T- and B- Cell Suppressors

Question 1

T- and B- Cell Suppressors Drug Names

Answer 1

Cyclosporine
Azathioprine
Glatiramer
Mycophenolate
Tacrolimus

Question 2

T- and B- Cell Suppressors Therapeutic Actions

Answer 2

• Block antibody production by B cells, inhibit suppressor and helper T cells, and modify the release of interleukins and of T cell growth factor

Question 3

T- and B- Cell Suppressors Indications

Answer 3

• Cyclosporine: Suppression of rejection in variety of transplants; rheumatoid arthritis, psoriasis
• Azathioprine: Prevention of rejection in renal hemotransplants; treatment of rheumatoid arthritis
• Glatiramer: Reduction of number of relapses in multiple sclerosis in adults
• Mycophenolate: Prevention of rejection after renal or heart transplant in adults
• Tacrolimus: Prevention of rejection after heart or liver transplant

Question 4

T- and B- Cell Suppressors Contraindications and Cautions

Answer 4

Contraindications:
• Pregnancy and lactation
• Known allergy
• Hepatic disease

Question 5

T- and B- Cell Suppressors Adverse Effects

Answer 5

• Increased risk for infection and development of neoplasms due to their blocking effect on the immune system as well as hepatotoxicity, renal toxicity, renal dysfunction, and pulmonary edema.

Question 6

T- and B- Cell Suppressors:

Assessment

Answer 6

Assess:
Hx: Contraindications and cautions
Physical: vital signs, weight, temp, orientation and reflexes (baseline)
Labs: baseline ECG

Question 7

T- and B- Cell Suppressors:

Diagnosis

Answer 7

Dx:

• Acute pain: to CNS, GI and flu-like effects
• Risk for infection related to immune suppression
• Imbalanced nutrition: less than body requirements, related to nausea and vomiting
• Deficient knowledge: drug therapy

Question 8

T- and B- Cell Suppressors:

Implementation

Answer 8

Implementation:
• Arrange for laboratory tests before and periodically during therapy
• Administer the drug as indicated; instruct the patient and a significant other if injections are required
• Protect the patient from exposure to infections and maintain a strict aseptic technique for any invasive procedures
• Monitor nutritional status during therapy; provide small, frequent meals, mouth care, and nutritional consultation
• Instruct females in use of barrier contraceptives
• Suggest another method of feeding the baby
• Provide thorough patient teaching

Question 9

T- and B- Cell Suppressors:

Evaluation

Answer 9

Eval:
Response to the drug 
Adverse effects 
Effectiveness of comfort measures Compliance with the regimen
Effectiveness of the teaching plan