drug therapy for immune and hematopoietic stimulation

Question 1

name an erythropoiesis-stimulating agent

Answer 1

epoetin alpha

Question 2

describe the action of erythropoiesis-stimulating agents

Answer 2

synthetic erythopoitein, stimulates RBC production

Question 3

what are some uses of erythropoiesis-stimulating agents

Answer 3

anemia

chemo induced or kidney failure

Question 4

describe the pharmacokinetics of erythropoiesis-stimulating agents

Answer 4

• IM, IV
• 11-14 days onset

Question 5

what are some adverse effects of erythropoiesis-stimulating agents

Answer 5

• hypertension (increase preload, increased work of heart, increased BP)
• black box warning: risk for MI

Question 6

name a contraindication of erythropoiesis-stimulating agents

Answer 6

severe hypertension

Question 7

what are some nursing considerations for erythropoiesis-stimulating agents

Answer 7

• monitor RBCs, Hgb, Hct
• goal Hgb no more than 12
• monitor BP
• need iron for drug to work

Question 8

describe patient teaching for erythropoiesis-stimulating agents

Answer 8

• patient may be on an iron supplement
• vitamin C helps with iron absorbtion (fruit, juice, strawberries)

Question 9

name come colony stimulating factors

Answer 9

• filgrastim
• pegfilgrastim

Question 10

describe the action of colony stimulating factors

Answer 10

stimulates neutrophil production in bone marrow (increases WBCs)

Question 11

what are colony stimulating factors used for

Answer 11

• prevent infection
• neutropenia from bone marrow transplant or chemo

Question 12

what are some adverse effects of colony stimulating factors

Answer 12

• fatigue
• flu like symptoms
• bone pain

Question 13

describe administration of colony stimulating factors

Answer 13

do not give 24hrs befoe or after chemo

wont get a good response

Question 14

name an interferon

Answer 14

interferon alfa 2b

Question 15

describe the action of interferons

Answer 15

increase overall response of immune system to viral infection or cancer

Question 16

what are interferons used for

Answer 16

treatment of viral infections and certain cancers

melanoma, genital warts, hep B

Question 17

what are some adverse effects of interferons

Answer 17

• flu like symptoms
• hematologic effects (low plts and wbcs)
• autoimmune or fatal infections

Question 18

what are some contraindications of interferons

Answer 18

• liver failure
• pregnancy (teratogenic)

Question 19

give an example of interleukins

Answer 19

aldesleukin

Question 20

describe the action of interleukins

Answer 20

stimulates immune system and inhibits tumor growth

stimulates T cells

Question 21

what are interleukins used for

Answer 21

• kidney cancer
• melanoma

Question 22

what are some adverse effects of interleukins

Answer 22

high risk drug per FDA with multiple black box warnings:
- anaphylaxis
- severe hypotension
- lethargy

med given by oncologist

Question 23

what are some nursing considerations for immune stimulants

Answer 23

• acetaminophin for bone pain/flu sx
• increase fluid intake
• flu like sx last up to 24hrs

Question 24

describe patient education for immune stimulants

Answer 24

• maintain healthy immune system
• keep well hydrated
• avoid pregnancy

Question 25

the expected outcome of administering epoietin alpha to a pt with chronic kidney failure is:

1) decreased bleeding
2) increased WBC production
3) increased RBC production
4) improved renal function

Answer 25

3) increased RBC production

Question 26

the nurse is administering filgrastim to a patient after bone marrow transplant. which lab value should the nurse monitor to determine effectiveness?

1) Hgb
2) basophils
3) Hct
4) neutrophils

Answer 26

4) neutrophils

Question 27

the nurse knows a patient taking epoitin alpha should also be taking:

1) iron
2) potassium
3) antacids
4) analgesics

Answer 27

1) iron