Immune System Drugs

Question 1

Alkylating agents prototype

Answer 1

Cyclophosphamide

Question 2

alkylating agents therapeutic use

Answer 2

lymphoma, leukemia, ovarian and breast cancers

Question 3

alkylating agents administration

Answer 3

PO and IV

Question 4

alkylating agents EPA

Answer 4

contains Alkyl group in chemical structure > abnormal link between DNA bases, cell cycle non-specific = can kill the cell at any time in the cell cycle

Question 5

alkylating agents ADRs

Answer 5

alopecia, bone marrow suppression, N/V, kidney damage, hemorrhagic cystitis, electrolyte imbalances

Question 6

alkylating agents RN intervention and client education

Answer 6

monitor I&Os
Pre medicate: anti emetics, fluids to help kidneys
Immunosuppression precautions including NO live vaccines

Question 7

alkylating agents contraindications and interactions

Answer 7

pregnancy and lactating, kidney impairment

Question 8

anthracyclines prototype

Answer 8

Doxorubicin

Question 9

anthracyclines therapeutic use

Answer 9

many cancer and in combination with radiation

Question 10

anthracyclines administration

Answer 10

IV

Question 11

anthracyclines EPA

Answer 11

binds with DNA to distort it and kill the cell. Binds to enzyme topoisomerase II to prevent repairing of DN, also killing cell = kill cancer cells and reduce metastasis

Question 12

anthracyclines ADRs

Answer 12

alopecia, cardiac toxicity, red urine and tears, liver and kidney damage

Question 13

anthracyclines RN intervention and client education

Answer 13

Central line!
Cardiac toxicity can occur immediately or months to years later: monitor heart rhythm and function
Monitor for thrush, super infections
Monitor s/sx liver damage, monitor CBC

Question 14

anthracyclines contraindications and interactions

Answer 14

Avoid barbituates (dec effect of drug)
Avoid drugs that prolong QT (inc risk of cardiac effects)
pregnancy/lactation

Question 15

monoclonal antibodies prototype

Answer 15

Trastuzumab

Question 16

monoclonal antibodies therapeutic use

Answer 16

breast cancer (growth factor HER2+)

Question 17

monoclonal antibodies administration

Answer 17

IV

Question 18

monoclonal antibodies EPA

Answer 18

binds to HER2 killing cells and reducing metastasis

Question 19

monoclonal antibodies ADRs

Answer 19

allergic reaction, flu symptoms, cardiac dysfunction/toxicity (dysrhythmias, edema, cough, nocturia, etc)

Question 20

monoclonal antibodies RN intervention and client education

Answer 20

Report rash, itchiness, SOB, (allergic reaction) and flu like symptoms
Report edema, ongoing SOB, insomnia, nocturia (heart failure)

Question 21

monoclonal antibodies contraindications and interactions

Answer 21

Anthracyclines (doxorubicin) - cardiac toxicity risk
pregnancy/lactation (wait 6 months)
Radiation therapy

Question 22

vinca alkaloid prototype

Answer 22

vincristine

Question 23

vinca alkaloids therapeutic use

Answer 23

acute leukemias, lymphomas, Wilms tumor, neuroblastoma in children, breast, lung

Question 24

vinca alkaloids administration

Answer 24

IV

Question 25

vinca alkaloids EPA

Answer 25

dervived from periwinkle plant, vinca rosea in latin; M phase specific where mitosis occurs = kills cancer cells by disrupting cell division

Question 26

vinca alkaloids ADRs

Answer 26

alopecia, neuropathy, constipation/colon impaction that may cause intestinal ileus in children

Question 27

vinca alkaloids RN intervention and client education

Answer 27

Monitor strength and feeling in hands & feet, monitor peripheral IV sites Assess bowel sounds, bowel regimen, high fiber diet, fluids

Question 28

vinca alkaloids contraindications and interactions

Answer 28

pregnancy/lactation Charcot-marie-tooth syndrome (genetic neruro disease causes peripheral nerve damage)

Question 29

antimetabolites prototype

Answer 29

mercaptopurine (6-MP)

Question 30

antimetabolites therapeutic use

Answer 30

acute childhood leukemia, lymphomas - also treats autoimmune diseases

Question 31

antimetabolites administration

Answer 31

PO

Question 32

antimetabolites EPA

Answer 32

purines are necessary for synthesis of neucleic acid that makes up our DNA, purine analogs convert to an active form and block the creation of pruine in the S phase of the cell cycle = cell cant divide

Question 33

antimetabolites ADRs

Answer 33

GI symptoms, bone marror suppression, liver toxicity (usually mild)

Question 34

antimetabolites RN intervention and client education

Answer 34

May need to decrease dose if GI symptoms occur, antiemetics Monitor CBC, liver enzymes

Question 35

antimetabolites contraindications

Answer 35

pregnancy/lactation Presence of active infection

Question 36

NNRTIs prototype

Answer 36

Delavirdine

Question 37

NNRTIs therapeutic use

Answer 37

treatment of HIV 1

Question 38

NNRTIs administration

Answer 38

PO

Question 39

NNRTIs EPA

Answer 39

drug absobed into HIV DNA chains reverse transcriptase (what HIV uses to insert RNA of the virus into host cells DNA) = HIV cannot replicate

Question 40

NNRTIs ADRs

Answer 40

rash (common), severe rash (SJS), GI symptoms, elevated liver enzymes

Question 41

NNRTIs RN intervention and client education

Answer 41

Report rash Occurs 1-3 weeks after starting, if it occurs with other symptoms like fever, blisters, lesions, muscle pain the d/c Monitor weight and persistent GI effects Monitor LFTs

Question 42

NNRTIs contraindications and interactions

Answer 42

Many drugs! Tell client to check before starting new regimen