UNIT 11 Granulocyte Colony- Stimulating Factor

Question 1

What drug class is Filgrastim?

A. NSAID
B. Proton Pump Inhibitor
C. Non opiod analgesic
D.Granulocyte Colony- Stimulating Factor

Answer 1

D.Granulocyte Colony- Stimulating Factor

Question 2

What is the action of Filgrastim?

Answer 2

increase white blood cells- works inside the bone marrow

Action
 Increases production, maturation, and activation of neutrophils and enhances their phagocytosis

 Uses
 To decrease the incidence of infection in patients who are taking chemotherapy agents or having bone marrow transplants that are myelosuppressive.

Also used in patients with chronic neutropenia

Question 3

Is it a normal finding for any signs of infection when a patient is taking Filgrastim?

A. No
B. Yes

Answer 3

A. No

the therapeutic action of the drug is to decrease the incidence of infection. This would not be a normal finding and would need to be reported.

Question 4

Side effects of Filgrastim

Answer 4

Side effects
 GI Upset
 Skeletal pain
 Joint pain flu-like symptoms, headache, cough/chest pain

Question 5

Adverse effect of Filgrastim

Answer 5

Adverse reactions
 Allergy
 Splenomegaly(enlarged spleen)

Question 6

Contraindications of Filgrastim

Answer 6

Contraindications
 Allergy to E. Coli
 24 hours before or after cytotoxic chemo

 Interactions
 No major interactions noted

Question 7

Monitor for any flu like symptoms for filgrastim?

A. No
B. Yes

Answer 7

B. Yes

Question 8

Should the patient be taking Filgrastim within 24hours of chemotherapy?

A. No
B. Yes

Answer 8

A. No

The patient should not be taking Filgrastim with 24hrs of chemotherapy.

the health care providers have to wait 24hrs after chemotherapy to administer Filgrastim

Question 9

What lab value should you check when administering Filgrastim or Epoetin?

Answer 9

Assessment
 Obtain a medical and medication history
 Obtain baseline labs including CBC
 Family’s ability to self-administer
 Head to toe assessment
 Allergies

Question 10

Nursing Interventions for FiLGRASTIM And Epoetin

Answer 10

Nursing interventions
 Monitor patient for side effects focusing on vitals signs, fluid
balance, DVT, cardiac, respiratory
 Increase fluids to 2L day
 Monitor for signs and symptoms of anemia (epoetin alfa) and
plan care accordingly. Monitor for SE/AR
 Monitor for signs and symptoms of infection (filgrastim) and
plan care accordingly. Monitor for SE/AR
 Evaluation
 Epoetin Alfa – increase in RBC’s
 Filgrastim – No s/s of infection

Question 11

How do you know Filgrastim worked?

Answer 11

No signs and symptoms of infection

Question 12

Which nursing intervention is designed to treat the most
common side effects of filgrastim?
a. Provide antihypertensives to lower blood
pressure.
b. Provide bronchodilators to treat wheezing.
c. Provide antibiotics to treat secondary infections.
d. Provide analgesia to relieve bone pain.

Answer 12

Answer: D
 Rationale: Patients receiving filgrastim (Neupogen) therapy
frequently experience pain in their bones, requiring analgesics