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Pharmacology Exam 2 > Immune Modulators > Flashcards

Immune Modulators Flashcards

1
Q

What is the main purpose of immune modulators?

A

To modify the actions of the immune system.

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2
Q

Immune modulators only suppress the immune system.

TRUE/FALSE

A

FALSE

They are stimulants AND suppressants.

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3
Q

What is the main action of Immune stimulants?

A

To energize the immune system when it needs help fighting a pathogen.

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4
Q

What is the main action of Immune suppressants?

A

To block the normal effects of the immune system in organ transplantation and autoimmune disorders.

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5
Q

What are some lifespan considerations that should be taken into account when giving immune modulators to a child?

A

Should be used with caution - monitor closely for infection, GI, renal, hematological or CNS effects.
Immune suppressants are needed in higher doses than adults.
Protect against infection and injury.

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6
Q

What are some lifespan considerations that should be taken into account when giving immune modulators to adults?

A

Teach proper injection technique.
Avoid infection and injury.
Contraindicated in pregnancy/lactation.
Some drug may impair fertility.

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7
Q

What are some lifespan considerations that should be taken into account when giving immune modulators to older adults?

A

Their immune system is less efficient and less responsive hence they are more susceptible to the drug effect.
Monitor renal and liver function to determine dosage.
More susceptible to infection - teach infection and injury prevention.

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8
Q

What are the immune stimulants that we must know?

A

Interferons
Interleukins
Colony-stimulating factors

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9
Q

What are interferons?

A

Proteins that are naturally released from human cells in response to viral invasion.

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10
Q

What are Interleukins?

A

Proteins that provide communications between lymphocytes to stimulate cellular immunity and inhibit tumor growth.

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11
Q

What does Colony-stimulating factors do?

A

They stimulate the bone marrow to produce more WBC’s.

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12
Q

What does interferon alfa-2b do?

A

Prevent virus particles from replicating inside other cells.
Stimulates interferon receptors on noninvaded cells to produce antiviral proteins.
Inhibits tumor growth and replication.

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13
Q

Why would we give Interferon alfa-2b to a patient?

A

To help treat various cancers, hepatitis B&C and multiple sclerosis.

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14
Q

What is contraindicated to interferons?

A

Allergy and Pregnancy

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15
Q

When should we exhibit caution when administering interferons?

A

If the patient is breastfeeding.
If the patient have CD, myelosuppression or CNS dysfunction.

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16
Q

What are the main adverse effects of interferons?

A

Lethargy, myalgia, arthralgia, anorexia, nausea, headache, dizziness, bone marrow depression.

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17
Q

Are there any drug-drug interactions with interferons? If so, what are they?

A

No know drug-drug interactions.

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18
Q

How does interleukins work on the body?

A

They increase the number of NKC’s and lymphocytes.
Activates cellular immunity and inhibits tumor growth.
Increases circulating platelets.

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19
Q

Why would we give Interleukins to a patient?

A

Aldesleukin : Specific renal carcinomas, possible treatment of AIDS and AIDS related disorders.
Oprelvekin: Prevention of severe thrombocytopenia after myelosuppressive chemotherapy.

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20
Q

In what patients are Interleukins contraidicated?

A

Patients that have an allergy to them, patients who are pregnant or breastfeeding.

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21
Q

In what patients should we exhibit caution when giving Interleukins?

A

Patients who suffer from renal, liver of CV impairment.

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22
Q

What are the most common adverse reactions to interleukins?

A

Lethargy, Myalgia, Arthralgia, Fever, Respiratory difficulties, Depression with suicidal ideation.

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23
Q

What are the Colony-Stimulating drug classes that we need to know?

A

Filgrastim
Pegfilgrastim

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24
Q

What does colony-stimulating factors do?

A

Increase production of neutrophilsin the bone marrow with little effect on other hematopoietic cells.

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25
Q

Why would we administer Filgrastim to a patient?

A

Filgrastim is a colony-stimulating factor and it can be used to reduce the incidence of infection in patients with bone marrow suppressions, to decrease neutropenia associated with bone marrow transplants and chemotherapy and to help in the treatment of carious blood-related cancers.

Colony stimulating factor

26
Q

In what patients are Pegfilgrastim contraindicated?

A

Patients that are allergic to the drug or patients undergoing radiations and chemotherapy.

Colony stimulating factor

27
Q

What patients should show caution when taking Colony stimulating factors?

A

Patients that are pregnant or breastfeeding.

28
Q

What are the most common adverse effects to Filgrastim?

A

Gi related side effects, CNS-headache, fatigue, generalized weakness.
Derm- alopecia and dermatitis.
Generalized pain & bone pain.

Colony stimulating factor

29
Q

What should we be assessing for prior to giving a patient Pegfilgrastim?

A

Assess for contraindications and cautions
Physical : Skin lesions, weight, monitor temperature, check heart rate and rhythm and
blood pressure, orientation and reflexes
Baseline ECG
Renal and liver function, CBC

Colony stimulating factor

30
Q

What nursing diagnosis should expected for colony stimulating agents?

A

Impaired comfort related to CNS, GI, and flulike effects

Malnutrition risk related to flulike effects

Acute or chronic fear or anxiety related to diagnosis and drug therapy

Knowledge deficit

31
Q

What nursing implementations should be made when giving a patient Filgrastim?

