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Pharm 2 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Basic Use of Immunosuppressive Drugs

A

Prevent organ transplant rejections and Auto immune disorders

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2
Q

What are 2 toxicities of Immunosuppressives?

A

Infection and Neoplasam

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3
Q

What do immunosuppressant attac

A

Specific Tissues

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4
Q

What must happen to use immunosuppressant in kids

A

Benefits must out weigh risks

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5
Q

What Immunosuppressant is safe for pregnant women?

A

Basiliximab

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6
Q

Should you breastfeed while on immunosuppressants?

A

No

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7
Q

Education to give patients in immunosuppressants?

A

use extra birth control, limit sun exposure, flu sx can be serious, fever is bad sign

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8
Q

General Considerations of Immunosuppressants?

A

monitor for infection, wear protection when handling, take meds at some time each day

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9
Q

Calcineurin Inhibitors are what drugs?

A

Gengraf and Prograf

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10
Q

Indication of Cyclosporine (Gengraf)

A

Allogenic kideny, liver and heart rejection med.

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11
Q

What auto immune disorders are cyclosporine used for?

A

Psoriasis and RA

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12
Q

What is the preferred rout of Cyclosporine?

A

Oral Admin

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13
Q

When do you give IV cyclosporine?

A

If PO cant tolorate

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14
Q

Common SE of Cyclosporine?

A

Hairgrowth

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15
Q

Serious SE of Cyclosporine

A

Nephrotoxicity, Hepatotoxicity

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16
Q

SE of Gengraf that is rare but more with IV admin?

A

Anaphylaxis

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17
Q

What drugs decrease cyclosporine drugs?

A

Seizure drugs and TB

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18
Q

How long will you take Gengraf?

A

Forever

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19
Q

What drugs do you give with Gengraf?

A

Steroids

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20
Q

What labs do monitor while taking Gengraf?

A

BUN, Cr, LFT

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21
Q

Prograf is also called what?

A

Tacrolimus

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22
Q

Prograf is used for what?

A

Organ rejection for live, kidney and heart transplants.

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23
Q

Something special about Prograf?

A

Works better but more sideeffects

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24
Q

Routes to give Prograf?

A

PO, IV

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25
Q

Prograf does not interact with what?

A

Liver

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26
Q

What meds should you not take with Prograf?

A

NSAIDS

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27
Q

Unique AE of Prograf?

A

Gum Hyperplasia

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28
Q

High or low risk for toxicity with Prograf?

A

High Risk

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29
Q

Cytotoixic Drugs do what?

A

Kills cells by targeting the life cycle, cant pick good or bad cells kills all.

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30
Q

Azathioprine is what class of drug?

A

Cytotoxic

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31
Q

How to give Azathioprine

A

Oral or IV

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32
Q

Serious SE of Azathioprine?

A

Neutropenia, Thrombocytopenia, Neoplasama

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33
Q

Dont mix Azathiorine with what drug?

A

Allopurinol

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34
Q

CellCept is what class of drug?

A

Cytotoxic

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35
Q

Route to give CellCept? (MM)

A

PO

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36
Q

Half life of cellCept (mm)

A

18 hours

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37
Q

AE effects of Cellcept (mm)?

A

Blood cells issues and sepsis

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38
Q

What electrolytes does cellcept interact with?

A

Mag and Aluminum

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39
Q

What drug should you not take with cellcept?

A

Antaicds

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40
Q

What drugs do you want to take with CellCept?

A

Steroids and Cyclosporine

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41
Q

What class of drugs is Basiliximab?

A

Antibodies

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42
Q

What is Basiliximab used for?

A

Acute rejection of renal transplant

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43
Q

How do you give Basiliximab?

A

IV

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44
Q

What is serious Ae of Basiliximab?

A

Anaphylaxis

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45
Q

What drugs do you give with Basiliximab?

A

Steroids and cyclosporine

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46
Q

Antithymocyte globulin is what class?

A

Antibodies

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47
Q

What drugs do you premedicate patients with before giving Antithumocyte gloubin?

