifying drugs (BRMs)

A

They alter the body’s response to diseases such as cancer and autoimmune, inflammatory, infectious disease

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2
Q

What are the 2 classes of BRMs

A

Hematopoietic drugs
Immunomodulating drugs (IMDs)

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3
Q

What are the 4 subclasses of IMDs

A

Interferons (IFNs)
Monoclonal antibodies (MABs)
Interleukin(IL) receptor agonists and antagonists
Miscellaneous drugs

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4
Q

What are immunomodulating drugs

A

They alter a patients immune response to malignant tumour cells

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5
Q

What part of cancer therapy are IMDs

A

Fourth part

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6
Q

What other diseases are IMDs used for

A

Autoimmune
Inflammatory
Infectious

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7
Q

What is the MOA of BRMs

A

Enhancement of hematopoietic functions
Enhancement or regulation of the host’s immune system defenses against the tumor
Inhibition of metastases, prevention of cell division, or inhibition of cell maturation

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8
Q

What are the two components of the immune system and briefly describe them

A

Humoral immunity (B-cell functions)
Cell-mediated immunity (T-cell functions)

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9
Q

Where do B cells originate from

A

Bone marrow

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10
Q

What do B cells do?

A

They create the antibodies

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11
Q

What are Monoclonal antibodies

A

Identical cells derived from a single cell

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12
Q

What are the five major types of naturally occurring immunoglobulins

A

A, D, E, G, and M

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13
Q

Where do T cells originate and mature

A

Originate from bone marrow but mature in thymus

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14
Q

What are the 3 types of T cells

A

Cytotoxic T cells
T-helper cells
T-suppressor cells

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15
Q

What is the ratio of T-helper cells to T-suppressor cells in a healthy immune system

A

T-helper cells are twice as many as T-suppressor cells

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16
Q

Name 2 hematopoietic drugs and what type they are

A

Darbepoetin alfa is an erythropoietic drugs
Filgrastim is a colony-stimulating factor

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17
Q

What is the MOA of hematopoietic drugs

A

Decreases the duration of chemotherapy-induced anemia, neutropenia, thrombocytopenia
Enable higher doses of chemo to be given
Decrease bone marrow recovery time after bone marrow transplantation or irradiation
Stimulate other cells in the immune system to destroy or inhibit the growth of cancer cells and virus or fungus infected cells

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18
Q

What does filgrastim do?

A

Stimulates precursor cells for granulocytes

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19
Q

When is filgrastim administered?

A

Before the patient develops an infection

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20
Q

Which form is filgrastim administered?

A

SQ injections for 7-14 days

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21
Q

T/F: Do not start filgrastim until 18 hrs after chemo is completed

A

False: Do not start until 24 hours after chemo is completed

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22
Q

How is filgastrim stored and what should you do before use?

A

Refrigerated
Take out minimum 30 minutes before use

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23
Q

When should you discontinue

A

When the absolute neutrophil count (ANC) reaches 1 x 10^9/ L

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24
Q

What is Nadir

A

When blood counts are at their lowest

25
Q

How long does Nadir last

A

As long as 28 days

26
Q

What are the indications for hematopoietic drugs

A

Patients who have experienced destruction of bone marrow cells as a result of cytotoxic chemo
Decreasing the duration of low neutrophil counts, thus reducing the incidence and duration of infections

27
Q

What are the adverse effects of hematopoietic drugs

A

Fever
Muscle aches
Bone pain
Flushing

28
Q

What are interferons

A

Proteins with 3 basic properties
Antiviral
Antitumor
IMD

29
Q

What are the 3 groups of interferon drugs

A

Alfa
Beta
Gamma

30
Q

What is the MOA of interferons

A

Enable cells to produce enzymes that protect human cells from viral attacks
Prevent cancer cells from dividing and replicating
Increase the activity of other immune system cells (NK, macrophages, etc.)

31
Q

What effects do interferons have on the immune system

A

Restore immune systems function if it’s impaired
Augment the immune systems ability to function as the body’s defense
Inhibit the IS from working (autoimmune disorders)

32
Q

What are the indications of interferons

A

Viral infections
Cancer
Autoimmune disorders

33
Q

What are the adverse effects of interferons

A

Flulike symptoms
Anorexia
Dizziness
Vomiting
Diarrhea

34
Q

What is a dose limiting adverse effect of interferons

A

Fatigue

35
Q

Name 4 interferon drugs and their indications

A

IFN alfa-2b (Hep B and C, cancer, etc)
PegIFN alfa-2a (chronic Hep C)
IFN beta-1a (MS)
IFN beta -1b (MS)

36
Q

What are the indications for Monoclonal antibodies

A

Treatment of cancer, rheumatoid arthritis, MS and organ transplantation

37
Q

What is the MOA of MABs

A

Target cancer cells and have minimal effect on healthy cells

38
Q

What are the contraindications of MABs

A

Active TB and other infections because of its immunosuppressive qualities

39
Q

MABs are anti TNF properties. What is TNF

A

Tumor Necrosis Factor is a cytokine involved in systemic inflammation
It is produced mainly by activated macrophages

40
Q

What are TNF inhibitors

A

Drugs that help stop inflammation

41
Q

What are they also known as?

A

TNF blockers or anti-TNF drugs

42
Q

Name 4 MAB drugs

A

Adalimumab
Infliximab
Rituximab
Natiluzumab

43
Q

Name an Interleukin(IL) drug

A

Aldesleukin

44
Q

What is the MOA of interleukins (IL)

A

It binds to receptors in the T cells, which stimulates the T cells to multiply.
Lymphokine-activated killer (LAK) cells
LAK cells recognize and destroy only cancer cells

45
Q

What is capillary leak syndrome?

A

Capillaries lose ability to retain vital colloids.
Capillaries become leaky and substances migrate into surrounding tissues

46
Q

What are adverse effects of IL

A

Fluid retention as a result of capillary leak syndrome
Respiratory distress
HF
MI
Dysrhythmias

47
Q

Is capillary leak syndrome reversible?

A

Yes, after IL therapy is discontinued

48
Q

What are the contraindications of aldesleukin

A

Organ transplants

49
Q

What does aldesleukin treat?

A

Metastatic renal cell carcinoma and metastatic melanoma

50
Q

What is the difference between osteoarthritis and RA

A

RA is autoimmune related
Osteoarthritis is not an auto-immune related condition

51
Q

Disease-modifying antirheumatic drugs (DMARDs)

A

Inhibit the movement of various cells into an inflamed, damaged area, such as a joint

52
Q

Name 2 nonbiological disease-modifying antirheumatic drugs

A

Methotrexate
Leflunomide

53
Q

What is the first line therapy for RA

A

Methotrexate

54
Q

What are the doses for methotrexate and what is the onset of action?

A

7.5mg to 20 mg per week
It is always per week
3-6 weeks

55
Q

What is taken concurrently with methotrexate to lessen adverse effects

A

Folic acid supplement

56
Q

Biological Disease-modifying antirheumatic drugs

A

Adalimumab
Etanercept
Infliximab
Abatacept

57
Q

What is etanercept

A

Used to treat RA and moderate to severe chronic plaque psoriasis
Onset is 1 to 2 weeks
Contraindicated in presence of active infections

58
Q

What is abatacept

A

Used to treat RA
Caution if the patient has a history of recurrent infections or COPD
May decrease response to dead or live vaccines
Patients must be up to date on immunizations before starting therapy

59
Q

Watching for febrile neutropenia; it needs ________________________

A

urgent treatment and monitoring

NURS 251 (Pharmacology 1) (20 decks)

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