Immune System Medications Flashcards by Daisy Perez

Antimetabolite indicated for immune disorders such as RA, psoriasis, certain cancers, and for the dissolvement of ectopic pregnancies

Methotrexate (Rheumatrex)

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Methotrexate (Rheumatrex) side effects

Infections, hepatotoxicity, bone marrow suppression, stomatitis

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Methotrexate (Rheumatrex) black box warning

Fetal toxicity/death

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Methotrexate (Rheumatrex) nursing care

Monitor for S/S of infection, liver function, and CBC

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Medication indicated for prevention of organ rejection in transplant patients, UC, and RA

Cyclosporine (Sandimmune)

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Cyclosporine (Sandimmune) side effects

Infections, hepatotoxicity, nephrotoxicity, hirsutism, hypertension, tremor

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Cyclosporine (Sandimmune) nursing care

Notify provider right away of s/s of infection, monitor liver and renal function

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Cyclosporine (Sandimmune) black box warning

Development of tumors

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Doxorubicin (Adriamycin) is an example of an

Antineoplastic agent

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Doxorubicin (Adriamycin) side effects

GI upset, alopecia, bone marrow suppression (anemia, neutropenia, thrombocytopenia), cardiac toxicity, red discoloration of urine/sweat/tears

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Doxorubicin (Adriamycin) black box warning

Bone marrow suppression, cardiac toxicity, leukemia

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Doxorubicin (Adriamycin) nursing care

Monitor for infection, cardiac function, and CBC levels; administer antiemetics for N/V

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Vincristine is an example of an

Antineoplastic agent

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T or F: vincristine causes bone marrow suppression

FALSE

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Vincristine side effects

Peripheral neuropathy, phlebitis (IV site), GI upset, alopecia

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Vincristine nursing care

Administer antiemetics for N/V, monitor for signs of neuropathy, use central line for infusion

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Cyclophosphamide (Cytoxan) is an example of an

Antineoplastic agent

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Cyclophosphamide (Cytoxan) side effects

Bone marrow suppression, GI upset, alopecia, hemorrhagic cystitis (inflammation and bleeding from bladder)

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Cyclophosphamide (Cytoxan) nursing care

encourage patient to increase fluid intake to 2-3 L/day during therapy (to help prevent hemorrhagic cystitis)
monitor for blood in urine
monitor CBC levels
give antiemetics for N/V
wear gloves when handling and wash hands IMMEDIATELY after handling

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Antineoplastic agent indicated for the prevention and treatment of breast cancer

Tamoxifen (Nolvadex)

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Tamoxifen (Nolvadex) side effects

Hot flashes, vaginal bleeding, increased risk of thromboembolism, Hypercalcemia, bone pain, increased risk of uterine and endometrial cancer

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Tamoxifen (Nolvadex) nursing care

Monitor CBC and calcium levels during therapy; advise patient to report bone pain

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Antineoplastic immune modifier indicated for cancers and viral infections such as hepatitis

Interferon alpha-2B

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Interferons are proteins that _________ the body’s immune response to tumors/viruses and _________ cancer proliferation

Enhance; slow

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Interferon side effects

Flu-like symptoms (fever, muscle aches, chills, lethargy) bone marrow suppression, cardiotoxicity, hepatotoxicity, dyspnea, alopecia, GI upset, psychiatric disorders

Interferon nursing care

Monitor: CBC, cardiac function (EKG), liver function, infection, bleeding

Interferon black box warning

Risk for psychiatric, autoimmune, ischemic, and infectious disorders

Azithromycin (Zithromax) and erythromycin (E-Mycin) are examples of

Macrolides (anti-infectives)

Macrolides are indicated for

Bacterial infections (such as respiratory)

T or F: Macrolides are effective against MRSA

FALSE

Macrolides are _________ meaning they work by inhibiting protein synthesis and slowly bacterial growth

Bacteriostatic

Macrolides side effects

GI upset, dysrhythmias (including torsades de pointe), ototoxicity, rash

Administration of Macrolides

Take on empty stomach with a full glass of water

Lincosamide anti-infective indicated for severe bacterial infections

Clindamycin (Cleocin)

