UNIT F Pharmacology

Question 1

Cyclophosphamide

Determine the (1) pharmacological treatments for specific disorders including uses and routes of administration, (2) side effects, (3) adverse reactions, (4) medication classification (i.e. ACE inhibitor, aminoglycoside) , and (5) nursing interventions of the following medication

Answer 1

1. This medication is an analogue of nitrogen mustard and has activity against neoplastic disease including Hodgkin and non-Hodgkin lymphoma, acute and chronic lymphocytic leukemia, multiple myeloma, breast and ovarian carcinoma, lung cancer and retinoblastoma. This medication can also be used for lupus nephritis and has shown to prevent progressive renal scaring, preserve renal function, induce renal remission, and decrease end-stage renal failure. This medication can be given orally or intravenously. Oral cyclophosphamide is well absorbed in the GI system.
2. Side effects include hemorrhagic cystitis and increased pigmentation of the nail beds.
3. Adverse reactions include infertility, fatigue, alopecia, and mucositis (stomatitis).
4. This medication is classified as an alkylating drug.
5. The nurse should educate the patient about staying well-hydrated while taking this medication to prevent hemorrhagic cystitis. Advise patient about good oral hygiene with a soft toothbrush for stomatitis. Have patient use a soft toothbrush when platelet count is less than 50,000. Assess for use of alternate and complementary therapies that may interact with chemotherapy drugs. These alternate and complementary therapies include garlic, ginkgo, echinacea, St. John wort, astragalus, and mistletoe.

Question 2

Methotrexate (MTX)

Determine the (1) pharmacological treatments for specific disorders including uses and routes of administration, (2) side effects, (3) adverse reactions, (4) medication classification (i.e. ACE inhibitor, aminoglycoside) , and (5) nursing interventions of the following medication

Answer 2

1. used to treat malignant and nonmalignant conditions (e.g., RA and psoriasis). MTX effects cells that have a high metabolic rate, such as neoplasms, hair follicles, endothelium, cells of the GI tract, fetal cells, and bone marrow; it is used to treat leukemias and cancers of the GI tract, head and neck, breast and ovaries. Because MTX causes apoptosis to fetal cells, it can be used for ectopic pregnancy. Can be given PO or IV
2. NSAIDs given with or before after intermediate of high doses MTX, can lead to severe hematologic and GI toxicity. NSAID may mask signs of fever and fever. Older adults may be more sensitive to toxicity and adverse events.
   3.
3. Folate antimetabolite
   5.

Question 3

Rituxan

Answer 3

Rituximab is used to treat certain types of cancer (such as non-Hodgkin’s lymphoma, chronic lymphocytic leukemia). It works by slowing or stopping the growth of cancer cells. Some brands of rituximab are also used to treat rheumatoid arthritis and can decrease joint pain and swelling.
Rituximab suppresses the immune system. Therefore, serious fungal, bacterial, and new or reactivated viral infections (for example, hepatitis B or C, shingles) can occur during or after treatment with rituximab. Generally, rituximab is avoided in the presence of active, significant infections

Question 4

Corticosteroids

Answer 4

Corticosteroids
Action
Suppress inflammatory process associated with tumor growth
Use
Treat leukemias, multiple myeloma, inflammatory bowel disease, transplant rejection
Side effects/adverse reactions
Hyperglycemia, insomnia, irritability, euphoria, psychosis, delirium, fluid retention, weakness

Question 5

Filgrastim

Answer 5

Filgrastim injection products (Granix, Neupogen, Nivestym, Zarxio) are used to decrease the chance of infection in people who have non myeloid cancer (cancer that does not involve the bone marrow) and are receiving chemotherapy medications that may decrease the number of neutrophils
Filgrastim is a growth factor that stimulates the production, maturation, and activation of neutrophils (a type of white blood cell). Filgrastim also stimulates the release of neutrophils from the bone marro

Question 6

Epotein alfa (Epogen)

Answer 6

This medication is used to treat anemia (low red blood cell count) in people with long-term serious kidney disease (chronic kidney failure), people receiving zidovudine to treat HIV, and people receiving chemotherapy for some types of cancer (cancer that does not involve the bone marrow or blood cells). It may also be used in anemic patients to reduce the need for blood transfusions before certain planned surgeries that have a high risk of blood loss (usually given with an anticoagulant/”blood thinner” medication such as warfarin to lower the risk of serious blood clots). Epoetin alfa works by signaling the bone marrow to make more red blood cells. This medication is very similar to the natural substance in your body (erythropoietin) that prevents anemia.