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Med Surg 2 > Med Know - Immune > Flashcards

Med Know - Immune Flashcards

1
Q

What medications can cause Alopecia?

A

vincristine, topotecan (Hycamtin), cyclophosphamide, doxorubicin (Adriamycin)

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2
Q

What medications can cause bone marrow suppression?

A

topotecan (Hycamtin), paclitaxel (Taxol, Abraxane), imatinib (Gleevec), cytarabine (Cytosar-U), mercaptopurine (Purinethol), cisplatin, carmustine (BiCNU), cyclophosphamide, interferon alfa-2a (Roferon-A), interferon alfa-2b (Intron A), methotrexate (Trexall), doxorubicin (Adriamycin)

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3
Q

What type of drug is vincristine?

A

Vinca alkaloid

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4
Q

What does vincristine treat?

A

Acute leukemias, lymphomas, Wilms’ tumor and neuroblastoma in children, breast and lung cancer, soft tissue sarcomas

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5
Q

What are the possible adverse effects of vincristine?

A

Peripheral neuropathy, alopecia (in 20% of clients), tissue damage if IV infiltrates, severe constipation/upper colon impaction/possible intestinal ileus

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6
Q

What form(s) are available for vincristine?

A

Only IV administration

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7
Q

What are some specific administration considerations for vincristine?

A

Administer IV dose directly into tubing, and infuse IV over at least 1 minute.
Avoid contact of drug with eyes - can cause corneal damage; flush both eyes immediately with large amounts of water if injury occurs.
Calculate dosage by weight and decrease if liver impairment occurs.

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8
Q

What are some specific client instructions for vincristine?

A

Immediately report pain, swelling, or pallor/redness of IV site.
Report constipation, hard stools, or a decrease in bowel movements.

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9
Q

What type of drug is topotecan?

A

Topoisomerase inhibitor

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10
Q

What is the name brand of topotecan?

A

Hycamtin

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11
Q

What does topotecan treat?

A

Metastatic ovarian cancer, small-cell lung cancer, cancers that other anticancer drugs have failed to treat

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12
Q

What are the possible adverse effects of topotecan?

A

GI symptoms: N/V/D, constipation, abdominal pain, bone marrow suppression, thrombocytopenia and anemia are common, alopecia

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13
Q

What form(s) are available for topotecan?

A

Only IV administration

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14
Q

What are some specific administration considerations for topotecan?

A

Base dose on client’s weight, adjust dose for renal impairment.
Usually infused over 30 minutes for 5 consecutive days; repeat 4 times, using a 16-day rest period in between treatments.
Carefully monitor for infiltration and extravasation of IV solution.
Do not allow topotecan to get on skin: rinse thoroughly with water and soap if contamination occurs.

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15
Q

What are some specific client instructions for the adverse reaction of bone marrow suppression?

A

Report fever, sore throat, easy bruising, and unusual fatigue.
Use scrupulous hand washing techniques; restrict visitors who are ill.
Wash fresh fruits and vegetables well and cook foods properly.
Institute frequent oral care to prevent stomatitis.
Use soft toothbrush/electric razor to prevent bleeding; take measures to prevent bruising.

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16
Q

What type of drug is paclitaxel?

A

Taxane

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17
Q

What are the brand names of paclitaxel?

A

Taxol, Abraxane

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18
Q

What does paclitaxel treat?

A

Ovarian cancer, breast cancer, Kaposi’s sarcoma, non-small cell lung cancer (investigational use for many other types of cancer, such as leukemia, gastrointestinal cancers, head/neck cancers, etc.)

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19
Q

What are some adverse effects of paclitaxel?

A

Bradycardia (usually lasts only during infusion), peripheral neuropathy, bone marrow suppression, allergic reaction to Taxol form of paclitaxel: difficulty breathing, swelling of face, throat, rash, itching

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20
Q

What forms are available for paclitaxel?

A

Available for IV use

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21
Q

What are some specific administration considerations for paclitaxel?

