Pharmacology exam #4 - Study guide Flashcards
comprehensive part/ Endocrine/ oncology drugs and immunosuppressive drugs
Cadaveric Transplantation
a dead person’s health organ transplanted to another individual in need of the organ (life-share_
Immune reconstitution inflammation Syndrome
a syndrome related to a disease-or pathogen-specific inflammatory response in patients with antiretroviral therapy being initiated or changed.
Induction Therapy
Treatment that provides these immunosuppression with drugs designed to diminish antigen presentation and T-cell response.
Living-donor transplantation
a living person organ donated to someone in need of the organ
Opportunistic Infection
Infections that occur in immunocompromised individuals who have a low white blood cell count.
Postexposure prophylaxis
the treatment regimen instituted after exposure to the HIV (human immunodeficiency virus).
Transplant rejection
this occurs when the immune system of the transplant recipient attacks the transplanted organ.
viral Load
a measurement of the amount of a virus circulating in the blood
Window Period
the time delay from infection to a positive test result
Alkylating Drug
these are killers for all phases of the cancer cell cycle. example is cyclophosphamide
Antimetabolites
this chemotherapy can cross the blood brain barrier one of the contraindications is pregnant patients and narrow therapeutic index
Antineoplastic drugs
an agent that destroys all cancer cells
Antitumor antibiotics
these are highly protein bound and can be cardiotoxic these are colored red.
Apoptosis
cell death
Biologic response modifiers
these enhance, direct, and restore the body’s immune system
Capillary-leak syndrome
rare disorder that is from extravasation of plasma proteins and fluids in the extravascular space appearance of severe hypotension/ multiorgan dysfunction.
Cell cycle-nonspecific
medications that can act during any part of the cell cycle.
Cell-cycle specific
only work during a specific part of the cell cycle.
Colony-stimulating factors
help creates red blood cells and white blood cells
Combination Chemotherapy
the combination of 2 or more chemotherapy drugs to treat cancer in patients
Cytostatic therapy
inhibits extra cell growth of cancer cells.
cytotoxic therapy
this treatment kills the cancer cells
Erythropoietin
creates red blood cells also called EPO
Hormone agonists/antagonists
these are not meant to be chemotherapy but they mask the cancer cells and use prevention to producing hormones
Metastasis
cancer spread by the blood or through the tumor to other areas of the body
Mitosis
this is a cell division
Monoclonal antibodies
antibodies made by one clone of cells or a cell line
Efavirenz
Class of medication/purpose:
Antiretroviral treats HIV-1 or HIV-2
Side effects: rash, nausea, diarrhea, CNS effects, amnesia, dizziness, impaired concentration
Adverse reactions: allergic reaction, convulsion, liver failure, neuropathy, abnormal vision, hyperlipidemia
Education: the feeling of being drunk or stoned should clear up within a few weeks
Tenofovir
Class of medication/purpose of drug: antiretroviral treats HIV-1 and Hepatits B
SE: N/V/D, Insomnia, depression, fever, chest pain
AE: Latic acidosis, hepatomegaly, renal insuficiency,
teaching: teach about safe sex practices, inform patients to avoid otc certain medications, Inform this is not a cure it treats the symptoms only and lower the amount of virus transmissible to another recipient.
Zidovudine
Medication class/purpose of drug: Antiretroviral therapy used to trat HIV infection and prevention of maternal-fetal HIV transmission
SE: Headache, malaise, Nausea, anorexia, vomiting, asthenia
AE:severe anemia, lactic acidosis, neutropenia, pancytopenia, sezures, CHF, myelosuppression
Teaching: safe practices of sex and do not drive until you are adjusted on this medication as it can cause fainting or dizziness,
Atazanavir
Medication class/ purpose of drug: antiretroviral therapy
SE: Rash, Nausea, vomiting, diarrhea, cough, fever
AE: atrioventricular block, hyperglycemia, Jaundice, lipodystrophy
Teaching: safe sex practices/
Cyclosporine
Medication Class/ Medication purpose: immunosuppressant these are used to prevent transplant rejection.
SE: Hypertension, hirsutism, infection, headache,
AE: transplant rejection, hypertension,
Teachings: do not go into large crowded areas as this drug puts you at a greater risk of infection, wear a mask when you go outside to prevent contracting a infection, drink bottled water only no tap water
Sirolimus
medication class/purpose of drug: Immunosuppressant
SE: rash, acne, photosensitivity
AE: Anemia, hepatotoxicity and pleural effusion
Teaching points: avoid large crowds and contact sports.
we will need to provide routine labsto check on your kidney and for infection.
