Immune System Medications Flashcards
Vaccinations
- produce antibodies that provide active immunity
- may take months to have effect but confer long-lasting protection against infectious diseases
- eradication of infectious diseases
- prevention of childhood and adult infectious disease and their complications
Vaccinations:
complications
contraindications
precautions
- anaphylactic reactions
- moderate to severe illnesses with or without contraindications
- provider to analyze and weigh risk of vaccinations
- immunocompromised individuals:
a. hematologic or solid tumors
b. congenital immunodeficiency
c. long-term immunosuppressive therapy (corticosteroids) - CDC guidelines for adult and pediatric clients
Vaccinations:
nursing administration
1) SQ vaccines in outer aspect of upper arm or anterolateral thight
2) have emergency medication and equipment on standby in case of allergic response such as anaphylaxis
3) follow storage and reconstitution directions
4) if reconstituted, use within 30 min
5) provider written vaccination information sheets. Review content with client
6) instruct parents and clients to observe for complications and notify provider if adverse effects occur
7) document administration of vaccines
- date
- route and site of vaccination number
- type manufacturer
- lot number and expiration of vaccine
- name, address, and signature
Chemotherapy Agents
- cure some cancers
- augment treatment of other cancers
- attempt to increase survival rate
- combination chemotherapy:
a. more than one chemotherapy agent to treat cancer
b. acts in different places on cell cycle
c. used to reduce medication resistance, increase effectiveness, and reduce toxic effects with lower medication doses - follow safe handling precautions to prevent absorption through handler’s skin
- follow institutional procedures when chemotherapy spill occurs
- for large spills contact Occupational Safety and Health Administration
Cytotoxic Chemotherapy Agents
- toxic to cancer cells
- kill fast-growing cancer cells and healthy cells
- adverse effects:
i. nausea, vomiting
ii. myelosuppression
iii. alopecia
Cytotoxic Chemotherapy Agents: categories and actions
1) antimetabolites: interrupt specific phase of cell reproduction
2) antitumor antibiotics: stop synthesis of RNA, DNA, or proteins
3) antimitotics: inhibit mitosis and prevent cell division
4) alkylating agents: kill fast-growing cancer cells by altering DNA structure and preventing cell reproduction
5) Topoisomerase inhibitors: interrupt DNA synthesis
6) Others: kill cells by various mechanisms including interrupting DNA and RNA synthesis in leukemia cells
Antimetabolic Medications:
nursing administration
1) reduce dosage in clients who have renal disease
2) encourage fluids
3) administer with sodium bicarbonate capsules to alkalinize urine
4) advise female clients to use birth control during treatment
5) avoid using ETOH (alcohol)
6) monitor bleeding and infection
7) monitor I&O
8) administer antiemetics for nausea, vomiting
9) promote good hand hygiene
10) monitor skin for jaundice
Antitumor Antibiotics:
nursing administration
1) contraindicated in severe myelosuppression lifetime cumulative dose of 550 mg/m3
2) contraindicated in chicken pox or herpes zoster
3) reduce in liver disease
4) monitor for bleeding
5) monitor CBC and liver enzymes
6) administer antiemetic for nausea, vomiting
7) promote good oral hygiene and avoid mouthwash w/ ETOH
8) transient hair loss occurs in 7-10 days. select hair piece or wig
Antimitotics:
nursing administration
1) use cautiously w/ liver or neuromuscular disease
2) contraindicated in hypersensitivity to castor oil and neutrophil count less < 1,500/mm3
3) use caution in myelosuppression
4) assess for signs of neuropathy
5) reduce for clients who have liver disease
6) assess breath sounds for bronchospasm
7) monitor carefully for hypersensitive reaction
8) monitor for bleeding
9) monitor CBC and liver enzymes
10) use good oral mouth care
11) stop chemotherapy if extravasation occurs
12) advise clients to use birth control during treatment
Alkylating Agents:
nursing administration
1) contraindicated in myelosuppression
2) use in caution with kidney, leukopenia, thrombocytopenia, hearing loss
3) encourage adequate fluid intake
4) monitor blood in urine
5) reduce dose for clients who have liver disease
6) monitor bleeding
7) monitor CBC, uric acid level, liver enzymes
8) antiemetic for nausea, vomiting
9) advise client to use good mouth care
10) stop chemotherapeutic medications if extravasation occurs
11) use birth control during treatment
12) monitor hearing prior to treatment
Topoisomerase Inhibitors:
nursing administration
1) contraindicated in severe myelosuppression
2) monitor for bleeding
3) monitor CBC
4) give antiemetic for nausea, vomiting
5) perform good oral hygiene and avoid mouthwash with ETOC
6) use birth control measures
Other Antineoplastic Agents:
nursing administration
1) monitor for allergic reaction
2) administer antiemetic for nausea, vomiting
3) use good mouth care
4) use birth control during treatment
5) monitor for bleeding
6) monitor CBC
7) monitor for neurologic effects (confusion, paresthesia)
Noncytotoxic Chemotherapy Agents
- nontoxic to cells
- hormonal agents effective against tumors supported or suppressed by hormones
- biological response modulators: act as immunostimulants to enhance immune response and reduce proliferation of cancer cells
- targeted antineoplastic agents: are antibodies or small molecules that attach to specific target sites to stop cancer growth without injuring healthy tissue
Hormonal Agents: Prostate Cancer Medications
- contraindicated in hypersensitivity to gonadotropin-releasing agonists
- contraindicated with sever liver disease
- monitor PT/INR
- increase intake of calcium and vitamin D
- monitor for arrhythmias. assess for breath sounds
- prostate symptoms may worsen at beginning of treatment
- adverse effect: gynecomastia
Hormonal Agents: Breast Cancer Medications
- contraindicated in clients taking warfarin
- contraindicated w/ hx of blood clots or PE
- contraindicated in clients hypersensitive to medications
- use caution w/ liver disease
- use caution w/ heart disease. Assess breath sounds
- increase calcium and vitamin D intake. increase bone mass w/ weight-bearing exercises
- perform monthly breast self-exams
- schedule normal gynecologic and breast examinations and mammogram w/ provider
- monitor CBC and calcium levels
- monitor fluid status
- advise female clients to use birth control during therapy
