Exam 4 Flashcards
1
Q
Basic Use of Immunosuppressive Drugs
A
Prevent organ transplant rejections and Auto immune disorders
2
Q
What are 2 toxicities of Immunosuppressives?
A
Infection and Neoplasam
3
Q
What do immunosuppressant attac
A
Specific Tissues
4
Q
What must happen to use immunosuppressant in kids
A
Benefits must out weigh risks
5
Q
What Immunosuppressant is safe for pregnant women?
A
Basiliximab
6
Q
Should you breastfeed while on immunosuppressants?
A
No
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
8
Q
General Considerations of Immunosuppressants?
A
monitor for infection, wear protection when handling, take meds at some time each day
9
Q
Calcineurin Inhibitors are what drugs?
A
Gengraf and Prograf
10
Q
Indication of Cyclosporine (Gengraf)
A
Allogenic kideny, liver and heart rejection med.
11
Q
What auto immune disorders are cyclosporine used for?
A
Psoriasis and RA
12
Q
What is the preferred rout of Cyclosporine?
A
Oral Admin
13
Q
When do you give IV cyclosporine?
A
If PO cant tolorate
14
Q
Common SE of Cyclosporine?
A
Hairgrowth
15
Q
Serious SE of Cyclosporine
A
Nephrotoxicity, Hepatotoxicity
16
Q
SE of Gengraf that is rare but more with IV admin?
A
Anaphylaxis
17
Q
What drugs decrease cyclosporine drugs?
A
Seizure drugs and TB
18
Q
How long will you take Gengraf?
A
Forever
19
Q
What drugs do you give with Gengraf?
A
Steroids
20
Q
What labs do monitor while taking Gengraf?
A
BUN, Cr, LFT
21
Q
Prograf is also called what?
A
Tacrolimus
22
Q
Prograf is used for what?
A
Organ rejection for live, kidney and heart transplants.
23
Q
Something special about Prograf?
A
Works better but more sideeffects
24
Q
Routes to give Prograf?
A
PO, IV
25
Prograf does not interact with what?
Liver
26
What meds should you not take with Prograf?
NSAIDS
27
Unique AE of Prograf?
Gum Hyperplasia
28
High or low risk for toxicity with Prograf?
High Risk
29
Cytotoixic Drugs do what?
Kills cells by targeting the life cycle, cant pick good or bad cells kills all.
30
Azathioprine is what class of drug?
Cytotoxic
31
How to give Azathioprine
Oral or IV
32
Serious SE of Azathioprine?
Neutropenia, Thrombocytopenia, Neoplasama
33
Dont mix Azathiorine with what drug?
Allopurinol
34
CellCept is what class of drug?
Cytotoxic
35
Route to give CellCept? (MM)
PO
36
Half life of cellCept (mm)
18 hours
37
AE effects of Cellcept (mm)?
Blood cells issues and sepsis
38
What electrolytes does cellcept interact with?
Mag and Aluminum
39
What drug should you not take with cellcept?
Antaicds
40
What drugs do you want to take with CellCept?
Steroids and Cyclosporine
41
What class of drugs is Basiliximab?
Antibodies
42
What is Basiliximab used for?
Acute rejection of renal transplant
43
How do you give Basiliximab?
IV
44
What is serious Ae of Basiliximab?
Anaphylaxis
45
What drugs do you give with Basiliximab?
Steroids and cyclosporine
46
Antithymocyte globulin is what class?
Antibodies
47
What drugs do you premedicate patients with before giving Antithumocyte gloubin?
Tylenoel, Benedryl, and Steroids
48
Serious AE of Antithymocyte?
Anaphylaxis
49
How will you give Antithymocyte?
With IV and in line filter
50
Labs levels for Immunosuppressants use?
WBC>400, HgB>8 Platelets>75,000
51
What labs to monitor while on immunosuppressants?
CBC, Platelets Renal and Liver function
52
Ways to treat Cancer?
radiation, surgery and drugs
53
Characteristics of Neoplastic Cells?
Fast growth, Invasive, Metastasis, don't die
54
What make cancer not be able to die?
Telomerase preserves telomeres
55
What is the growth fraction?
Ratio of proliferation cells vs resting cells
56
GO phase is what?
Resting phase of mitosis
57
G1 is what in growth fraction?
Restarting mitosis
58
Chemo is more toxic to tissue wth low or high growth fraction
High
59
Obstacles with Chemo?
Toxic to normal cells, solid tumors respond slow, only kills exact number of cells, must kill 100% of cells
60
Benefit to intermittent chemo?
gives good cells a chance to grow while killing bad cells.
61
What is combo therapy?
more than 1 drug used, better drug resistance and cell kill count. Less damage to good cells
62
Benefit to regional Tx?
Admin drug right to area of tumor
63
Major toxicities of Chemo?
Bone Marrow Suppression, GI Issues, N/V
64
Can you use Chemo in first trimester of pregnancy?
No
65
What is Nadir?
When neutrophils are below 500 10-14 days
66
If there is thrombocytopenia
Give Platelets
67
What causes N/V
Stimulation of Chemoreceptor trigger zone
68
What s most effective for N/V in chemo?
