Immune Drugs Flashcards
What causes hyperglycemia?
- Stress within the body
- Cortisol causes liver to release glucose
What are the side effects of corticosteroids? (5)
- Elevated glucose
- Immunosuppression (decreased WBCs / lack of fever)
- Electrolyte imbalances
- Tachycardia
- Decreased calcium - risk of osteoporosis
What is the drug class of cyclosporine (Sandimmune)?
Calcineurin inhibitor
Describe the MOA of cyclosporine (Sandimmune)
Inhibits calcineurin to suppress helper T cells
What are the indications of cyclosporine (Sandimmune)? (4)
- Prevention of organ rejection
- Arthritis
- Psoriasis
- IBS
Describe the primary nursing intervention associated with cyclosporine (Sandimmune)
Narrow therapeutic range - monitor trough levels
What are the routes of cyclosporine (Sandimmune)?
- PO (IR)
- IV
What are the black box warnings associated with cyclosporine (Sandimmune)? (6)
- Renal impairment
- Serious / fatal infections (avoid live vaccines)
- Liver impairment
- Seizures
- Encephalopathy (higher risk for patients with diabetes)
- Skin cancer (avoid UV / sun exposure)
What are the contraindications of cyclosporine (Sandimmune)? (3)
- Liver / renal impairment
- Uncontrolled hypertension
- Concurrent radiation therapy - UV / burns can cause skin cancer
What are the adverse effects of cyclosporine (Sandimmune)? (5)
- Hypertension
- Neurotoxicity - tremors
- Hepatotoxicity
- Nephrotoxicity - dose limiting (higher doses increase risk)
- Opportunistic infections / malignancy
Describe the education associated with cyclosporine (Sandimmune)
- Dilute in orange / apple juice (taste)
- No live virus vaccines
- Draw drug levels before the next dose (trough monitoring)
Describe the monitoring associated with cyclosporine (Sandimmune)
- BUN / creatinine
- LFTs
- Potassium
- Magnesium
What interaction increases the risk of cyclosporine (Sandimmune) toxicity?
Grapefruit juice - increases absorption
cyclosporine (Sandimmune) is ______
Highly protein bound
Describe the MOA of interferons
- Protect human cells from viruses by destroying RNA within the cell
- Prevent cancer cells from dividing / replicating