drug therapy for immune and hematopoietic stimulation Flashcards
name an erythropoiesis-stimulating agent
epoetin alpha
describe the action of erythropoiesis-stimulating agents
synthetic erythopoitein, stimulates RBC production
what are some uses of erythropoiesis-stimulating agents
anemia
chemo induced or kidney failure
describe the pharmacokinetics of erythropoiesis-stimulating agents
- IM, IV
- 11-14 days onset
what are some adverse effects of erythropoiesis-stimulating agents
- hypertension (increase preload, increased work of heart, increased BP)
- black box warning: risk for MI
name a contraindication of erythropoiesis-stimulating agents
severe hypertension
what are some nursing considerations for erythropoiesis-stimulating agents
- monitor RBCs, Hgb, Hct
- goal Hgb no more than 12
- monitor BP
- need iron for drug to work
describe patient teaching for erythropoiesis-stimulating agents
- patient may be on an iron supplement
- vitamin C helps with iron absorbtion (fruit, juice, strawberries)
name come colony stimulating factors
- filgrastim
- pegfilgrastim
describe the action of colony stimulating factors
stimulates neutrophil production in bone marrow (increases WBCs)
what are colony stimulating factors used for
- prevent infection
- neutropenia from bone marrow transplant or chemo
what are some adverse effects of colony stimulating factors
- fatigue
- flu like symptoms
- bone pain
describe administration of colony stimulating factors
do not give 24hrs befoe or after chemo
wont get a good response
name an interferon
interferon alfa 2b
describe the action of interferons
increase overall response of immune system to viral infection or cancer
what are interferons used for
treatment of viral infections and certain cancers
melanoma, genital warts, hep B
what are some adverse effects of interferons
- flu like symptoms
- hematologic effects (low plts and wbcs)
- autoimmune or fatal infections
what are some contraindications of interferons
- liver failure
- pregnancy (teratogenic)
give an example of interleukins
aldesleukin
describe the action of interleukins
stimulates immune system and inhibits tumor growth
stimulates T cells
what are interleukins used for
- kidney cancer
- melanoma
what are some adverse effects of interleukins
high risk drug per FDA with multiple black box warnings:
- anaphylaxis
- severe hypotension
- lethargy
med given by oncologist
what are some nursing considerations for immune stimulants
- acetaminophin for bone pain/flu sx
- increase fluid intake
- flu like sx last up to 24hrs
describe patient education for immune stimulants
- maintain healthy immune system
- keep well hydrated
- avoid pregnancy
the expected outcome of administering epoietin alpha to a pt with chronic kidney failure is:
1) decreased bleeding
2) increased WBC production
3) increased RBC production
4) improved renal function
3) increased RBC production
the nurse is administering filgrastim to a patient after bone marrow transplant. which lab value should the nurse monitor to determine effectiveness?
1) Hgb
2) basophils
3) Hct
4) neutrophils
4) neutrophils
the nurse knows a patient taking epoitin alpha should also be taking:
1) iron
2) potassium
3) antacids
4) analgesics
1) iron
