drug therapy for immune and hematopoietic stimulation Flashcards

1
Q

name an erythropoiesis-stimulating agent

A

epoetin alpha

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2
Q

describe the action of erythropoiesis-stimulating agents

A

synthetic erythopoitein, stimulates RBC production

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3
Q

what are some uses of erythropoiesis-stimulating agents

A

anemia

chemo induced or kidney failure

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4
Q

describe the pharmacokinetics of erythropoiesis-stimulating agents

A
  • IM, IV
  • 11-14 days onset
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5
Q

what are some adverse effects of erythropoiesis-stimulating agents

A
  • hypertension (increase preload, increased work of heart, increased BP)
  • black box warning: risk for MI
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6
Q

name a contraindication of erythropoiesis-stimulating agents

A

severe hypertension

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7
Q

what are some nursing considerations for erythropoiesis-stimulating agents

A
  • monitor RBCs, Hgb, Hct
  • goal Hgb no more than 12
  • monitor BP
  • need iron for drug to work
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8
Q

describe patient teaching for erythropoiesis-stimulating agents

A
  • patient may be on an iron supplement
  • vitamin C helps with iron absorbtion (fruit, juice, strawberries)
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9
Q

name come colony stimulating factors

A
  • filgrastim
  • pegfilgrastim
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10
Q

describe the action of colony stimulating factors

A

stimulates neutrophil production in bone marrow (increases WBCs)

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11
Q

what are colony stimulating factors used for

A
  • prevent infection
  • neutropenia from bone marrow transplant or chemo
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12
Q

what are some adverse effects of colony stimulating factors

A
  • fatigue
  • flu like symptoms
  • bone pain
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13
Q

describe administration of colony stimulating factors

A

do not give 24hrs befoe or after chemo

wont get a good response

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14
Q

name an interferon

A

interferon alfa 2b

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15
Q

describe the action of interferons

A

increase overall response of immune system to viral infection or cancer

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16
Q

what are interferons used for

A

treatment of viral infections and certain cancers

melanoma, genital warts, hep B

17
Q

what are some adverse effects of interferons

A
  • flu like symptoms
  • hematologic effects (low plts and wbcs)
  • autoimmune or fatal infections
18
Q

what are some contraindications of interferons

A
  • liver failure
  • pregnancy (teratogenic)
19
Q

give an example of interleukins

A

aldesleukin

20
Q

describe the action of interleukins

A

stimulates immune system and inhibits tumor growth

stimulates T cells

21
Q

what are interleukins used for

A
  • kidney cancer
  • melanoma
22
Q

what are some adverse effects of interleukins

A

high risk drug per FDA with multiple black box warnings:
- anaphylaxis
- severe hypotension
- lethargy

med given by oncologist

23
Q

what are some nursing considerations for immune stimulants

A
  • acetaminophin for bone pain/flu sx
  • increase fluid intake
  • flu like sx last up to 24hrs
24
Q

describe patient education for immune stimulants

A
  • maintain healthy immune system
  • keep well hydrated
  • avoid pregnancy
25
Q

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

A

3) increased RBC production

26
Q

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

A

4) neutrophils

27
Q

the nurse knows a patient taking epoitin alpha should also be taking:

1) iron
2) potassium
3) antacids
4) analgesics

A

1) iron