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Pharmacology HOSA > Immunomodulating Drugs > Flashcards

Immunomodulating Drugs Flashcards

1
Q

Cytokines

A

Proteins, which aid cells, signal the immune response, and stimulate cells to move to the site of inflammation

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2
Q

Erythrocytes

A

Red blood cells, one of several formed elements in the blood

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3
Q

Erythropoiesis

A

Process of making RBCs

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4
Q

Folinic acid rescue

A

In chemo, the technique of administering leucovorin after a large dose of methotrexate, thereby allowing normal calls to survive aka leucovorin rescue

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5
Q

Hematopoiesis

A

Undifferentiated stem cells are stimulated to become specific blood cells

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6
Q

Intrinsic factor

A

Substance produced by the cells in the stomach and necessary for the absorption of vitamin B12

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7
Q

Iron deficient anemia

A

Condition resulting wen the body doesn’t have enough iron to meet its need for iron

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8
Q

Leukocytes

A

White blood cells (WBCs)

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9
Q

Macrocytic anemia

A

Anemia resulting from abnormal formation (enlargement) or erythrocytes

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10
Q

Megakaryocytes

A

Precursor cell to the platelets

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11
Q

Megaloblastic anemia

A

Anemia characterized by large, abnormal, immature erythrocytes circulating in the blood, results from folic acid deficiency

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12
Q

Thrombopoiesis

A

Formation of platelets (thrombocytes)

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13
Q

CSFs MOA

A

Glycoproteins that act on the hematopoietic cells used to stimulate proliferation, differentiation, and maturation of WBCs

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14
Q

CSFs use

A

Used to treat or prevent infection caused by chemo induced neutropenia during solid tumor treatment, neutropenia during bone marrow transplantation, production of stem cells for harvest before bone marrow transplant, neutropenia in those susceptible to symptomatic chronic infection

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15
Q

Filgrastim administrations

A

Started at least 24 hours after chemo and continued until ANC is at least 10,000. It isn’t recommended to use for more than 2 weeks, and should be stopped 1 day before the next chemo cycle

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16
Q

Pegfilgrastim administration

A

Given as a single dose between chemo cycles

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17
Q

Sargamostim use

A

Following BMT, following induction chemo used with leukemia, and stimulate stem cells for harvest

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18
Q

CSFs side effects

A

Bone pain, hypertension, nausea, vomiting, alopecia, hypersensitivity

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19
Q

Filgrastim precautions

A

Hypothyroidism,

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20
Q

CSFs precautions

A

Pregnancy (cat

C) and lactation

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21
Q

Pegfilgrasim precautions

A

Can cause a sickle cell crisis in those with the disease

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22
Q

CSFs interactions

A

Can stimulate cancer cell growth in cancer types that are stimulated by growth factors, and an even higher increase in neutrophil count can occur when taken with lithium

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23
Q

Hypersensitivity reactions from CSFs should be treated by

A

Antihistamines, steroids and bronchodilators

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24
Q

Oprelvekin MOA

A

Stimulates thrombopoiesis (precessions of making platelets)

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25
Q

Oprelvekin use

A

Prevent severe thrombocytopenia associated with chemo for solid tumor treatment, and reduces the need for several platelet transfusions, and ITP (acute or chronic bleeding disorder)

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26
Q

Oprelvekin administrations

A

Started at least 6 hours after a Chemo cycle, and drug is continued until platelet count reaches 50,000. Isn’t recommended for more than 21 days and is stopped 2 days before next chemo cycle

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27
Q

ITP signs

A

Signs of bleeding (purple areas on skin), and fatigue

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28
Q

How to treat ITP

A

Corticosteroids or removal of spleen

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29
Q

Eltrombopag use

A

ITP

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30
Q

Romiplostim use

A

ITP

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31
Q

Thrombopoietin side effects

A

Fluid retention, peripheral edema, dyspnea, syncope, fever, allergic reactions, tachycardia, palpitation, atrial fibrillation, arrhythmias resulting in stroke or pulmonary edema, capillary leak syndrome

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32
Q

Eltrombopag side effects

A

Can be toxic to the liver, LFTs are done prior to starting and every 2 weeks

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33
Q

Oprelvekin contraindications

A

Shouldn’t be used in people getting chemo that is very myelosuppressive

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34
Q

Thrombopoietin Drugs precautions

A

Renal failure, heart failure, or atrial arrhythmia, children under 12, pregnancy (cat C)

