Immune System Medications Flashcards
Antimetabolite indicated for immune disorders such as RA, psoriasis, certain cancers, and for the dissolvement of ectopic pregnancies
Methotrexate (Rheumatrex)
Methotrexate (Rheumatrex) side effects
Infections, hepatotoxicity, bone marrow suppression, stomatitis
Methotrexate (Rheumatrex) black box warning
Fetal toxicity/death
Methotrexate (Rheumatrex) nursing care
Monitor for S/S of infection, liver function, and CBC
Medication indicated for prevention of organ rejection in transplant patients, UC, and RA
Cyclosporine (Sandimmune)
Cyclosporine (Sandimmune) side effects
Infections, hepatotoxicity, nephrotoxicity, hirsutism, hypertension, tremor
Cyclosporine (Sandimmune) nursing care
Notify provider right away of s/s of infection, monitor liver and renal function
Cyclosporine (Sandimmune) black box warning
Development of tumors
Doxorubicin (Adriamycin) is an example of an
Antineoplastic agent
Doxorubicin (Adriamycin) side effects
GI upset, alopecia, bone marrow suppression (anemia, neutropenia, thrombocytopenia), cardiac toxicity, red discoloration of urine/sweat/tears
Doxorubicin (Adriamycin) black box warning
Bone marrow suppression, cardiac toxicity, leukemia
Doxorubicin (Adriamycin) nursing care
Monitor for infection, cardiac function, and CBC levels; administer antiemetics for N/V
Vincristine is an example of an
Antineoplastic agent
T or F: vincristine causes bone marrow suppression
FALSE
Vincristine side effects
Peripheral neuropathy, phlebitis (IV site), GI upset, alopecia
Vincristine nursing care
Administer antiemetics for N/V, monitor for signs of neuropathy, use central line for infusion
Cyclophosphamide (Cytoxan) is an example of an
Antineoplastic agent
Cyclophosphamide (Cytoxan) side effects
Bone marrow suppression, GI upset, alopecia, hemorrhagic cystitis (inflammation and bleeding from bladder)
Cyclophosphamide (Cytoxan) nursing care
- encourage patient to increase fluid intake to 2-3 L/day during therapy (to help prevent hemorrhagic cystitis)
- monitor for blood in urine
- monitor CBC levels
- give antiemetics for N/V
- wear gloves when handling and wash hands IMMEDIATELY after handling
Antineoplastic agent indicated for the prevention and treatment of breast cancer
Tamoxifen (Nolvadex)
Tamoxifen (Nolvadex) side effects
Hot flashes, vaginal bleeding, increased risk of thromboembolism, Hypercalcemia, bone pain, increased risk of uterine and endometrial cancer
Tamoxifen (Nolvadex) nursing care
Monitor CBC and calcium levels during therapy; advise patient to report bone pain
Antineoplastic immune modifier indicated for cancers and viral infections such as hepatitis
Interferon alpha-2B
Interferons are proteins that _________ the body’s immune response to tumors/viruses and _________ cancer proliferation
Enhance; slow
Interferon side effects
Flu-like symptoms (fever, muscle aches, chills, lethargy) bone marrow suppression, cardiotoxicity, hepatotoxicity, dyspnea, alopecia, GI upset, psychiatric disorders
Interferon nursing care
Monitor: CBC, cardiac function (EKG), liver function, infection, bleeding
Interferon black box warning
Risk for psychiatric, autoimmune, ischemic, and infectious disorders
Azithromycin (Zithromax) and erythromycin (E-Mycin) are examples of
Macrolides (anti-infectives)
Macrolides are indicated for
Bacterial infections (such as respiratory)
T or F: Macrolides are effective against MRSA
FALSE
Macrolides are _________ meaning they work by inhibiting protein synthesis and slowly bacterial growth
Bacteriostatic
Macrolides side effects
GI upset, dysrhythmias (including torsades de pointe), ototoxicity, rash
