Immune System Drugs Flashcards
Alkylating agents prototype
Cyclophosphamide
alkylating agents therapeutic use
lymphoma, leukemia, ovarian and breast cancers
alkylating agents administration
PO and IV
alkylating agents EPA
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
alkylating agents ADRs
alopecia, bone marrow suppression, N/V, kidney damage, hemorrhagic cystitis, electrolyte imbalances
alkylating agents RN intervention and client education
monitor I&Os
Pre medicate: anti emetics, fluids to help kidneys
Immunosuppression precautions including NO live vaccines
alkylating agents contraindications and interactions
pregnancy and lactating, kidney impairment
anthracyclines prototype
Doxorubicin
anthracyclines therapeutic use
many cancer and in combination with radiation
anthracyclines administration
IV
anthracyclines EPA
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
anthracyclines ADRs
alopecia, cardiac toxicity, red urine and tears, liver and kidney damage
anthracyclines RN intervention and client education
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
anthracyclines contraindications and interactions
Avoid barbituates (dec effect of drug)
Avoid drugs that prolong QT (inc risk of cardiac effects)
pregnancy/lactation
monoclonal antibodies prototype
Trastuzumab
monoclonal antibodies therapeutic use
breast cancer (growth factor HER2+)
monoclonal antibodies administration
IV
monoclonal antibodies EPA
binds to HER2 killing cells and reducing metastasis
monoclonal antibodies ADRs
allergic reaction, flu symptoms, cardiac dysfunction/toxicity (dysrhythmias, edema, cough, nocturia, etc)
monoclonal antibodies RN intervention and client education
Report rash, itchiness, SOB, (allergic reaction) and flu like symptoms
Report edema, ongoing SOB, insomnia, nocturia (heart failure)
monoclonal antibodies contraindications and interactions
Anthracyclines (doxorubicin) - cardiac toxicity risk
pregnancy/lactation (wait 6 months)
Radiation therapy
vinca alkaloid prototype
vincristine
vinca alkaloids therapeutic use
acute leukemias, lymphomas, Wilms tumor, neuroblastoma in children, breast, lung
vinca alkaloids administration
IV
vinca alkaloids EPA
dervived from periwinkle plant, vinca rosea in latin; M phase specific where mitosis occurs = kills cancer cells by disrupting cell division
vinca alkaloids ADRs
alopecia, neuropathy, constipation/colon impaction that may cause intestinal ileus in children
vinca alkaloids RN intervention and client education
Monitor strength and feeling in hands & feet, monitor peripheral IV sites
Assess bowel sounds, bowel regimen, high fiber diet, fluids
vinca alkaloids contraindications and interactions
pregnancy/lactation
Charcot-marie-tooth syndrome (genetic neruro disease causes peripheral nerve damage)
antimetabolites prototype
mercaptopurine (6-MP)
antimetabolites therapeutic use
acute childhood leukemia, lymphomas - also treats autoimmune diseases
antimetabolites administration
PO
antimetabolites EPA
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
antimetabolites ADRs
GI symptoms, bone marror suppression, liver toxicity (usually mild)
antimetabolites RN intervention and client education
May need to decrease dose if GI symptoms occur, antiemetics
Monitor CBC, liver enzymes
antimetabolites contraindications
pregnancy/lactation
Presence of active infection
NNRTIs prototype
Delavirdine
NNRTIs therapeutic use
treatment of HIV 1
NNRTIs administration
PO
NNRTIs EPA
drug absobed into HIV DNA chains reverse transcriptase (what HIV uses to insert RNA of the virus into host cells DNA) = HIV cannot replicate
NNRTIs ADRs
rash (common), severe rash (SJS), GI symptoms, elevated liver enzymes
NNRTIs RN intervention and client education
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
NNRTIs contraindications and interactions
Many drugs! Tell client to check before starting new regimen