Hematological/Oncological

Question 1

Oprelvekin

Answer 1

• stimaulate production of platelets

Question 2

Hydroxyurea

Answer 2

• manages sickle cell disease

Question 3

Methotrexate

Answer 3

• manages rheumatoid arthritis
• treat ectopic pregnancy that hasn’t ruptured
• chemotherapeutic agent

Question 4

Verapamil

Answer 4

• CCB
• manages HTN

Question 5

Nortriptyline

Answer 5

• Tricyclic antidepressant
• detremental to SCD

Question 6

Enoxaprin

Answer 6

• prefilled syringe subQ
• no diet restrictions
• given for risk for thrombocytopenia following surgery
• antidote is protamine sulfate
• monitor platelets, NOT aPTT

Question 7

Heparin lab values

Answer 7

• aPTT
  
  • normal
    
    • 30-40 seconds
  • heparin
    
    • 1.5x-2.5x
      
      • 70 seconds
• risk for heparin-induced thrombocytopenia (HIT)
  
  • low platelets

Question 8

Lithium a/e

Answer 8

• leukocytosis

Question 9

Clozapine a/e

Answer 9

• neutropenia (decrease in neutrophils)

Question 10

Ribavirin

Answer 10

• antiviral that treats Hep C

Question 11

Warfarin monitor

Answer 11

• black, tarry stool
• indicates internal bleeding
• monitor INR
  
  • INR decreases until reaches therapeutic range
  • INR 2-3x is therapeutic
  • if INR is HIGH and bleeding, give plasma
• UAP may shave client
  
  • electric razor only

Question 12

Tranexamic acid

Answer 12

• causes inhibition of fibrinolysis
• helps reduce blood loss during operative procedures

Question 13

Non-heparin products

Answer 13

• apixaban
  
  • only avoid alcohol
  • dont take double dose
• dabigatran
• rivaroxaban
• no frequent lab monitoring needed

Question 14

Dutasteride

Answer 14

• finasteride
• lowers testosterone
• treats prostate cancer and alopecia
• risk for erectile dysfunction and muscle loss

Question 15

Letrozole

Answer 15

• aromatase inhibitor (breast cancer/gynecomastia)
• treats breast cancer
• causes hot flashes and night sweats (normal)
  
  • may give venlafaxine to counter

Question 16

Filgrastim

Answer 16

• treats chemo-induced leukopenia and neutropenia
• causes bone pain d/t increased bone marrow activity (normal)
  
  • give acetaminophen to counter this

Question 17

Tamoxifen

Answer 17

• estrogen antagonist (-ifen) that prevents breast cancer
• increases risk of clotting, DVT, and pulmonary embolism
• report
  
  • leg/chest pain
  • dyspnea + edema

Question 18

Phentolamine

Answer 18

• give for extravasation
• if unavailable
  
  • use topical nitroglycerin
• give for rebound hypertension

Question 19

Fondaparinux

Answer 19

• selective ihibitor of factor Xa
• indicated for prophylaxis treatment of DVT and PE
• SubQ, once daily

Question 20

Doxorubicin

Answer 20

• cancer drug = vesicant = central line
• can cause pancytopenia
  
  • low WBC, RBC, platelets
• risk for infection
  
  • MONITOR FEVER
• highly cardiotoxic
  
  • cardiac monitoring needed

Question 21

Codeine phosphate

Answer 21

• used in hemophilia
  
  • no aspirin included
  • for moderate to severe pain