Immune Drugs Flashcards

1
Q

What causes hyperglycemia?

A
  • Stress within the body
  • Cortisol causes liver to release glucose
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2
Q

What are the side effects of corticosteroids? (5)

A
  • Elevated glucose
  • Immunosuppression (decreased WBCs / lack of fever)
  • Electrolyte imbalances
  • Tachycardia
  • Decreased calcium - risk of osteoporosis
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3
Q

What is the drug class of cyclosporine (Sandimmune)?

A

Calcineurin inhibitor

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4
Q

Describe the MOA of cyclosporine (Sandimmune)

A

Inhibits calcineurin to suppress helper T cells

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5
Q

What are the indications of cyclosporine (Sandimmune)? (4)

A
  • Prevention of organ rejection
  • Arthritis
  • Psoriasis
  • IBS
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6
Q

Describe the primary nursing intervention associated with cyclosporine (Sandimmune)

A

Narrow therapeutic range - monitor trough levels

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7
Q

What are the routes of cyclosporine (Sandimmune)?

A
  • PO (IR)
  • IV
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8
Q

What are the black box warnings associated with cyclosporine (Sandimmune)? (6)

A
  • Renal impairment
  • Serious / fatal infections (avoid live vaccines)
  • Liver impairment
  • Seizures
  • Encephalopathy (higher risk for patients with diabetes)
  • Skin cancer (avoid UV / sun exposure)
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9
Q

What are the contraindications of cyclosporine (Sandimmune)? (3)

A
  • Liver / renal impairment
  • Uncontrolled hypertension
  • Concurrent radiation therapy - UV / burns can cause skin cancer
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10
Q

What are the adverse effects of cyclosporine (Sandimmune)? (5)

A
  • Hypertension
  • Neurotoxicity - tremors
  • Hepatotoxicity
  • Nephrotoxicity - dose limiting (higher doses increase risk)
  • Opportunistic infections / malignancy
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11
Q

Describe the education associated with cyclosporine (Sandimmune)

A
  • Dilute in orange / apple juice (taste)
  • No live virus vaccines
  • Draw drug levels before the next dose (trough monitoring)
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12
Q

Describe the monitoring associated with cyclosporine (Sandimmune)

A
  • BUN / creatinine
  • LFTs
  • Potassium
  • Magnesium
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13
Q

What interaction increases the risk of cyclosporine (Sandimmune) toxicity?

A

Grapefruit juice - increases absorption

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14
Q

cyclosporine (Sandimmune) is ______

A

Highly protein bound

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15
Q

Describe the MOA of interferons

A
  • Protect human cells from viruses by destroying RNA within the cell
  • Prevent cancer cells from dividing / replicating
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16
Q

Interferons are activated in response to ______

A

Viral infections

17
Q

What are the effects of interferons on the immune system? (3)

A
  • Restore impaired immune function
  • Alter imune function
  • Inhibit immune system from working (for autoimmune diseases)
18
Q

What are the indications of interferons?

A
  • Cancer
  • Rheumatoid arthritis
  • Osteoarthritis
  • Multiple sclerosis
  • Hepatitis
  • Crohn’s disease
19
Q

What are the side effects of interferons?

A
  • Flu-like symptoms
  • Neutropenia
  • Fatigue
  • Depression
20
Q

Describe the education associated with interferons

A

Teach SQ injections

21
Q

Describe the MOA of vaccines

A
  • Stimulate antibody production
  • Stimulate existing antibodies to facilitate an immune reaction
22
Q

Describe active immunity

A
  • Body’s immune response is stimulated by an antigen / hen a pathogen enters the body
  • Body recognizes foreign proteins - produces antibodies to react (memory cells)
  • When the foreign protein is reintroduced - memory cells release antibodies
  • Life-long
  • Can be natural or vaccine induced
23
Q

Describe passive immunity

A
  • Can be natural or acquired
  • Antibodies recognize foreign proteins and attach - harmless
  • Limited - only lasts as long as circulating antibodies last (body does not produce its own antibodies)
24
Q

Describe acquired passive immunity

A

Acquired through antibody-containing blood products (immunoglobulin)

25
Q

Describe immunizations

A
  • Artificial stimulation of active immunity
  • Exposes the body to weakened proteins associated with disease-causing organisms
  • Goal = immune response without suffering full course of disease
26
Q

Vaccines promote ______

A

Active immunity

27
Q

______ are vaccines made from toxins produced by microorganisms

A

Toxoids

28
Q

Vaccines are dependent on what factors?

A
  • Age
  • Exposure
29
Q

______ can be used to evaluate immunization response / determine the need for additional booster

A

Antibody titers

30
Q

What are the types of bacterial vaccines?

A
  • Pneumococcal
  • Meningococcal
31
Q

What are the types of toxoid vaccines?

A
  • DTaP (diphtheria, tetanus, & pertussis)
  • Tetanus
32
Q

What are the types of viral vaccines?

A
  • COVID-19
  • MMR (measles, mumps, rubella)
  • Inactivated polio vaccine (IPV)
  • Influenza
  • Varicella (Zostavax) - prevention of herpes zoster (shingles) in adults > 50 years old
  • Rabies - based on exposure
  • Hepatitis A / B
  • HPV
33
Q

What are the contraindications of vaccines?

A
  • Immune deficiency / immunosuppression (live vaccine)
  • Pregnancy
  • Known allergies to vaccine components (eggs)
  • Patients receiving immunoglobulin or who have received blood/blood products in past 3 months – serious immune reaction could occur
  • Caution in children with history of febrile seizures or cerebral injury, or any condition where fever could be dangerous
  • Caution use in presence of any active infection
34
Q

What are the systemic side effects of vaccines?

A
  • Moderate fever
  • Rash
  • Malaise
  • Chills
  • Drowsiness
  • Anorexia
  • Vomiting
  • Irritability
35
Q

What are the injection site side effects of vaccines?

A
  • Pain
  • Redness
  • Swelling
  • Nodule formation
36
Q

Avoid ______ with immunocompromised patients

A

Live vaccines

37
Q

Describe the nursing considerations associated with vaccines

A
  • Do not use to treat an active infection
  • Do not administer if patient with s/s of acute infection
  • Review proper preparation and administration of the vaccine
  • Check the timing and dose of each injection
  • Maintain emergency equipment including epinephrine - in case of anaphylaxis
  • Educate patient on supportive care & comfort measures for flu-like symptoms (rest, Tylenol) & injection discomfort (heat to injection site, anti-inflammatories, rest arm/injection site)
  • Educate on need to keep written record of immunizations
38
Q

Describe the MOA of pooled human IgG (immune globin)

A

Provide passive immunity to a specific antigen or prophylactic treatment after disease exposure in immunosuppressed patients

39
Q

What are the indications of pooled human IgG (immune globin)?

A
  • ITP
  • Kawasaki disease,
  • Guillain Barre
  • Prevention / treatment of opportunistic infectionwith IgG deficiency