Exam 3 Flashcards
Filgrastim (Neupogen) side effects
bone pain, leukocytosis, splenomegaly
Adverse effects of Oprelvekin (Interleukin 11)
- Fluid retention
- anemia
- Cardiac dysrhythmias
- Severe allergic reactions
Cyclosporine side effects
nephrotoxicity, hyperkalemia, infection.
additional: hepatotoxicity, lymphomas, HTN, tremors, hirsutism, leukopenia, gingival hyperplasia, gynecomastia, anaphylactic reactions.
Cyanocobalamin (vitamin B12) adverse effect
hypokalemia
Azathioprine adverse effects
blood dyscrasias (neutropenia and thrombocytopenia), N/V, mutagenic and teratogenic, neoplasms, pancreatitis
Test dose for iron dextran (Dexiron)
25mg over 5 minutes and observe patient for at least 15 minutes prior to starting infusion
Benefits of drug combination chemotherapy
benefits of drug combinations, suppression of drug resistance, increased cancer cell kill, reduced injury to normal cells
Medications that can be used for CINV
aprepitant (Emend), dexamethasone, Zofran
Therapeutic use of Mesna (Mesnex)
protective agent to prevent hemorrhagic cystitis with use of cyclophosphamide (cytotoxan)
Tamoxifen contraindications
hypercalcemia
Symptoms of Vincristine (Oncovin) toxicity
peripheral neuropathy, decreased reflexes, weakness, paresthesia, sensory losses
Toxicity effects of Daunorubicin
injury to the heart
indications of ceftazidime (Fortaz)
If patient has neutropenia (<500) and fever get cultures and start on Ceftazidime (Fortaz) which is an IV abx against gram negative bacteria
Adverse effects of activated factor VII
well-tolerated, no human proteins (no risk for transmitting human viruses), can cause thrombolytic events (arterial thrombosis, cerebral sinus thrombosis, MI)
Dose of factor VII to stop bleeding in non-hemophiliacs
90mcg/kg repeated Q2H until bleeding stops
What is Immune Tolerance Therapy
tx for patients who develop inhibitors. Can eliminate inhibitor production. Usually successful in Hem A but not B. If unsuccessful, the use of drugs is employed.
Adverse effects of Desmopressin
hyponatremia and fluid retention
2 types of antifibrinolytics agents used for hemophilia
aminocaproic acid and tranexamic acid
3 treatment options for patients who develop inhibitors (Hemophilia)
Immune Tolerance Therapy (ITT)
Activated Factor VII
Anti-inhibitor coagulant complex (AICC)
Immunosuppressants for preventing organ rejection
cyclosporine, sirolimus, and tracolimus
cytotoxic meds for preventing organ rejection
Azathioprine
Antibodies for preventing organ rejection
Basiliximab
MOA of Cyclophosphamide
cell cycle non-specific; kills fast growing cancer cells by altering DNA structure and preventing cell production. Resistance is common.
Tx of malignant hyperthermia
1mg/kg of Dantrolene
Antidote for versed
Flumazenil (Romazicon) 0.2mg IVP
AE of ondansetron
HA, diarrhea, dizziness, prolonged QT interval, risk of Trosade’s de pointes
Azathioprine (Imuran) adverse effects
pancreatitis, blood dyscrasias (neutropenia and thrombocytopenia), progressive multifocal leukoencephalopathy (PML), N/V, mutagenic and teratogenic, neoplasms
Effects of beta blockers on EKG
- Decrease automaticity of the SA node.
- Decreases the velocity of the conduction through the AV node.
- Decreases myocardial contractility
symptoms of serotonin syndrome
clonus, mydriasis, diaphoresis, agitation, tachycardia, increased bowel sounds, diarrhea, autonomic instability often hypertensive
MOA of HCTZ
promotes urine production by blocking reabsorption of Na and Cl in the early segment of the distal tubule. Retention of the NaCl causes water to be retained, producing increased flow of urine. Lower effect than loop diuretics.
*Ineffective if GFR < 15-20%
AE of HCTZ
Hypokalemia, hyponatremia, hypochloremia, dehydration, hyperglycemia, hypomagnesemia
MOA of Dabigatran (Pradaxa)
direct thrombin inhibitor
AE of Dabigatran (Pradaxa)
bleeding, GI symptoms
Advantages of Dabigatran (Pradaxa)
dose is fixed, rapid onset, no routine lab tests needed, less incidence of bleeding/hemorrhagic stroke, few drug-food interactions
Disadvantages of Dabigatran (Pradaxa)
dose on time is important, no antidote, limited clinical experience
Captopril maintenance dosage for HTN
25-50 mg BID/TID
Indications for Epogen
- CRF
- Non-myeloid malignancies secondary to chemo
- HIV taking zidovudine
- Anemia facing surgery
AE of Oprelvekin (Interleukin-11)
fluid retention, anemia, cardiac dysrhythmias, severe allergic rxns
Vincristine (Oncovin) AE
peripheral neuropathy, decreased reflexes, weakness, paresthesia, sensory losses
2 types of phosphate binders
calcium based phosphate binders and calcium-free phosphate binders
Side effects of phosphate binders
GI upset
Meds not to take with Ferrous sulfate
antacids, tetracycline
Test dose for iron dextran (Dexiron) infusion
25mg over 5 minutes and observe patient for at least 15 min prior to starting infusion
Hydrocortisone (solu-cortef) education
- can increase risk of infection
- hyperglycemia
- usually taken in the morning
- needs to be increased in time of stress/illness
What is the adult dose of Ferrous sulfate?
65 mg TID
