Mod 8- Immune Modulators

Question 1

When are immune stimulants used?

Answer 1

To energize the immune system when it needs help fighting a specific pathogen

Question 2

When are immune suppressants used?

Answer 2

To block the effects of the immune system in organ transplant and autoimmune disorders

Question 3

T/F Children need higher doses of immune suppressants?

Answer 3

TRUE

Question 4

T/F barrier contraceptives should be used when taking immune modulators

Answer 4

TRUE- contraindicated in pregnancy/ lactation

Question 5

3 Types of Immune stimulants

Answer 5

Interferons- naturally released in response to viral invasion
Interleukins- stimulate cellular immunity and inhibit tumor growth
Colony-stimulating factors- stimulate bone marrow to produce more WBCs

Question 6

ADE of Interferons

Answer 6

FLU like symptoms- lethargy, myalgia, arthralgia, anorexia, N/ HA, dizziness, bone marrow depression increases risk of infection

Question 7

T/F Interferons have too many drug interactions and a drug guide should be consulted prior to administration

Answer 7

FALSE- no known interactions

Question 8

Interferon Prototype

Answer 8

Interferon Alfa-2b

Question 9

2 Interleukin Medications

Answer 9

aldesleukin- human interleukin make by using e. coli bacteria
Oprelvekin- newer agent produced by DNA technology

Question 10

Actions of interleukins

Answer 10

Increases the number of natural killer cells and lymphocytes; activated cellular immunity and inhibits tumor growth

Question 11

Aldesleukin is used to treat

Answer 11

renal carcinomas and AIDS

Question 12

Oprelvekin is used to treat

Answer 12

prevention of severe thrombocytopenia after myelosuppressive chemotherapy

Question 13

ADE of interleukins

Answer 13

Flu like symptoms
respiratory difficulties
depression w/ suicidal ideation

Question 14

Interleukin prototype

Answer 14

aldesleukin

Question 15

What is a colony-stimulating factor medication?

Answer 15

Filgrastim

Question 16

When are Colony-Stimulating Factors indicated?

Answer 16

to treat the incidence of infection in patients w/ bone marrow suppression, to decrease neutropenia associated w/ bone marrow transplant, and help w/ various blood related cancers

Question 17

Contraindications for Colony-Stimulating Factors

Answer 17

Allergy, pregnancy, lactation, renal/ hepatic disease

Radiation & chemotheraphy, will cancel meds out if given during or immediately after

Question 18

ADE of Colony-Stimulating Factors

Answer 18

Generalized pain and bone pain d/t long bone production of WBC
GI, HA, fatigue, alopecia and dermatitis

Question 19

Drug/ drug interactions with Colony-Stimulating Factors

Answer 19

increase if myeloproliferative effects of sagramostim when combined w/ lithium or corticosteroids

Question 20

Colony-Stimulating Factor Prototype

Answer 20

Filgrastim

Question 21

What lab tests should be done for a pt taking immune stimulants

Answer 21

CBC w/ differential, kidney/ liver functions

Question 22

What is an immune modulator medication?

Answer 22

Apremilast blocks release of various cytokines and activation of lymphocytes, decreasing immune activity

Question 23

Contraindications for immune modulators

Answer 23

Pregnancy, lactation, severe liver impairment

Question 24

T/F there are unknown ADE and Drug/Drug interactions w/ immune modulators (suppressant)

Answer 24

TRUE

Question 25

What does the T- and B-Cell Suppressor cyclosporine do?

Answer 25

suppression of rejection in transplants, RA, psoriasis

Question 26

What does the T- and B-Cell Suppressor azathioprine do?

Answer 26

prevention of rejection in renal hemotransplants; tx of RA

Question 27

What does the T- and B-Cell Suppressor Glatiramer do?

Answer 27

Reduction of # of relapses of MS in adults

Question 28

What does the T- and B-Cell Suppressor mycophenolate do?

Answer 28

prevents rejection after renal or heart transplant in adults

Question 29

What does the T- and B-Cell Suppressor tacrolimus do?

Answer 29

Prevention os rejection after heart or liver transplant

Question 30

ADE of T- and B-Cell Suppressors

Answer 30

Risk for infection
development of neoplasms d/t blocking of immune system
hepatotoxicity, renal toxicity, renal dysfunction, pulmonary edema

Question 31

Drug/ drug interactions for T- and B-Cell Suppressor

Answer 31

increased risk of toxicity if combined w/ other drugs are that hepatotoxic/ nephrotoxic

Question 32

How long do you take T- and B-Cell Suppressor Cyclosporine?

Answer 32

Remainder of life

Question 33

What medication is an Interleukin Receptor Antagonist?

Answer 33

Anakinra

Question 34

What is the action of Interleukin Receptor Antagonists?

Answer 34

used to treat RA

blocks activity of interleukin-1

Question 35

Contraindications for Interleukin Receptor Antagonists 🦠

Answer 35

allergy to E Coli; pregnancy, lactation, renal impairment, and immunosuppression or active infection

Question 36

ADE of Interleukin Receptor Antagonists

Answer 36

HA, sinusitis, nausea, diarrhea

Question 37

Drug/ drug interactions w/ Interleukin Receptor Antagonists

Answer 37

Etanercept (immune suppressant) may cause severe, life-threatening infections

Question 38

Monoclonal Antibodies (-mab) Medications

Answer 38

Adalimumab
certolizumab
golimumab
infliximab

Question 39

ADE of Monoclonal Antibodies

Answer 39

most severe is pulmonary edema, fluid retention, flu-like symptoms

Question 40

Monoclonal Antibodies prototype

Answer 40

Bevacizumab

Question 41

Why do you assess weight for someone taking an immune suppressant?

Answer 41

fluid retention r/t pulmonary edema

Question 42

What is a nursing diagnosis r/t immune suppressants

Answer 42

Risk for infection r/t immune suppression