A

Tylenoel, Benedryl, and Steroids

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48
Q

Serious AE of Antithymocyte?

A

Anaphylaxis

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49
Q

How will you give Antithymocyte?

A

With IV and in line filter

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50
Q

Labs levels for Immunosuppressants use?

A

WBC>400, HgB>8 Platelets>75,000

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51
Q

What labs to monitor while on immunosuppressants?

A

CBC, Platelets Renal and Liver function

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52
Q

Ways to treat Cancer?

A

radiation, surgery and drugs

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53
Q

Characteristics of Neoplastic Cells?

A

Fast growth, Invasive, Metastasis, don’t die

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54
Q

What make cancer not be able to die?

A

Telomerase preserves telomeres

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55
Q

What is the growth fraction?

A

Ratio of proliferation cells vs resting cells

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56
Q

GO phase is what?

A

Resting phase of mitosis

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57
Q

G1 is what in growth fraction?

A

Restarting mitosis

58
Q

Chemo is more toxic to tissue wth low or high growth fraction

A

High

59
Q

Obstacles with Chemo?

A

Toxic to normal cells, solid tumors respond slow, only kills exact number of cells, must kill 100% of cells

60
Q

Benefit to intermittent chemo?

A

gives good cells a chance to grow while killing bad cells.

61
Q

What is combo therapy?

A

more than 1 drug used, better drug resistance and cell kill count. Less damage to good cells

62
Q

Benefit to regional Tx?

A

Admin drug right to area of tumor

63
Q

Major toxicities of Chemo?

A

Bone Marrow Suppression, GI Issues, N/V

64
Q

Can you use Chemo in first trimester of pregnancy?

A

No

65
Q

What is Nadir?

A

When neutrophils are below 500 10-14 days

66
Q

If there is thrombocytopenia

A

Give Platelets

67
Q

What causes N/V

A

Stimulation of Chemoreceptor trigger zone

68
Q

What s most effective for N/V in chemo?

A

Combination of drugs

69
Q

Alopecia starts in how long after chemo?

A

7-10 days

70
Q

Cytotoxic drugs cause what in men?

A

Irréversible sterility

71
Q

What type of line do you give chemo in?

A

Central Line

72
Q

Is Chemo a carcinogenic?

A

Yes

73
Q

Safety aspects of chemo?

A

Double glove, gown up if crushing, dispose in yellow bin, waste is toxic, single use toilet, no kids use same bathroom

74
Q

Where do cytotoxic drugs work?

A

On cancer cells

75
Q

What drug is a Alkylating Agent?

A

Cyclophosphamide

76
Q

What does Cyclophosphamide disupt?

A

DNA RNA symthesis

77
Q

How do you give Cyclophosphamide?

A

IV and oral

78
Q

Cisplatin disrupts what?

A

DNA and RNA synthesis

79
Q

How do you give Cisplati?

A

IV

80
Q

What drugs are Antimetabolite’s?

A

Methotrexate, Fluirouracil, and Mercaptopurine

81
Q

How can you give Methotrexate?

A

IV, Oral, Intrathecal, and IM

82
Q

How do you give Fluorouracil?

A

IV

83
Q

How do you give Mercaptopurine?

A

Oral

84
Q

What does Vincristine disrupt?

A

Mitosis

85
Q

How do you give Vicristine?

A

IV

86
Q

What does Topotecan disrupt?

A

DNA replication

87
Q

How do you give Topotecan?

A

IV

88
Q

Do not give Topotecan if WBC are below what?

A

1500

89
Q

What does Asparaginase disrupt?

A

Sysnthesis of histones

90
Q

How do you give Asparaginase?

A

IV and IM

91
Q

What side effects does Cyclophosphamide have?

A

Bone Marrow Suppression and N/V

92
Q

Special issue with Cyclophosphamide

A

Hemorrhagic Cystitis

93
Q

What is nursing action with Cyclophosphamide?

A

Maintain hydration

94
Q

What SE does Cisplatin cause?

A

N/V

95
Q

Special issues with Cisplatin?