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35
Q

Eltrombopag discontinuation considerations

A

Platelet levels may decrease to lower than original diagnoses counts

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36
Q

Romiplostim discontinuation considerations

A

Platelet levels may decrease below original diagnosed counts

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37
Q

Ifosfamide interactions

A

Severe hypokalemia can occur with thrombopoietins

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38
Q

Oprelvekin contraindications

A

Lactation,

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39
Q

Oprelvekin pregnancy cat

A

C

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40
Q

Anemia in chronic kidney disease

A

Anemia resulting from a reduced production of erythropoietin, a hormone secreted by the kidneys that stimulates production of RBCs

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41
Q

Pernicious anemia

A

Anemia resulting from lack of secretion by the gastric mucosa of the intrinsic factor essential to the formation of RBCs and the absorption of vitamin
B12

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42
Q

Folic acid deficiency

A

Anemia occurring because of a dietary lack of folic acid, a component necessary in the formats of RBCs

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43
Q

Erythopoiesis stimulating agents (ESAs) MOA

A

Glycoproteins that stimulate and regulate the production of erythrocytes

44
Q

ESAs use

A

Treat anemia associated with chronic kidney disease, chemo, zidovudine for HIV and post surgical blood replacement in place of allogeneic transfusions

45
Q

Darbepoetin alfa use

A

Anemia associated with chronic kidney disease in people receiving dialysis and in those not receiving dialysis, and they elevate and maintain RBC levels and decrease need for transfusions

46
Q

Methoxy polyethylene-epoetin B use

A

Anemia associated with chronic kidney disease in both people receiving and not receiving dialysis, and they also elevate and maintain RBC levels and decrease need for transfusions

47
Q

ESAs side effects

A

Hypertension, headache, nausea, vomiting, diarrhea, rashes, fatigue, arthralgia and skin reaction at injection site

48
Q

Epoetin Alfa side effects nature

A

Well tolerated when used to maintain hemoglobin levels no higher than 12

49
Q

Darbepoetin Alfa side effects nature

A

Well tolerated when used to maintain hemoglobin levels no higher than 12

50
Q

Methoxy polyethylene side effects nature

A

Well tolerated when used to maintain hemoglobin levels no higher than 12

51
Q

Epoetim Alfa contraindications

A

Uncontrolled hypertension, those needing an emergency transfusion, and those with an allergy to human albumin

52
Q

Darbepoetin Alfa contraindications

A

Uncontrolled hypertension

53
Q

ESAs risks

A

Polycythemia (am overload of RBCs in the circulation) can occur if hemoglobin isn’t monitored

54
Q

What can polycythemia result in

A

Increased mortality, serious cardio or thromboembolic events, and possible tumor progression in cancer patients

55
Q

Epoetin Alfa precautions

A

Hypertension, Hearst disease, HF, history of seizures, pregnancy (cat C), and lactation

56
Q

Darbepoetin Alfa precautions

A

Hypertension, heart disease, HF, history of seizures, pregnancy (cat C), and lactation

57
Q

Iron preparations MOA

A

Elevating the serum iron concentration, which replenishes hemoglobin and depleted iron stores

58
Q

Iron administration

A

Usually oral, best absorbed on an empty stomach

59
Q

Iron preparations side effects

A

GI irritation, nausea, vomiting, constipation, diarrhea, darker stools, headache, backache, allergic reactions

60
Q

Parenteral iron side effectiveness

A

Soreness and inflammation

61
Q

IM iron side effects

A

Sterile abscesses at IM site, brown discoloration of skin

62
Q

IV iron side effects

A

Phlebitis at the injection site

63
Q

Iron contraindications

A

Hemochromatosis or hemolytic anemia,

64
Q

Iron precautions

A

Aspirin allergy

65
Q

Iron interactions

A

Decreased Gi absorption of the antibiotic, decreased absorption of levothyroxine, decreased effect of levodopa and methyldopa absorbed acid (vitamin C) increased iron absorption

66
Q

Folic acid use

A

Treating megaloblastic anemias caused by a deficiency of folic acid, can decrease risk of neural tube defects (given to pregnancy and lactating women)

67
Q

What to do if patient with folic acid deficiency can’t take oral meds

A

Leuvcovorin

68
Q

Folic acid side effects

A

Few side effects, but parenteral administration can rarely cause an allergic reaction

69
Q

Folic acid contraindications

A

Pernicious anemia or other anemia where vitamin B12 is deficient

70
Q

Folic acid pregnancy cat

A

A

71
Q

Leucovorin contraindications

A

Pernicious anemia or other anemias where vitamin B12 is deficient

72
Q

F9ic acid interactions

A

Increases in seizure activity with hydantoins, signs of folate deficiency with sulfasalazine

