Chapter 34, 40 Flashcards
What is the purpose of biological response modifiers
To enhance a person’s immune system
What are the different types of interferons?
Type I and II
Type I if IFN alpha and beta
Type II is IFN gamma
Do anticoagulants dissolve clots
No! They do not dissolve clots that are already formed, but acts prophylactically to prevent new thrombi from developing
What are colony-stimulating factors
Proteins that stimulate or regulate the growth, maturation, and differentiation
Can heparin be given PO
No - it does not digest well in GI mucosa and will be destroyed by heparinase - can only be administered parenterally (IV and subQ)
Why would someone with disseminated intravascular coagulation (DIC) be treated with heparin even though it is a problem with bleeding
The heparin is necessary to prevent addition clots from developing
What are the three functions of biological response modifiers
- Enhance host immunologic function
- Destroy or interfere with tumor activities
- Promote differentiation of stem cells
Name an important absolute contraindication for filgrastim
Cannot take 24 hours before or after chemo
Which organ is responsible for heparin
Liver
What are contraindications for low molecular weight heparins
Strokes, peptic ulcers, blood abnormalities, eye, brain, and/or spinal surgery
What are additional items you can administer to a patient who is bleeding
Fresh frozen plasma, red blood cells, platelets
What do low platelets cause
Thrombocytopenia- bleeding
What is erythropoietin
Stimulates RBC production in response to hypoxia; produced by the kidneys
What does the term thrombosis refer to
Formation of a clot in arterial or venous vessels
What are the therapeutic ranges for INR
- Normal INR: 1.3-2
- On warfarin: 2-3
- On warfarin with prosthetic valve: 2.5-4.5
Name important teaching points to include with your patient taking enoxparin
- How to administer injections
- Monitor signs and symptoms of bleeding
- Do not take antiplatelet drugs - avoid aspirin
How do low molecular weight heparins work
Inactivating factor Xa
When should a patient with cancer take erythropoietin
Treatment is begun when the Hemoglobin is <10g/dl
Which drug works by increasing the production of neutrophils, and enhances phagocytosis
Filgrastim
Is bruising a normal side effect of enoxaparin
Yes - it does cause bruising on the skin
How does warfarin work
Depresses hepatic synthesis of vitamin K clotting factors II, VII, IX, and X
What is the most concerning adverse reaction for warfarin
Hemorrhage
Name important patient education points for a patient on warfarin
- Need to decrease diet in vitamin K
- Limit intake of alcohol
- Monitor for signs and symptoms of bleeding
- Use a soft bristle toothbrush and electric razor
What are risks associated with erythropoietin
Risk of death and cardiovascular events if Hgb >12g/dl