A

Kidney damage, ear issues and peripheral neuropaathy

96
Q

Nursing Consideration for Cisplatin?

A

Maintain hydration to decrease kidney issues

97
Q

Methotrexate Side effects?

A

Bone MArrown Suppression, N/V, GI

98
Q

Special Issue with Methotrexate?

A

Intestinal perforation or hemorrhagic enteritis

99
Q

Nursing Action for Methotrexate?

A

Monitor for hyperuricemia

100
Q

Methotrexate is an analog of what?

A

Folic Acid

101
Q

Fluorouracil is an analog of what?

A

Pyrimidine acid

102
Q

Fluorouracil has what SE?

A

BM, GI, N/V

103
Q

Special issue with Fluorouracil?

A

Hand foot syndrome

104
Q

Nursing actions for Fluorouracil

A

cool hands and feet, wear loos fitting shoes

105
Q

Mercaptopurine is an analog of what?

A

Purine analog

106
Q

Side effects of Mercaptopurine

A

BM, N/V, GI

107
Q

Special Issues with Mercaptopurine?

A

Intestinal ulcers and Liver issues

108
Q

Nursing Actions for Mercaptopurine

A

Watch liver stuff and GI Bleeding

109
Q

Doxorubicin has what SE?

A

BM, N/V, GI

110
Q

Special issue with Doxirubicin?

A

Vesicant and cardiac changes

111
Q

Vincristine SE?

A

No nomral Chemo side effects

112
Q

Nursing Action for Vincristine?

A

Use central line and may need to lower dose for neuropathy

113
Q

Side effects of Topotecan?

A

BM, N/V, GI

114
Q

Special thing about Topotecan?

A

Don’t give if WBC are <1500

115
Q

Asparaginase has what SE?

A

N/V

116
Q

Special issues with Asparaginase?

A

CNS effects

117
Q

Nursing actions for asparaginase?

A

be capable of resuscitation

118
Q

What types of drugs are Non-cytotoxic Agents?

A

Hormonal Agents and Targeted Drugs

119
Q

What is tamoxifen used for?

A

Treat or prevent breast cancer

120
Q

Route to give Tamoxifen?

A

PO

121
Q

AE of Tamoxifen?

A

Hot Flash, uterus cancer, thrombotic events, vag bleeding

122
Q

Nursing actions for Tamoxifen?

A

Monitor and Educate

123
Q

Anastrozole is give how?

A

PO

124
Q

Adverse Effects of Anastrozole?

A

Menopause sx plus vag bleeding

125
Q

Anastrozole is given for what?

A

Treatment post menopause

126
Q

Trastuzumab is given for what?

A

Treat metastatic breast cancer

127
Q

Trastuzumab is given how?

A

IV

128
Q

Advers effects of Trastuzumab?

A

Cardiotoxicity, HF and Pulmonary HTN

129
Q

Nursing Actions ofr Trastuzumab?

A

Baseline EKG and monitor for signs of HF

130
Q

GnRH Agonist does what?

A

Prevents testosterone production by testes

131
Q

Which GnRh gives a flare up in T from it being produced other places?

A

Agonist–Leuprolide

132
Q

Where do Androgen receptor blockers block testosterone?

A

Receptor sites

133
Q

If you use a Androgen receptor blocker with a GnRH do ou still get flare of sx?

A

No

134
Q

Does GnRH antagonist have flare of sx?

A

No

135
Q

How do you give GnRH agonist?

A

SQ, IM

136
Q

Common AE of all Androgen Derived Therapy

A

Hot flash, less bone and muscle, low sex drive, boobs

137
Q

What drug is an androgen receptor blocker?

A

Flutamide

138
Q

What drug is a GnRH antagonist?

A

Degarelix

139
Q

Route of Degarelix?

A

SQ

140
Q

Adverse Effects of degarelix?

A

Injection site reaction

141
Q

Special SE of Flutamide?

A

Liver toxicity

142
Q

What to monitor with Flutamde?

A

Liver Enzymes

Pharm 2 (6 decks)

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