A

Available in two forms:
Taxol: contains a solvent system and requires pretreatment with an antihistamine, corticosteroid, and a histamine2-receptor blocker 30 minutes before infusion to prevent allergic reactions; non-PVC tubing and IV bag necessary; infuse over 3 hours using an in-line IV filter.
Abraxane: no pretreatment or special equipment required; take care in dissolving drug in vial; infuse over 30 minutes without an in-line filter.
Expect to infuse paclitaxel every 2 to 3 weeks.

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22
Q

What are some specific client instructions for paclitaxel?

A

Inform client that frequent monitoring will be done.
Report palpitations or chest pain.
Immediately report swelling of mouth, throat, neck, rash, itching, and difficulty breathing.

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23
Q

What kind of drug is imatinib?

A

Targeted antineoplastic drug

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24
Q

What is the name brand for imatinib?

A

Gleevec

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25
Q

What is imatinib used to treat?

A

Initial treatment of chronic myeloid leukemia, acute lymphoblastic leukemia, treats certain types of metastatic gastrointestinal tumors

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26
Q

What are some adverse effects of imatinib?

A

GI symptoms: N/V/D, musculoskeletal pain, muscle cramping, rash, bone marrow suppression (neutropenia and thrombocytopenia), fluid retention

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27
Q

What forms are available for imatinib?

A

Only available in oral form

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28
Q

What are some specific administration considerations for imatinib?

A

Give with at least 8 oz of water and a meal.
Dosage depends on disease being treated and phase of CML.

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29
Q

What are some specific client instructions for imatinib?

A

Report muscle and joint aches or muscle cramping. Report rash and itching. Report SOB, and edema in extremities.

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30
Q

What type of drug is cytarabine?

A

Pyrimidine analog

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31
Q

What is the name brand of cytarabine?

A

Cytosar-U

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32
Q

What does cytarabine treat?

A

Acute myelocytic and acute lymphocytic leukemias, non-Hodgkin’s lymphoma, prevents and treats meningitis caused by leukemia (intrathecal form), maintains remission in the above cancers

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33
Q

What are some adverse reactions to cytarabine?

A

GI effects: nausea, vomiting, stomatitis, bone marrow suppression
Intrathecal form: arachnoiditis, causes nausea, vomiting, headache, and fever

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34
Q

What forms are available for cytarabine?

A

Available for subcutaneous, IV, and intrathecal use

35
Q

What are some specific administration considerations for cytarabine?

A

Give SQ form every 1 to 4 weeks.
Give intrathecal form daily for 4 consecutive days or one dose every 4 days.
Decrease normal dose in renal impairment.
Administer dexamethasone, sometimes used as an antiemetic, along with intrathecal cytarabine.

36
Q

What are some specific client instructions for cytarabine?

A

Take antiemetic as prescribed. Eat small, frequent meals.
Advise client why dexamethasone is being given.
Report nausea, vomiting, headache.
Immediately report pregnancy.

37
Q

What type of drug is mercaptopurine?

A

Purine analog

38
Q

What is the name brand of mercaptopurine?

A

Purinethol

39
Q

What does mercaptopurine treat?

A

Acute lymphocytic and acute myelogenous leukemia in adults and children, may cause temporary remission in chronic granulocytic leukemia

40
Q

What are some adverse effects of mercaptopurine?

A

GI symptoms: N/V/D, intestinal ulceration, bone marrow suppression, liver toxicity ( usually mild

41
Q

What forms are available for mercaptopurine?

A

Available only in oral form

42
Q

What are some specific administration considerations for mercaptopurine?

A

Give dose once daily with or without food.
Base dose on client’s weight.

43
Q

What are some specific client instructions for mercaptopurine?

A

Report GI symptoms. Take prescribed antiemetic as needed. Report abdominal pain or discomfort, jaundice, and decreased appetite.
Use a reliable method of birth control during chemotherapy, and immediately report pregnancy.

44
Q

What type of drug is cisplatin?

A

Platinum compound

45
Q

What is cisplatin used for?