Cyclophosphamide
Medication class/purpose of drug: Antineoplastic drug
SE: N/V/D, anorexia, alopecia
AE: severe bladder inflammation, low WBC count (leukopenia), low platelet count less than 50,000, tumor lysis syndrome
Teaching point:
take early in the day to prevent the accumulation of the drug in the bladder, empty the bladder every 2-3 hours to prevent a bladder infection, use sunblock because this medication can make you sensitive to the sun,
do not crush this medication
Nadir
the time at which the WBC count is the lowest between 7-10 days after treatment
Doxorubicin
Medication class/purpose of drug: antitumor antibiotics attak tumors it is used in combination chemotherapy
SE: complete alopecia, stomatitis, anorexia, N/V/D, rash, reddish color urine
AE: cardiotoxicity, myelosuppression
teaching: use protective precautions avoid large crowds as you have a low WBC count meaning you are at a greater risk of infection.
Low WBC count
Leukopenia
Low red blood cell count
Anemia
low platelet count
Thrombocytopenia
Vincristine
medication class/purpose of medication: plant alkaloid prevent cell division from occurring of the cancer cell
SE:peripheral neuropathy, loss of deep tendon reflexes, phlebitis, constipation, cramps
AE: Neurotoxicity, sensory loss, hypotension, visual disturbances, hyponatremia,
life threatening-> intestinal necrosis, seizures, coma, acute bronchospasm, bone marrow suppression
Teaching: teach patient the signs of peripheral neuropathy, teach patients the signs of respiratory compromise, teach patient to report constipation, abdominal pain and difficulty with urination.
Imatinib
Medication class/ purpose of drug: antineoplastic tyrosine kinase inhibitor meant to indice apoptosis of the cancer cell
SE: edema, fluid retention, GI irritation, hematologic, dyscrasias, hepatotoxicity, electrolyte abnormalities
AE: cerebral edema, cardiac tamponade, increase ICP and papilledema
teaching: report symptoms immediately of black coffee ground looking output, yellowing of the skin report immediately to your provider, avoid grapefruit juice
targeted therapies
-mab, -mib, -nibs
Rituximab
Medication class/purpose of drug: Monoclonal antibody targeted therapy
SE: bone marrow suppression with pancytopenia, tumor lysis syndrome, hypotension, night sweats, joint and muscle aches, headache
AE: infusion reactions, cardiac dysrhythmias, heart failure,
Teaching: monitor glucose more frequently for diabetic patients, teach proper waste of agents,
Filgrastim
Medication class/purpose of drug: colony stimulating factor decrease the incidence of infection in patients
SE: N/V/D, fever, fatigue, skin rash, anorexia, sore throat, dizziness, dyspnea
AE: Splenomegaly, thrombocytopenia, MI, Capillary leak syndrome,
teaching: use protective precautions
Somatropin
Purpose: given for people with growth horomone deficiency secretes growth horomone deficiency from pituitary gland
Routes: PO and IM
SE:paresthesia, arthralgia, myalgia, peripheral edema, weakness, and cephalgia
AE: Diabetes,seizures, intracranial hypertension, and secondary malignancy
Nursing considerations: epiphyseal closure
Teachings: do not take antidiabetic medication with this medication as it can cause hypoglycemia.
bromocriptine
Purpose of medication: inhibits the secretion of growth hormone is part of the pituitary gland
SE:hyperhidrosis, cephalgia, and fatigue
AE:chest pain, hypertension, and elevated hepatic transaminases (cardiac effects, seizures, CVA) (neuro effects)
Teachings: take this with food
Vasopressin/desmospressin
purpose of medication: ADH promotes water reabsorption from the renal tubules from the posterior pituitary glands treats Diabetes Insipidus (dry inside) it slows urine loss
SE/AE: hyponatremia, cephalgia, dyspepsia, diarrhea, nausea, and vomiting. Seizures may occur due to hyponatremia. Hypotension and tachycardia can occur due to hypovolemia.
Conivaptan/tolvaptan
Purpose: increase the excretion of urine for syndrome of inappropriate antidiuretic hormone (SIADH)
SE: related to fluid loss ( contipation, dry mouth, thirst, dizziness, orthostatic hypotension )
what are nursing considerations for somatropin and bromocriptine?