A

Arrange for laboratory tests before and periodically during therapy
Administer drug as indicated; instruct the patient and a significant other if injections
are required
Monitor for severe reactions
Arrange for supportive care and comfort measures for flulike symptoms
Ensure patient is well hydrated.
Instruct female patients in the use of barrier contraceptives to avoid pregnancy.
patient teaching

Colony-stimulating agent

32
Q

What drug categories are under immune suppressants?

A

Immune modulators
T&B cell suppressors
Interleukin receptor antagonists
Monoclonal antibodies

33
Q

What drug do we need to know for immune modulators?

A

Apremilast.

34
Q

What does Apremilast do?

A

Inhibits the secretion of proinflammatory cytokines and increase the secretion of anti-inflammatory cytokines from monocytes and have varying effects on cell proliferation.

35
Q

Why would you give a patient Apremilast?

A

For Psoriatic Arthritis

36
Q

In which patients are apremilast contraindicated?

A

Pregnancy

37
Q

what are the drug-drug interactions with Apremilast?

A

There are none that are known.

38
Q

What are the most common adverse effects of Aprimelast?

A

There are no known adverse effects.

39
Q

What are the drug classes we need to know for T&B cell suppressors?

A

Cyclosporine
Mycophenolate
Tacrolimus

40
Q

Why would you give a patient Cyclosporine?

A

We would give it to transplant patients because it suppresses the rejection of the new organ.
We would also give it for Rheumatoid arthritis and psoriasis.

cyclosporine is a T and B cell supressor.

41
Q

Why would you give a patient Mycophenolate?

A

To prevent rejection after renal or heart transplant in adults.

Mycophenolate is a T and B cell suppressor.

42
Q

Why would you give a patient Tecrolimus?

A

To prevent rejection after heart or liver transplant.

Tacrolimus is a T and B cell suppressor

43
Q

Which patients should we not give T & B cell suppressors to?

A

Patients with a known drug allergy to the drugs, patients that are pregnant or breastfeeding.

44
Q

Are there any drug-drug interactions with T and B cell suppressors? If so, what are they?

A

Hepatotoxic or Nephrotoxic drugs.

45
Q

What are the drugs that we need to know for Interleukin receptor Antagonists?

A

Anakinra

46
Q

How does Anakinra work?

A

They block the activity or the interleukins that are released in an inflammatory or immune response.
Interleukin-1 thought to be responsible for degradation of cartilage.

47
Q

Why would you give Interleukins to a patient?

A

To treat Rheumatoid Arthritis.

48
Q

Which patients would be not give Anakinra to?

A

Patients with a known allergy to Escherichia coli-produced products or allergy to Anakinra.

49
Q

Which patients would we be cautious of giving Anakinra to?

A

Patients that are pregnant or breastfeeding.
Patients with renal impairment and immunosuppression or any active infection.

50
Q

What are the adverse effects of Anakinra?

A

Headache, sinusitis, neausea and diarrhea.

51
Q

Are there any drug-drug interactions to Anakinra and if so what are they?

A

Yes, Etanercepts may cause severe and possibly life-threatening infections.

52
Q

What are the drugs/suffixes we need to know for Monoclonal Antibodies?

A

(-mab)
Adalimumab, Certolizumab, Golimumab, infliximab.

53
Q

How does Monoclonal Antibodies work?

A

They are antibodies that attaches to specific receptors and are developed to respond to specific situations.

54
Q

Which patients should we not give Monoclonal Antibodies to?

A

Patients with a know allergy to the drug.
Patients who are experiencing fluid overload.
Patients who are pregnant or breastfeeding.

55
Q

Which patients should we be cautious with giving Monoclonal antibodies to?

A

Patients with a fever.

56
Q

What are some adverse reactions to monoclonal antibodies?

A

Pulmonary edema
Fluid retention
Flu like symptoms

57
Q

Are there any drug-drug interactions to monoclonal antibodies and if so what are they?

A

Yes, severe immune suppression may occur with the use of other suppressants.

58
Q

When administering Immune suppressants to a patients, what assessments should we do prior to this?

A

Assess for contraindications and cautions
Physical: Obtain weight, monitor for fluid retention, temperature, pulse and blood
pressure, orientation and reflexes.
Obtain baseline ECG
Monitor renal and liver functions and CBC

59
Q

What nursing diagnosis could be made prior to administering Immune Suppressants?

A

Impaired comfort related to CNS, GI, and flulike effects

Infection risk related to immune suppression

Malnutrition risk related to nausea and vomiting

Knowledge deficit risk regarding drug therapy

60
Q

What implementations should we expect to possibly make when giving patients immune suppressants?

A

Arrange for laboratory tests before and periodically during therapy.
Administer the drug as indicated; instruct the patient and a significant other if
injections are required.

Protect the patient from exposure to infections and maintain a strict aseptic
technique for any invasive procedures.
Arrange for supportive care and comfort measures for flulike symptoms.
Monitor nutritional status during therapy; provide small, frequent meals, mouth
care, and nutritional consultation.
Instruct females in use of barrier contraceptives.
Suggest another method of feeding the baby.
Provide thorough patient teachings.

Pharmacology Exam 2 (10 decks)

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