73
Q

Vitamin B12 uses

A

For patients with a vitamin B12 deficiency which is seen in people with a strict vegetarian lifestyle, total gastrectomy or subtotal gastric resection, intestinal diseases (ulcerative colitis or sprue), gastric carcinoma, congenital decrease in the number of gastric cells that secrete intrinsic factor, and is also used to perform the schilling test, which is used to diagnose pernicious anemia

74
Q

Vitamin B12 side effects

A

Mild diarrhea and itching, and signs that signal a marked increase in RBC production

75
Q

Marked increase in RBC production side effects

A

Acne, peripheral vascular thrombosis, HF, and pulmonary edema

76
Q

Vitamin B12 contraindications

A

Allergy to cyanocobalamin

77
Q

Vitamin B12 oral pregnancy cat

A

A

78
Q

Vitamin B12 parenteral pregnancy cat

A

C

79
Q

Vitamin B12 precautions

A

Pregnancy, pulmonary disease and anemia

80
Q

Vitamin B12 interactions

A

Alcohol, neomycin, and colchicine decrease oral vitamin B12 absorption

81
Q

Immunosuppressive Drugs MOA

A

Reduces the strength of the body’s own immune system

82
Q

Immunosuppressive Drugs use

A

Psoriasis, multiple sclerosis, crohn disease, or ulcerative colitis or rheumatoid arthritis, and as anti rejection drugs

83
Q

Drugs used to suppress immunity include

A

Corticosteroids, calcineurin inhibitors, mTOR inhibitors, IMDH inhibitors, biologics, and monoclonal antibodies

84
Q

Anti-organ rejection agents ex

A

Azathioprine, basiliximab, belatacept, cyclosporine, mycophenolate mofetil, sirolimus, tacrolimus,

85
Q

Immunosuppressive agents for crohn disease and ulcerative colitis ex

A

Adalimumab, certolizumab pegol, golimumab, infliximab, vedolizumab

86
Q

Immunosuppressive Drugs for hepatitis C ex

A

Peginterferon Alfa-2B, interferon alfacon-1

87
Q

Immunosuppressive Drugs for hepatitis B ex

A

Peginterferon Alfa-2a, peginterferon Alfa-2b

88
Q

Immunosuppressive Drugs for multiple sclerosis ex

A

Adalimumab, dimethyl fumarate, fingolimod, glatiramer, interferon beta-1A, peginterferon beta-1A, interferon beta-1B, natalizumab, teriflunomide,

89
Q

Immunosuppressive drugs for plaque psoriasis ex

A

Adalimumab, alefacept, apremilast, cyclosporine, efalizumab, etanercept, golimumab, infliximab, secukinumab, ustekinumab

90
Q

Rheumatoid arthritis immunosuppressive drugs ex

A

Abatacept, adalimumab, anakinra, azathioprine, canakinumab, certolizumab pegrol, cyclosporine, etanercept, golimumab, infliximab, rilonacept, tocilizumab

91
Q

Immunosuppressive Drugs side effects

A

Headache, chills, and fever, itching, dizziness, and myalgias

92
Q

Calcineurin inhibitors side effects

A

Gum hyperplasia, hair growth, tremors

93
Q

Monoclonal antibodies side effects

A

Nauseated, or GI distress, acute infusion reactions (typically 1st dose and within 30 mins)

94
Q

Immunosuppressive agents contraindications

A

Live virus vaccines,

95
Q

People on monoclonal antibodies should be monitored for

A

Neutropenia

96
Q

IMDH inhibitors interactions

A

Severe decreases in WBCs, RBCs and platelets are seen with ACE inhibitors

97
Q

Calcineurin inhibitors interactions

A

Increased risk of arrhythmia with antiarrhythmics,

98
Q

People on calcineurin inhibitors should be monitored for

A

Blood urea nitrogen levels should be monitored because calcineurin inhibitors are nephrotoxic

99
Q

Immunosuppressants interactions

A

Grapefruit and other citrus

100
Q

Increased hemoglobin can cause an increased risk of

A

Myocardial infarction and stroke

101
Q

Iron anaphylactic reactions signs

A

Dyspnea, urticaria, rashes, itching and fever

102
Q

Hematopoietic factors for infection ex

A

Filgrastim, pegfilgrastim, sargramostin,

103
Q

Hematopoietic factors for bleeding ex

A

Eltrombopag, oprelvekin, romiplostim

104
Q

Adjuvant immunostimulant agents

A

Plerixafor

105
Q

Hematopoietic factors for anemia ex

A

Darbepoetin Alfa, epoetin Alfa, methoxy polyethylene, peginesatide, ferrous, folic acid, iron dextran, iron sucrose, leucovorin, sodium ferric gluconate complex, vitamin B12,

Pharmacology HOSA (37 decks)

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