Chapter 37 : Biologic Response Modifers

Question 1

What is biologic response modifiers?

What is the action?(2)

Answer 1

Substance naturally produced by body and those developed in the lab

Killer cancer cells directly and indirectly

Of stimulate body immune system

Question 2

What is the function of biologic response modifier? (4)

Answer 2

Stimulate immune system
Convert function of cancer cells
( act like normal cells )
Prevent growth of cancer

Enhance body ability to repair cells

Question 3

What is interferons?

Alpha beta and gamma

Answer 3

Proteins naturally occurring in the body and produced in the lab

Question 4

What is the action of interferons?

Answer 4

Slow growth of cancer
Cancer act normal
Stimulate WBC to fight cancef

Question 5

What is type 1 interferon?
What is type 2 interferon?

Answer 5

Alpha and beta

Gamma

Question 6

What is side effects of interferons? (6)

I N terferon

Answer 6

Neuropsychiatric ( mental status )
Ischemic disorder ( bleeding )
Autoimmune and infectious disorders
Fatigue
Anorexia
Hepatotoxity

Question 7

What is colony stimulating factors?

What is it used for?

Answer 7

Proteins that regular growth, maturation and differentiation of bone marrow stem cells

Neutropenia

Question 8

Notes
Colony stimulating factors

Promote growth of blood cells depleted by chemotherapy

Decrease the length of post treatment neutropenia

Permit the delivery of high doses of chemotherapy

Reduce bone marrow recovery time after bone marrow transplantation

Enahance macrophage or granulocyte tumor, virus and fungus destroying ability

Prevent severe thrombocytopenia after myelosuppresive chemo

Question 9

Remember how most chemo drugs are going to cause patients to have NADIR, that 7-10 days period in which their blood count is at its lowest

What do you think colony stimulating factor is going to do?

Answer 9

Decrease the length of time they are having that low blood count

And preventing thrombocytopenia

Question 10

So we can give colony stimulating factors to help reduce the time a patient with NADIR, what might that also indicate to us that we can do?

Answer 10

Give them higher doses of chemo in order to try to fight it off since

Colony stimulatimg factor is helping prevent it

Question 11

What is a colony stimulating factor medication?

Answer 11

Erythropoietin stimulating agents

Question 12

What is the function of erythropoietin stimulating agent?

Answer 12

Stimulated RBC production in bone marrow

Question 13

What is the side effect of erythropoietin stimulation agent? (3)

BIG THING TO NOTE OF BLACK BOX WARNING!(1)

Answer 13

Patients with HGB above 11, can cause death

Anaphylaxis
Hypertension
Injection site pain

Question 14

Colony stimulating factors
2 big things to remember

Answer 14

Look at H&H before administration
And hgb above 11 don’t give
( not even if it’s 10.9 )

Question 15

What is granulocyte colony stimulating factor medication?

Answer 15

Filgrastim- neupogen

Question 16

Function of filgrastim-neupogen?

Answer 16

Stimulates production of neutrophils

Question 17

What is the side effect of filgrastim (neupogen)? (5)

Think of the S in filgraStim

Answer 17

Splenomegaly
Splenic rupture
Pulmonary bleeding / alveolar hemorrhage
Cutaneous vaculitis ( rash on skin )

N/V/D
( nausea vomit diarrhea )

Question 18

If the patient is having pain in the spleen where is it?

Answer 18

Upper left quadrant

Thy will feel pain here

Question 19

Practice question 1
A patient is receiving cyclosporine after transplantation surgery. Which of the following items should be avoided?

A. Apple juice
B. Grape juice
C. Orange juice
D. Grapefruit juice

Answer 19

D. Grapefruit juice

Question 20

Practice question 2
Which of the following are principles of Immunosuppression?

A. Monotherpay reduces risk of organ rejection

B. Multiple drug therapy reduces risk of drug toxicity

C. Drugs which increase T-cell response reduce rejection

D. Drugs that activate lymphocytes reduce risk of rejection

Answer 20

B. Multiple drug therapy reduces risk of drug toxicity

Question 21

Practice question 3
A patient receiving an organ transplant was given basiliximab 2 h before surgical transplantation. When will the second dose be given?

A. Immediately after transplantation surgery

B. Two hours after transplantation surgery

C. Four days after transplantation surgery

D. Six weeks after transplantation surgery

Answer 21

C. Four days after transplantation surgery

Question 22

Practice question 4
Patients receiving targeted therapy, imatinib mesylate, to treat cancer need to avoid which food?

A. chocolate
B. Grapefruit
C. Green tea
D. Aged cheese

Answer 22

B. Grapefruit

Question 23

Practice question 5
The nurse identifies which statement about targeted therapy for cancer as being true?

A.They are more general in their mechanisms and effects than traditional cancer chemotherapy.

B.They exert their effects by damaging the DNA of nearly any cell.

C. They require a specific molecular target as the recipient of their effects.

D. They require fewer tests on cancer cells to determine if the therapy will be effective.

Answer 23

C. They require a specific molecular target as the recipient of their effects.

Question 24

Practice question 6
Which nursing intervention is designed to treat the most common side effects of filgrastim?

A. Provide antihypertensives to lower blood pressure.

B.Provide bronchodilators to treat wheezing.

C. Provide antibiotics to treat secondary infections.

D.Provide antiemetic to relieve vomiting.

Answer 24

C. Provide antibiotics to treat secondary infections.

Question 25

Practice question 7
When working with a patient receiving epoetin alpha, which of the following is most important development for the nurse to assess?

A. Bone pain and headaches
B. Hypertension and edema
C. Nausea and vomiting
D. Fluid retention and allergic reactions

Answer 25

B. Hypertension and edema

Question 26

Practice question 8
Before administering epoetin alpha, it is most important for the nurse to assess the patient for a history of which condition?

A. Anemia
B. Chronic renal failure
C. Pancreatitis
D. Hypertension

Answer 26

D. Hypertension