Administration of Macrolides
Take on empty stomach with a full glass of water
Lincosamide anti-infective indicated for severe bacterial infections
Clindamycin (Cleocin)
Clindamycin (Cleocin) inhibits protein synthesis and can be _________ or _________ depending on concentration
Bactericidal; bacteriostatic
Clindamycin (Cleocin) side effects
GI upset, diarrhea, superinfection (C.diff)
Clindamycin (Cleocin) nursing care
Monitor bowel movements
Aminoglycoside indicated for serious bacterial infections
Gentamicin (Garamycin)
Gentamicin (Garamycin) works by inhibiting protein synthesis and is _________ (kills bacteria)
Bactericidal
Gentamicin (Garamycin) side effects
Ototoxicity, nephrotoxicity, vertigo, ataxia
Gentamicin (Garamycin) nursing care
Monitor for: tinnitus, hearing loss, kidney function, peak/trough levels (d/t narrow therapeutic range)
Route of administration for gentamicin (Garamycin)
IM or IV
Doxycycline (Vibramycin) and tetracycline (Sumycin) are examples of _________ indicated for a wide variety of bacterial infections including acne, Lyme disease, STDs, Rocky Mountain spotted fever
Tetracyclines
Tetracyclines work by preventing protein synthesis and inhibiting bacterial growth (____________)
Bacteriostatic
Side effects of tetracyclines
GI upset, tooth discoloration in children (and fetuses), hepatotoxicity, photosensitivity, superinfection (C.diff)
Tetracyclines should not be given to
Pregnant women or children under 8 years old
Tetracyclines patient education
Take on empty stomach and with full glass of water; wear sunscreen; use additional form of protection as these meds decrease effectiveness of oral contraceptives
What foods/meds decrease absorption of tetracyclines
Dairy products, foods high in calcium and iron, antacids
Antibiotic indicated for serious bacterial infections and antibiotic-associated C.diff
Vancomycin
Vancomycin side effects
Ototoxicity, nephrotoxicity, infusion reaction (“red man syndrome” — slow the infusion down, diphenhydramine), phlebitis (can be prevented if administered via PICC line)
Vancomycin nursing care
Monitor peak/trough levels and adjust dose depending on creatinine (kidney function)
Vancomycin should be infused over ___ hour(s) or more
1
Side effects of penicillin G and amoxicillin (Moxatag)
GI upset (diarrhea, N/V), allergic reaction (dyspnea, rash), renal toxicity, superinfection (c.diff)
Penicillin G and amoxicillin (Moxatag) should not be given to patient with a history of
Allergies to penicillin or cephalosporin
Penicillin G and amoxicillin (Moxatag) nursing care
Monitor for allergic response and bowel function
Extended release penicillin indicated for moderate to severe bacterial infections, including many penicillin-resistant bacteria
Piperacillin/tazobactam (Zosyn)
Side effects of piperacillin/tazobactam (Zosyn)
Diarrhea, superinfection (C.diff), allergic reaction, phlebitis (at IV site), hepatotoxicity, nephrotoxicity
Piperacillin/tazobactam (Zosyn) should not be given to patients with a history of allergies to
Penicillin or cephalosporin
Piperacillin/tazobactam (Zosyn) nursing care
Monitor for: allergic reactions, bowel function, liver and renal labs
Cephalexin (Keflex), ceftriaxone (Rocephin), ceftazidime (Tazicef), and cefepime (Maxipime) are examples of _________ indicated for bacterial infections
Cephalosporins
Side effects of cephalosporins
GI upset, allergic reaction, superinfections (C.diff)
Cephalosporins should not be given to patients with a history of allergies to
Penicillin
Cephalosporins patient education
DO NOT consume alcohol during therapy; take with food
