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MSII Medication Review > Lewis 34 - Hematologic Disorders > Flashcards

Lewis 34 - Hematologic Disorders Flashcards

1
Q

MOA/Class

deferoxamine, deferasirox, deferiprone

A

Binds to the iron for excretion by the kidneys

Chelating agent / heavy metal antagonist

Tucker 49

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2
Q

Side Effects

deferoxamine, deferasirox, deferiprone

A

red urine, abdominal pain, ototoxicity, oculotoxicity

Tucker 49

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3
Q

Nursing Considerations

deferoxamine, deferasirox, deferiprone

A

Monitor urine output

Tucker 49

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4
Q

Indications

deferoxamine, deferasirox, deferiprone

A

Iron overload

Tucker 49

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5
Q

MOA/Class

hydroxyurea

A

Myelosuppression. (Inhibits reticulocyte production.)

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6
Q

Side Effects

hydroxyurea

A

Bone marrow suppression.

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7
Q

Nursing Considerations

hydroxyurea

A

Risk for infection, bleeding, low SpO2/fatigue.

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8
Q

Indications

hydroxyurea

A

Polycythemia, sickle cell anemia, hematologic cancers

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9
Q

MOA/Class

Aspirin (ASA)

A

Inhibits the synthesis of prostaglandin (pain)
Inhibits platelet aggregation by inhibiting the synthesis of thromboxane A2 and prostacyclin.

Salicylate

Tucker 16

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10
Q

Side Effects

Aspirin (ASA)

A

GI upset, bleeding, salicylism

Tucker 16

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11
Q

Nursing Considerations

Aspirin (ASA)

A

Risk for Reye’s syndrome when given to children or with concurrent chicken pox or influenza.
Salicylism manifestations - tinnitus, sweating, headache, dizziness, acidosis. Give activated charcoal and/or bicarbonate.
Dose of 81 mg is typically for antiplatelet activity. May give larger dose for antiplatelet effect in acute situations (i.e., active MI).
Risk for hypersensitivity in patients with asthma and/or nasal polyps.

Tucker 16

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12
Q

Indications

Aspirin (ASA)

A

Mild-moderate pain/fever
Inflammatory conditions (IBD, RA, etc.)
MI/TIA prevention

Tucker 16

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13
Q

MOA/Class

allopurinol

A

Inhibits the production of uric acid by inhibiting xanthine oxidase.

Xanthine oxidase inhibitor

Tucker 16

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14
Q

Side Effects

allopurinol

A

Rash - discontinue use immediately if rash develops.

Tucker 16

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15
Q

Nursing Considerations

allopurinol

A

Increased risk of bleeding when given with warfarin.
Maintain hydration to avoid renal calculi.

Tucker 16

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16
Q

Indications

allopurinol

A

Hyperuricemia
(Gout, high levels of cell destruction [i.e., cancer treatment])

Tucker 16

17
Q

MOA/Class

Prednisone, methylprednisolone

A

Steroids stabilize leukocytes (WBCs) preventing the release of intracellular chemical/inflammatory mediators

Systemic glucocorticoid/corticosteroid

Tucker 36

18
Q

Side Effects

Prednisone, methylprednisolone

A

Growth suppression, elevated blood glucose, weight gain
GI upset (tolerated best in AM with food/milk)
Osteoporosis (long-term use)

Tucker 36

19
Q

Nursing Considerations

Prednisone, methylprednisolone

A

Taper dose when stopping to prevent adrenal insufficiency

Tucker 36

20
Q

Indications

Prednisone, methylprednisolone

A

Used to decrease inflammation/immune responses.

Tucker 36

21
Q

MOA/Class

azathioprine, cyclosporine, tacrolimus

A

Suppresses cell-mediated immunity

Immunosuppressant

Tucker 17

22
Q

Side Effects

azathioprine, cyclosporine, tacrolimus

A

Bone marrow suppression. Hepatotoxicity.

Tucker 17

23
Q

Nursing Considerations

azathioprine, cyclosporine, tacrolimus

A

Increased risk for infection and cancers. Avoid live-virus vaccines. Good infection control implementation. Avoid grapefruit juice.

Tucker 17

24
Q

Indications

azathioprine, cyclosporine, tacrolimus

A

Crohn’s disease/UC, transplant rejection, RA

Tucker 17

25
Q

MOA/Class

alendronate, zolendronate acid

A

Slows bone resorption (degeneration)

Tucker 37

26
Q

Side Effects

alendronate, zolendronate acid

A

GI and musculoskeletal pain, constipation, esophageal burns

Tucker 37

27
Q

Nursing Considerations

alendronate, zolendronate acid

A

Take on an empty stomach 30-60 minutes before food. Adminsitered with a full glass of water. Remain upright 30 minutes after administration.
Ensure adequate calcium intake during therapy.

Tucker 37

28
Q

Indications

alendronate, zolendronate acid

A

osteoporosis, Paget’s disease, multiple myeloma, hypercalcemia

Tucker 37

29
Q

MOA/Class

filgrastim

A

Increases the production of neutrophils in the bone marrow.

Colony stimulating factor

Tucker 17

30
Q

Side Effects

filgrastim

A

N/V, generalized pain, bone pain

Tucker 17

31
Q

Nursing Considerations

filgrastim

A

Teach and implement good infection control mechanisms.
Monitor absolute nuetrophil count (ANC). Implement neutropenic precautions for ANC <1.
Most effective when given at least 24 hours after myelosuppressive therapies.

Tucker 17

32
Q

Indications

filgrastim

A

Neutropenia associated with bone marrow transplants, chemo, and blood-related cancers.

Tucker 17

MSII Medication Review (13 decks)

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