Exam 3

Question 1

Filgrastim (Neupogen) side effects

Answer 1

bone pain, leukocytosis, splenomegaly

Question 2

Adverse effects of Oprelvekin (Interleukin 11)

Answer 2

1. Fluid retention
2. anemia
3. Cardiac dysrhythmias
4. Severe allergic reactions

Question 3

Cyclosporine side effects

Answer 3

nephrotoxicity, hyperkalemia, infection.
additional: hepatotoxicity, lymphomas, HTN, tremors, hirsutism, leukopenia, gingival hyperplasia, gynecomastia, anaphylactic reactions.

Question 4

Cyanocobalamin (vitamin B12) adverse effect

Answer 4

hypokalemia

Question 5

Azathioprine adverse effects

Answer 5

blood dyscrasias (neutropenia and thrombocytopenia), N/V, mutagenic and teratogenic, neoplasms, pancreatitis

Question 6

Test dose for iron dextran (Dexiron)

Answer 6

25mg over 5 minutes and observe patient for at least 15 minutes prior to starting infusion

Question 7

Benefits of drug combination chemotherapy

Answer 7

benefits of drug combinations, suppression of drug resistance, increased cancer cell kill, reduced injury to normal cells

Question 8

Medications that can be used for CINV

Answer 8

aprepitant (Emend), dexamethasone, Zofran

Question 9

Therapeutic use of Mesna (Mesnex)

Answer 9

protective agent to prevent hemorrhagic cystitis with use of cyclophosphamide (cytotoxan)

Question 10

Tamoxifen contraindications

Answer 10

hypercalcemia

Question 11

Symptoms of Vincristine (Oncovin) toxicity

Answer 11

peripheral neuropathy, decreased reflexes, weakness, paresthesia, sensory losses

Question 12

Toxicity effects of Daunorubicin

Answer 12

injury to the heart

Question 13

indications of ceftazidime (Fortaz)

Answer 13

If patient has neutropenia (<500) and fever get cultures and start on Ceftazidime (Fortaz) which is an IV abx against gram negative bacteria

Question 14

Adverse effects of activated factor VII

Answer 14

well-tolerated, no human proteins (no risk for transmitting human viruses), can cause thrombolytic events (arterial thrombosis, cerebral sinus thrombosis, MI)

Question 15

Dose of factor VII to stop bleeding in non-hemophiliacs

Answer 15

90mcg/kg repeated Q2H until bleeding stops

Question 16

What is Immune Tolerance Therapy

Answer 16

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.

Question 17

Adverse effects of Desmopressin

Answer 17

hyponatremia and fluid retention

Question 18

2 types of antifibrinolytics agents used for hemophilia

Answer 18

aminocaproic acid and tranexamic acid

Question 19

3 treatment options for patients who develop inhibitors (Hemophilia)

Answer 19

Immune Tolerance Therapy (ITT)
Activated Factor VII
Anti-inhibitor coagulant complex (AICC)

Question 20

Immunosuppressants for preventing organ rejection

Answer 20

cyclosporine, sirolimus, and tracolimus

Question 21

cytotoxic meds for preventing organ rejection

Answer 21

Azathioprine

Question 22

Antibodies for preventing organ rejection

Answer 22

Basiliximab

Question 23

MOA of Cyclophosphamide

Answer 23

cell cycle non-specific; kills fast growing cancer cells by altering DNA structure and preventing cell production. Resistance is common.

Question 24

Tx of malignant hyperthermia

Answer 24

1mg/kg of Dantrolene

Question 25

Antidote for versed

Answer 25

Flumazenil (Romazicon) 0.2mg IVP

Question 26

AE of ondansetron

Answer 26

HA, diarrhea, dizziness, prolonged QT interval, risk of Trosade's de pointes

Question 27

Azathioprine (Imuran) adverse effects

Answer 27

pancreatitis, blood dyscrasias (neutropenia and thrombocytopenia), progressive multifocal leukoencephalopathy (PML), N/V, mutagenic and teratogenic, neoplasms

Question 28

Effects of beta blockers on EKG

Answer 28

1. Decrease automaticity of the SA node. 2. Decreases the velocity of the conduction through the AV node. 3. Decreases myocardial contractility

Question 29

symptoms of serotonin syndrome

Answer 29

clonus, mydriasis, diaphoresis, agitation, tachycardia, increased bowel sounds, diarrhea, autonomic instability often hypertensive

Question 30

MOA of HCTZ

Answer 30

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%

Question 31

AE of HCTZ

Answer 31

Hypokalemia, hyponatremia, hypochloremia, dehydration, hyperglycemia, hypomagnesemia

Question 32

MOA of Dabigatran (Pradaxa)

Answer 32

direct thrombin inhibitor

Question 33

AE of Dabigatran (Pradaxa)

Answer 33

bleeding, GI symptoms

Question 34

Advantages of Dabigatran (Pradaxa)

Answer 34

dose is fixed, rapid onset, no routine lab tests needed, less incidence of bleeding/hemorrhagic stroke, few drug-food interactions

Question 35

Disadvantages of Dabigatran (Pradaxa)

Answer 35

dose on time is important, no antidote, limited clinical experience

Question 36

Captopril maintenance dosage for HTN

Answer 36

25-50 mg BID/TID

Question 37

Indications for Epogen

Answer 37

1. CRF 2. Non-myeloid malignancies secondary to chemo 3. HIV taking zidovudine 4. Anemia facing surgery

Question 38

AE of Oprelvekin (Interleukin-11)

Answer 38

fluid retention, anemia, cardiac dysrhythmias, severe allergic rxns

Question 39

Vincristine (Oncovin) AE

Answer 39

peripheral neuropathy, decreased reflexes, weakness, paresthesia, sensory losses

Question 40

2 types of phosphate binders

Answer 40

calcium based phosphate binders and calcium-free phosphate binders

Question 41

Side effects of phosphate binders

Answer 41

GI upset

Question 42

Meds not to take with Ferrous sulfate

Answer 42

antacids, tetracycline

Question 43

Test dose for iron dextran (Dexiron) infusion

Answer 43

25mg over 5 minutes and observe patient for at least 15 min prior to starting infusion

Question 44

Hydrocortisone (solu-cortef) education

Answer 44

- can increase risk of infection - hyperglycemia - usually taken in the morning - needs to be increased in time of stress/illness

Question 45

What is the adult dose of Ferrous sulfate?

Answer 45

65 mg TID