monitor blood glucose, electrolytes/ must be administered before epiphyses are fused/ drugs should be tapered, do not abruptly stop medication
what are some nursing considerstions to know about Conivaptan and vasopressin/desmopressin
monitor vital signs, fluid status, OU, daily weight
Levothyroxine Sodium
Medication purpose: to treat low levels of T3 and T4 replacement therapy for hypothyroidism
SE: nervousness, tremors, diarrhea, and insomnia
AE: thyroid storm
teaching: should be taken on an empty stomach at least 30-60 minutes before breakfast
thyroid storm
can result from abrupt withdrawal from medication
symptoms/signs: tachycardia, flushed skin, dysrhythmias, fever, heart failure, apathy, confusion, behavioral changes, and from long term vascular collapse and hypotension
Methimazole
purpose of medication: anti-thyroid drugs used for hyperthyroidism used in thyrotoxic crisis and in preparation for subtotal thyroidectomy
Nursing considerations: monitor vital signs, monitor serum T3/T4/TSH, administer thyroid replacement drug 30-60 minutes before breakfast, administer antithyroid drugs with meals, check labels before using OTCs, encourage medical alert tag, warn foods that inhibit thyroid secretion, warn of iodine effects, do not abruptly stop medications, advise to report signs of hypothyroidism/hyperthyoidism
Calcitriol
Purpose of the medication: hypocalcemia treatment secretes calcium in the PTH
SE: signs of hypercalcemia (fatigue, weakness, N/V/D, lethargy)
AE: late signs of hypercalcemia (anorexia, photophobia, dehydration, cardiac arrhythmias, decreased libido, hypertension, sensory disturbances, hypercalciuria, hypercalcemia, and hyperphosphatemia.)
causes of hypocalcemia
Vitamin D deficiency, renal impairment, diuretic therapy
Cinacalcet
MOA: reduces PTH secretion from mimicing calcium in the blood
Purpose of the medication: reduce PTH secretion in the blood
Teaching: Check serum calcium 1 wk after initiating treatment and 2 months thereafter, administer with food
nursing considerations: patients with hypocalcemia
Biphosphates
ending: -dronate
Purpose of medication: for osteoporosis
from the parathyroid gland
teaching: adequate intake of vitamin D and calcium
SE: abdominal and Musco skeletal pain, GI upsets, hypotension, and fever
Nursing considerations: esophageal constructures
normal calcium level
9-11 mg/dl
nursing consideration for parathyroid medications or calcitrol or cincalet or -dronate medication
take 30 minutes before first food in the am- must sit or stand upright or at least 30 minutes after administration
Prednisone
purpose of medication: decrease inflammation
diagnosis: addisons disease adrenal hyposecretion (addisons disease)/ adrenal hypersecretion (cushing syndrome)
SE: increased appetite, sweating, headache, flushing, mood changes, depression, psychosis,
tachycardia, hypertension
AE: abrupt withdrawal of medication leading to tachycardia
Rapid acting insulin names
insulin Lispro/ Insulin aspart
Rapid acting insulin Onset/ duration/ peak
Onset: about minutes
Duration: 2-5 hours
Peak: 30-90 minutes
(clear vial)
Fast acting insulin names
Insulin regular
fast acting insulin onset duration peak (clear)
Onset: 30 minutes
Duration:4-12 hours
Peak: 1.5-3.5 hours
Intermediate acting insulin names
NPH-isophane
Intermediate acting onset duration peak
Onset: 1-2 hours
Duration: 14-24 hours
peak: 4-12 hours
Long acting insulin name
insulin glargine/insulin detemir
Insulin glargine
(long acting)
onset of action: 1 hour
duration: 24 hours
administered at Bedtime
what is the only type of insulin given IV and in what situation would it be given IV and what is the peak
fast acting regular insulin would be given if patient was in DKA and the peak is 15 minutes
what is a sulfonureas
-izide/ -buride
purpose: stimulate pancreatic beta cells to secrete more insulin
what is a Biguanides
Metformin
Purpose: regulate blood glucose monitoring in type 2 diabetes mellitus
dizziness, headache, weakness, flushing chills
AE: palpitations, chest pain, hypoglycemia, metabolic acidosis
Insulin Detemir
(long acting)
Duration 24 hours
Peak 6-8 hours
what are the 2 types of insulin that can be in the same syringe
Regular/ NPH
(clear before cloudy)
what antidiabetic medications are contraindicate in heart disease
Pioglitazone and Rosiglitazone
what are signs of digoxin toxicity
halos around lights, bradycardia, nausea, vomiting, headahces, malaise
what is the antidote for digoxin
Digoxin-immune Fab
what is a nitrates
-nit
how long does nitroglycerin effects last for
30-60 minutes
nitroglycerin side effects and adverse effects
hypotension, dizziness, flusing, weakness, and faintness
what are calcium channel blockers
Verapamil, nifedipine, and diltiazem
what is a sodium channel blocker
Lidocaine
Transplant rejection
Elevated temp, drop in blood pressure, elevated hr, increased respirations