Imipenem/cilastatin (Primaxin) is an example of a broad spectrum _________ indicated for serious bacterial infections
Carbapenem
Carbapenems side effects
GI upset, rash, superinfection (C.diff), seizures
Patients allergic to penicillin and/or cephalosporin may have an allergic reaction to
Carbapenems
Ciprofloxacin (Cipro) and levofloxacin are examples of __________ antibiotics indicated for bacterial infections including UTIs, bone/joint infections, respiratory infections, and anthrax
Fluoroquinolone
Side effects of fluoroquinolones
Diarrhea, superinfection (C.diff), tendon rupture, photosensitivity
Fluoroquinolones nursing care
Monitor bowel movements, advise patient to wear sunscreen, monitor liver function (these meds may increase liver lab values)
Trimethoprim/sulfamethoxazole (Bactrim) is an example of a _________ antibiotic indicated for bacterial infections including UTIs, bronchitis, pneumonia, and otitis media
Sulfonamide
Side effects of trimethoprim/sulfamethoxazole (Bactrim)
GI upset, blood dycrasias, photosensitivity, crystalluria, rash, Steven’s-Johnson syndrome
Trimethoprim/sulfamethoxazole (Bactrim) nursing care
Assess for sulfa allergies; monitor CBC; advise patient to wear sunscreen and increase fluid intake (to prevent crystalluria)
Antibiotic used to treat UTIs
Nitrofurantoin (Macrobid)
Side effects of nitrofurantoin (Macrobid)
GI upset, hypersensitivity, pulmonary toxicity, peripheral neuropathy, brown discoloration of urine
Antibiotic indicated for bacterial and protozoan infections
Metronidazole (Flagyl)
Metronidazole (Flagyl) side effects
GI upset, metallic taste, dark urine, dizziness, headache
Metronidazole (Flagyl) patient education
DO NOT drink alcohol
TB medications (HINT: RIPE)
Rifampin, isoniazid, pyrazinamide, ethambutol
Key side effect of all TB drugs
Hepatotoxicity
Rifampin side effects
Orange secretions, GI upset, decreased effectiveness of oral contraceptives
Isoniazide side effect
Neuropathy
Pyrazinamide side effect
Arthralgia (Joint pain)
Ethambutol side effect
Changes in vision
TB meds patient education
NO alcohol; family members will need to be tested for TB; sputum samples needed every 2-4 weeks; patients with active TB will need to wear masks in public
Patients are no longer infectious with TB after ___ negative sputum samples
3
TB meds nursing consideration
Monitor for signs of liver damage
Amphotericin B (Fungizone), ketoconazole, and fluconazole (Diflucan) are examples of
Systemic antifungals
Key side effect of all antifungals
Hepatotoxicity
Side effects of amphotericin B
GI upset, nephrotoxicity, bone marrow suppression, phlebitis — HIGHLY toxic (only for life threatening fungal infections)
Side effects of ketoconazole
GI upset, arrythmias
Side effects of fluconazole
GI upset, rash
Systemic antifungals nursing care
Monitor for liver dysfunction (pale stools, dark urine, N/V, fatigue, jaundice)
Acyclovir (Zovirax), ganciclovir (Cytovene), oseltamivir (Tamiflu), and zanamivir (Relenza) are examples of
Systemic antivirals
Antiviral indicated for herpes and varicella-zoster viruses
Acyclovir (Zovirax)
Acyclovir (Zovirax) side effects
Phlebitis, GI upset, nephrotoxicity
Systemic antiviral indicated for cytomegalovirus
Ganciclovir (Cytovene)
Side effects of ganciclovir (Cytovene)
Phlebitis, GI upset, nephrotoxicity, bone marrow suppression
Antivirals indicated for influenza A and B
Oseltamivir (Tamiflu) and zanamivir (Relenza)
Systemic antiviral patient education
These meds do not CURE conditions
Oseltamivir (Tamiflu) and zanamivir (Relenza) should be administered within ___ hrs of influenza symptoms
48