A

Used in combination with other chemotherapy agents to treat metastatic testicular or ovarian cancer, used off-label to treat head and neck cancers or carcinoma of the bladder or uterine lining

46
Q

What are some adverse effects of cisplatin?

A

Severe nausea/vomiting occurs about 1 hour after infusion, bone marrow suppression, kidney toxicity and ototoxicity, peripheral neuropathy, anaphylactic reaction soon after IV infusion begins from allergy to platinum

47
Q

What form is available for cisplatin?

A

Only available in IV form

48
Q

What are some specific administration considerations for cisplatin?

A

Base dose on client’s weight.
Do not use any equipment containing aluminum when administering platinum compounds.
Wear gloves and take care when preparing solution; flush area with water if solution touches skin.

49
Q

What are some specific client instructions for cisplatin?

A

Report nausea and vomiting.
Take prescribed antiemetics as needed for several days following treatment.
Critical time for low platelet and WBC counts is 18 to 23 days after each treatment/ Report flank pain, decreased urination, weight gain, itching skin, nausea/vomiting, loss of appetite, and dry mucous membranes.
Report hearing loss, vertigo, or tinnitus.
Report numbness, tingling, and decreased sensation in hands or feet.
Immediately report rash, swelling of airway, or shortness of breath.

50
Q

What kind of drug is carmustine?

A

Nitrosoureas

51
Q

What is the name brand of carmustine?

A

BiCNU

52
Q

What is carmustine used for?

A

Primary and metastatic brain tumors, lymphomas, multiple myeloma, melanoma, hepatoma, gastrointestinal adenocarcinoma

53
Q

What are some adverse effects of carmustine?

A

Severe GI effects: nausea/vomiting, bone marrow suppression, decreased lung function (possibly leading to pulmonary fibrosis), vesicant drug: local thrombophlebitis, extravasation, and tissue damage caused by high dose carmustine IV therapy; extravasation near joints, such as hand, wrist, and antecubital space, may result in tissue necrosis, tendon, or nerve injury

54
Q

What forms are available for carmustine?

A

Available in topical and IV form

55
Q

What are some specific administration considerations for carmustine?

A

Topical: Gliadel; wafer implanted into brain tissue following brain cancer tumor removal.
IV: Dose calculated by client’s body mass, infused every 6 weeks. Decrease dose if bone marrow suppression occurs.

56
Q

What are some specific client instructions for carmustine?

A

Critical time for low platelet and WBC counts is 4 to 6 weeks after each carmustine IV treatment.
Report SOB, cough, or fever.
Immediately report IV site pain, redness, and swelling.
Use a reliable method of birth control, and immediately report pregnancy if it occurs.

57
Q

What type of drug is cyclophosphamide?

A

Nitrogen mustard

58
Q

What does cyclophosphamide treat?

A

Leukemias, multiple myelomas, lymphomas, solid tumors (adenocarcinomas) of head, ovary, or breast, and lung cancer

59
Q

What are some adverse effects of cyclophosphamide?

A

Alopecia, severe GI effects N/V, bone marrow suppression, kidney toxicity manifested frequently by hemorrhagic cystitis, electrolyte imbalance: hyperkalemia, hyponatremia most common

60
Q

What forms are available for cyclophosphamide?

A

Available in oral or IV form

61
Q

What are some specific administration considerations for cyclophosphamide?

A

Give oral dose without food for best absorption, or with food is severe nausea and vomiting occur

62
Q

What are some specific client instructions for cyclophosphamide?

A

Tell client early about alopecia so they can obtain a wig, hat, or scarf if desired; inform client that hair will grow back following cyclophosphamide.
Void before dose is given and increase fluid intake as able.
Report hematuria or pain with voiding.
Report weakness, palpitations, and muscle twitching.
Use reliable method of birth control, and immediately report pregnancy.

63
Q

What type of drug is trastuzumab?

A

Monoclonal antibody

64
Q

What is the brand name for trastuzumab?

A

Herceptin

65
Q

What does trastuzumab treat?

A

Specific type of metastatic breast cancer (tumors with human epidermal growth factor receptor 2 [HER2], which includes up to 30% of metastatic breast cancers)

66
Q

What are some adverse effects of trastuzumab?

