Mod 8- Immune Modulators Flashcards
When are immune stimulants used?
To energize the immune system when it needs help fighting a specific pathogen
When are immune suppressants used?
To block the effects of the immune system in organ transplant and autoimmune disorders
T/F Children need higher doses of immune suppressants?
TRUE
T/F barrier contraceptives should be used when taking immune modulators
TRUE- contraindicated in pregnancy/ lactation
3 Types of Immune stimulants
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
ADE of Interferons
FLU like symptoms- lethargy, myalgia, arthralgia, anorexia, N/ HA, dizziness, bone marrow depression increases risk of infection
T/F Interferons have too many drug interactions and a drug guide should be consulted prior to administration
FALSE- no known interactions
Interferon Prototype
Interferon Alfa-2b
2 Interleukin Medications
aldesleukin- human interleukin make by using e. coli bacteria
Oprelvekin- newer agent produced by DNA technology
Actions of interleukins
Increases the number of natural killer cells and lymphocytes; activated cellular immunity and inhibits tumor growth
Aldesleukin is used to treat
renal carcinomas and AIDS
Oprelvekin is used to treat
prevention of severe thrombocytopenia after myelosuppressive chemotherapy
ADE of interleukins
Flu like symptoms
respiratory difficulties
depression w/ suicidal ideation
Interleukin prototype
aldesleukin
What is a colony-stimulating factor medication?
Filgrastim
When are Colony-Stimulating Factors indicated?
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
Contraindications for Colony-Stimulating Factors
Allergy, pregnancy, lactation, renal/ hepatic disease
Radiation & chemotheraphy, will cancel meds out if given during or immediately after
ADE of Colony-Stimulating Factors
Generalized pain and bone pain d/t long bone production of WBC
GI, HA, fatigue, alopecia and dermatitis
Drug/ drug interactions with Colony-Stimulating Factors
increase if myeloproliferative effects of sagramostim when combined w/ lithium or corticosteroids
Colony-Stimulating Factor Prototype
Filgrastim
What lab tests should be done for a pt taking immune stimulants
CBC w/ differential, kidney/ liver functions
What is an immune modulator medication?
Apremilast blocks release of various cytokines and activation of lymphocytes, decreasing immune activity
Contraindications for immune modulators
Pregnancy, lactation, severe liver impairment
T/F there are unknown ADE and Drug/Drug interactions w/ immune modulators (suppressant)
TRUE
What does the T- and B-Cell Suppressor cyclosporine do?
suppression of rejection in transplants, RA, psoriasis
What does the T- and B-Cell Suppressor azathioprine do?
prevention of rejection in renal hemotransplants; tx of RA
What does the T- and B-Cell Suppressor Glatiramer do?
Reduction of # of relapses of MS in adults
What does the T- and B-Cell Suppressor mycophenolate do?
prevents rejection after renal or heart transplant in adults
What does the T- and B-Cell Suppressor tacrolimus do?
Prevention os rejection after heart or liver transplant
ADE of T- and B-Cell Suppressors
Risk for infection
development of neoplasms d/t blocking of immune system
hepatotoxicity, renal toxicity, renal dysfunction, pulmonary edema
Drug/ drug interactions for T- and B-Cell Suppressor
increased risk of toxicity if combined w/ other drugs are that hepatotoxic/ nephrotoxic
How long do you take T- and B-Cell Suppressor Cyclosporine?
Remainder of life
What medication is an Interleukin Receptor Antagonist?
Anakinra
What is the action of Interleukin Receptor Antagonists?
used to treat RA
blocks activity of interleukin-1
Contraindications for Interleukin Receptor Antagonists 🦠
allergy to E Coli; pregnancy, lactation, renal impairment, and immunosuppression or active infection
ADE of Interleukin Receptor Antagonists
HA, sinusitis, nausea, diarrhea
Drug/ drug interactions w/ Interleukin Receptor Antagonists
Etanercept (immune suppressant) may cause severe, life-threatening infections
Monoclonal Antibodies (-mab) Medications
Adalimumab
certolizumab
golimumab
infliximab
ADE of Monoclonal Antibodies
most severe is pulmonary edema, fluid retention, flu-like symptoms
Monoclonal Antibodies prototype
Bevacizumab
Why do you assess weight for someone taking an immune suppressant?
fluid retention r/t pulmonary edema
What is a nursing diagnosis r/t immune suppressants
Risk for infection r/t immune suppression
