Lewis 34 - Hematologic Disorders Flashcards
MOA/Class
deferoxamine, deferasirox, deferiprone
Binds to the iron for excretion by the kidneys
Chelating agent / heavy metal antagonist
Tucker 49
Side Effects
deferoxamine, deferasirox, deferiprone
red urine, abdominal pain, ototoxicity, oculotoxicity
Tucker 49
Nursing Considerations
deferoxamine, deferasirox, deferiprone
Monitor urine output
Tucker 49
Indications
deferoxamine, deferasirox, deferiprone
Iron overload
Tucker 49
MOA/Class
hydroxyurea
Myelosuppression. (Inhibits reticulocyte production.)
Side Effects
hydroxyurea
Bone marrow suppression.
Nursing Considerations
hydroxyurea
Risk for infection, bleeding, low SpO2/fatigue.
Indications
hydroxyurea
Polycythemia, sickle cell anemia, hematologic cancers
MOA/Class
Aspirin (ASA)
Inhibits the synthesis of prostaglandin (pain)
Inhibits platelet aggregation by inhibiting the synthesis of thromboxane A2 and prostacyclin.
Salicylate
Tucker 16
Side Effects
Aspirin (ASA)
GI upset, bleeding, salicylism
Tucker 16
Nursing Considerations
Aspirin (ASA)
Risk for Reye’s syndrome when given to children or with concurrent chicken pox or influenza.
Salicylism manifestations - tinnitus, sweating, headache, dizziness, acidosis. Give activated charcoal and/or bicarbonate.
Dose of 81 mg is typically for antiplatelet activity. May give larger dose for antiplatelet effect in acute situations (i.e., active MI).
Risk for hypersensitivity in patients with asthma and/or nasal polyps.
Tucker 16
Indications
Aspirin (ASA)
Mild-moderate pain/fever
Inflammatory conditions (IBD, RA, etc.)
MI/TIA prevention
Tucker 16
MOA/Class
allopurinol
Inhibits the production of uric acid by inhibiting xanthine oxidase.
Xanthine oxidase inhibitor
Tucker 16
Side Effects
allopurinol
Rash - discontinue use immediately if rash develops.
Tucker 16
Nursing Considerations
allopurinol
Increased risk of bleeding when given with warfarin.
Maintain hydration to avoid renal calculi.
Tucker 16
Indications
allopurinol
Hyperuricemia
(Gout, high levels of cell destruction [i.e., cancer treatment])
Tucker 16
MOA/Class
Prednisone, methylprednisolone
Steroids stabilize leukocytes (WBCs) preventing the release of intracellular chemical/inflammatory mediators
Systemic glucocorticoid/corticosteroid
Tucker 36
Side Effects
Prednisone, methylprednisolone
Growth suppression, elevated blood glucose, weight gain
GI upset (tolerated best in AM with food/milk)
Osteoporosis (long-term use)
Tucker 36
Nursing Considerations
Prednisone, methylprednisolone
Taper dose when stopping to prevent adrenal insufficiency
Tucker 36
Indications
Prednisone, methylprednisolone
Used to decrease inflammation/immune responses.
Tucker 36
MOA/Class
azathioprine, cyclosporine, tacrolimus
Suppresses cell-mediated immunity
Immunosuppressant
Tucker 17
Side Effects
azathioprine, cyclosporine, tacrolimus
Bone marrow suppression. Hepatotoxicity.
Tucker 17
Nursing Considerations
azathioprine, cyclosporine, tacrolimus
Increased risk for infection and cancers. Avoid live-virus vaccines. Good infection control implementation. Avoid grapefruit juice.
Tucker 17
Indications
azathioprine, cyclosporine, tacrolimus
Crohn’s disease/UC, transplant rejection, RA
Tucker 17
MOA/Class
alendronate, zolendronate acid
Slows bone resorption (degeneration)
Tucker 37
Side Effects
alendronate, zolendronate acid
GI and musculoskeletal pain, constipation, esophageal burns
Tucker 37
Nursing Considerations
alendronate, zolendronate acid
Take on an empty stomach 30-60 minutes before food. Adminsitered with a full glass of water. Remain upright 30 minutes after administration.
Ensure adequate calcium intake during therapy.
Tucker 37
Indications
alendronate, zolendronate acid
osteoporosis, Paget’s disease, multiple myeloma, hypercalcemia
Tucker 37
MOA/Class
filgrastim
Increases the production of neutrophils in the bone marrow.
Colony stimulating factor
Tucker 17
Side Effects
filgrastim
N/V, generalized pain, bone pain
Tucker 17
Nursing Considerations
filgrastim
Teach and implement good infection control mechanisms.
Monitor absolute nuetrophil count (ANC). Implement neutropenic precautions for ANC <1.
Most effective when given at least 24 hours after myelosuppressive therapies.
Tucker 17
Indications
filgrastim
Neutropenia associated with bone marrow transplants, chemo, and blood-related cancers.
Tucker 17