A

Allergic reaction (usually occurs with first dose or within 12 hours of that infusion): bronchospasm with wheezing, hypotension, SOB, urticaria.
Infusion reaction, chills, fever, flu-like symptoms during infusion.
Cardiac symptoms: heart failure, dysrhythmias.
CNS symptoms: headache, insomnia, dizziness, paresthesias.
GI symptoms: N/V/D.

67
Q

What forms are available for trastuzumab?

A

Available in IV form

68
Q

What are some specific administration considerations for trastuzumab?

A

Infuse weekly at a dosage based on client’s weight; first week begins with a larger loading dose.
Do not mix dose with dextrose solutions.

69
Q

What are some specific client instructions for trastuzumab?

A

Immediately report rash, SOB, and wheezing.
Report chills, and flu-like symptoms that occur during an infusion of trastuzumab.
Report SOB, edema of extremities, and palpitations.
Report persistent headache, insomnia, dizziness, numbness, and tingling of extremities.
Avoid hazardous activities, such as driving, until effects are known.

70
Q

What types of drugs are interferon alfa-2a and interferon alfa-2b?

A

Interferon

71
Q

What are the name brands of interferon alfa-2a/alfa-2b?

A

Roferon-A, Intron A

72
Q

What does interferon alfa-2a/alfa-2b treat?

A

Hairy cell leukemia, chronic myelogenous leukemia (interferon alfa-2a), malignant myeloma (interferon alfa-2b), Kaposi’s sarcoma

Interferon alfa-2a also treats chronic Hep C and interferon alfa-2b treats chronic Hep B and C

73
Q

What are some adverse effects of interferon alfa-2a/alfa-2b?

A

Flu-like symptoms: fatigue and fever
CNS symptoms: dizziness, insomnia, depression, tremor, headache
Bone marrow suppression
GI symptoms: abdominal pain, anorexia, weight loss, diarrhea

74
Q

What forms are available for interferon alfa-2a/alfa-2b?

A

Available in SQ, IM, and IV form

75
Q

What are some specific administration considerations for interferon alfa-2a/alfa-2b?

A

Give the prescribed biologic response modifier to the client; also verify doses, as they are usually prescribed in million units (MU), which should not be confused with mL.
Route of administration and amount of dilution depends on disorder.
Inject diluent into vial and gently rotate vial until contents are clear before withdrawing dose.

76
Q

What are some specific client instructions for interferon alfa-2a/alfa-2b?

A

Premedicate with acetaminophen if flu-like symptoms occur.
Report CNS symptoms.
Avoid hazardous activities until effects are known.

77
Q

What type of drug is methotrexate?

A

Folic acid analog

78
Q

What is the name brand of methotrexate?

A

Trexall

79
Q

What does methotrexate treat?

A

Acute leukemias, lymphomas, choriocarcinoma (uterine cancer associated with pregnancy), cancer of the head, neck, and pelvis

Treatment of rheumatoid arthritis and psoriasis; both disorders have an autoimmune component

80
Q

What are some adverse effects of methotrexate?

A

Bone marrow suppression, oral and gastrointestinal ulceration, liver damage, pulmonary fibrosis

81
Q

What forms are available for methotrexate?

A

Available in oral, IM, IV, and a preservative-free intrathecal form

82
Q

What are some specific administration considerations for methotrexate?

A

For high-dose cancer therapy, give leucovorin, a reduced form of folic acid, as an antidote for severe bone marrow suppression occurring with folic acid analogs.
Give doses at varied intervals, depending on the type of cancer being treated.
Oral doses may be given with or without food.
IV form: incompatible with multiple other drugs in solutions.

83
Q

What are some specific client instructions for methotrexate?

A

Report oral ulcerations. Report oral or abdominal pain. Report blood in vomitus or stool. Avoid ingesting alcohol. Report yellowing of the skin and eyes immediately. Report SOB. Contraception should be used during and immediately following therapy for both men and women.

Med Surg 2 (1 decks)

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