Combination of drugs
69
Alopecia starts in how long after chemo?
7-10 days
70
Cytotoxic drugs cause what in men?
Irréversible sterility
71
What type of line do you give chemo in?
Central Line
72
Is Chemo a carcinogenic?
Yes
73
Safety aspects of chemo?
Double glove, gown up if crushing, dispose in yellow bin, waste is toxic, single use toilet, no kids use same bathroom
74
Where do cytotoxic drugs work?
On cancer cells
75
What drug is a Alkylating Agent?
Cyclophosphamide
76
What does Cyclophosphamide disupt?
DNA RNA symthesis
77
How do you give Cyclophosphamide?
IV and oral
78
Cisplatin disrupts what?
DNA and RNA synthesis
79
How do you give Cisplati?
IV
80
What drugs are Antimetabolite's?
Methotrexate, Fluirouracil, and Mercaptopurine
81
How can you give Methotrexate?
IV, Oral, Intrathecal, and IM
82
How do you give Fluorouracil?
IV
83
How do you give Mercaptopurine?
Oral
84
What does Vincristine disrupt?
Mitosis
85
How do you give Vicristine?
IV
86
What does Topotecan disrupt?
DNA replication
87
How do you give Topotecan?
IV
88
Do not give Topotecan if WBC are below what?
1500
89
What does Asparaginase disrupt?
Sysnthesis of histones
90
How do you give Asparaginase?
IV and IM
91
What side effects does Cyclophosphamide have?
Bone Marrow Suppression and N/V
92
Special issue with Cyclophosphamide
Hemorrhagic Cystitis
93
What is nursing action with Cyclophosphamide?
Maintain hydration
94
What SE does Cisplatin cause?
N/V
95
Special issues with Cisplatin?
Kidney damage, ear issues and peripheral neuropaathy
96
Nursing Consideration for Cisplatin?
Maintain hydration to decrease kidney issues
97
Methotrexate Side effects?
Bone MArrown Suppression, N/V, GI
98
Special Issue with Methotrexate?
Intestinal perforation or hemorrhagic enteritis
99
Nursing Action for Methotrexate?
Monitor for hyperuricemia
100
Methotrexate is an analog of what?
Folic Acid
101
Fluorouracil is an analog of what?
Pyrimidine acid
102
Fluorouracil has what SE?
BM, GI, N/V
103
Special issue with Fluorouracil?
Hand foot syndrome
104
Nursing actions for Fluorouracil
cool hands and feet, wear loos fitting shoes
105
Mercaptopurine is an analog of what?
Purine analog
106
Side effects of Mercaptopurine
BM, N/V, GI
107
Special Issues with Mercaptopurine?
Intestinal ulcers and Liver issues
108
Nursing Actions for Mercaptopurine
Watch liver stuff and GI Bleeding
109
Doxorubicin has what SE?
BM, N/V, GI
110
Special issue with Doxirubicin?
Vesicant and cardiac changes
111
Vincristine SE?
No nomral Chemo side effects
112
Nursing Action for Vincristine?
Use central line and may need to lower dose for neuropathy
113
Side effects of Topotecan?
BM, N/V, GI
114
Special thing about Topotecan?
Don't give if WBC are <1500
115
Asparaginase has what SE?
N/V
116
Special issues with Asparaginase?
CNS effects
117
Nursing actions for asparaginase?
be capable of resuscitation
118
What types of drugs are Non-cytotoxic Agents?
Hormonal Agents and Targeted Drugs
119
What is tamoxifen used for?
Treat or prevent breast cancer
120
Route to give Tamoxifen?
PO
121
AE of Tamoxifen?
Hot Flash, uterus cancer, thrombotic events, vag bleeding
122
Nursing actions for Tamoxifen?
Monitor and Educate
123
Anastrozole is give how?
PO
124
Adverse Effects of Anastrozole?
Menopause sx plus vag bleeding
125
Anastrozole is given for what?
Treatment post menopause
126
Trastuzumab is given for what?
Treat metastatic breast cancer
127
Trastuzumab is given how?
IV
128
Advers effects of Trastuzumab?
Cardiotoxicity, HF and Pulmonary HTN
129
Nursing Actions ofr Trastuzumab?
Baseline EKG and monitor for signs of HF
130
GnRH Agonist does what?
Prevents testosterone production by testes
131
Which GnRh gives a flare up in T from it being produced other places?
Agonist--Leuprolide
132
Where do Androgen receptor blockers block testosterone?
Receptor sites
133
If you use a Androgen receptor blocker with a GnRH do ou still get flare of sx?
No
134
Does GnRH antagonist have flare of sx?
No
135
How do you give GnRH agonist?
SQ, IM
136
Common AE of all Androgen Derived Therapy
Hot flash, less bone and muscle, low sex drive, boobs
137
What drug is an androgen receptor blocker?
Flutamide
138
What drug is a GnRH antagonist?
Degarelix
139
Route of Degarelix?
SQ
140
Adverse Effects of degarelix?
Injection site reaction
141
Special SE of Flutamide?
Liver toxicity
142
What to monitor with Flutamde?
Liver Enzymes