Clindamycin (Cleocin) inhibits protein synthesis and can be _________ or _________ depending on concentration

Bactericidal; bacteriostatic

Clindamycin (Cleocin) side effects

GI upset, diarrhea, superinfection (C.diff)

Clindamycin (Cleocin) nursing care

Monitor bowel movements

Aminoglycoside indicated for serious bacterial infections

Gentamicin (Garamycin)

Gentamicin (Garamycin) works by inhibiting protein synthesis and is _________ (kills bacteria)

Bactericidal

Gentamicin (Garamycin) side effects

Ototoxicity, nephrotoxicity, vertigo, ataxia

Gentamicin (Garamycin) nursing care

Monitor for: tinnitus, hearing loss, kidney function, peak/trough levels (d/t narrow therapeutic range)

Route of administration for gentamicin (Garamycin)

IM or IV

Doxycycline (Vibramycin) and tetracycline (Sumycin) are examples of _________ indicated for a wide variety of bacterial infections including acne, Lyme disease, STDs, Rocky Mountain spotted fever

Tetracyclines

Tetracyclines work by preventing protein synthesis and inhibiting bacterial growth (____________)

Bacteriostatic

Side effects of tetracyclines

GI upset, tooth discoloration in children (and fetuses), hepatotoxicity, photosensitivity, superinfection (C.diff)

Tetracyclines should not be given to

Pregnant women or children under 8 years old

Tetracyclines patient education

Take on empty stomach and with full glass of water; wear sunscreen; use additional form of protection as these meds decrease effectiveness of oral contraceptives

What foods/meds decrease absorption of tetracyclines

Dairy products, foods high in calcium and iron, antacids

Antibiotic indicated for serious bacterial infections and antibiotic-associated C.diff

Vancomycin

Vancomycin side effects

Ototoxicity, nephrotoxicity, infusion reaction (“red man syndrome” — slow the infusion down, diphenhydramine), phlebitis (can be prevented if administered via PICC line)

Vancomycin nursing care

Monitor peak/trough levels and adjust dose depending on creatinine (kidney function)

Vancomycin should be infused over ___ hour(s) or more

Side effects of penicillin G and amoxicillin (Moxatag)

GI upset (diarrhea, N/V), allergic reaction (dyspnea, rash), renal toxicity, superinfection (c.diff)

Penicillin G and amoxicillin (Moxatag) should not be given to patient with a history of

Allergies to penicillin or cephalosporin

Penicillin G and amoxicillin (Moxatag) nursing care

Monitor for allergic response and bowel function

Extended release penicillin indicated for moderate to severe bacterial infections, including many penicillin-resistant bacteria

Piperacillin/tazobactam (Zosyn)

Side effects of piperacillin/tazobactam (Zosyn)

Diarrhea, superinfection (C.diff), allergic reaction, phlebitis (at IV site), hepatotoxicity, nephrotoxicity

Piperacillin/tazobactam (Zosyn) should not be given to patients with a history of allergies to

Penicillin or cephalosporin

Piperacillin/tazobactam (Zosyn) nursing care

Monitor for: allergic reactions, bowel function, liver and renal labs

Cephalexin (Keflex), ceftriaxone (Rocephin), ceftazidime (Tazicef), and cefepime (Maxipime) are examples of _________ indicated for bacterial infections

Cephalosporins

Side effects of cephalosporins

GI upset, allergic reaction, superinfections (C.diff)

Cephalosporins should not be given to patients with a history of allergies to

Penicillin

Cephalosporins patient education

DO NOT consume alcohol during therapy; take with food

Imipenem/cilastatin (Primaxin) is an example of a broad spectrum _________ indicated for serious bacterial infections

Carbapenem

Carbapenems side effects

GI upset, rash, superinfection (C.diff), seizures

Patients allergic to penicillin and/or cephalosporin may have an allergic reaction to

Carbapenems

Ciprofloxacin (Cipro) and levofloxacin are examples of __________ antibiotics indicated for bacterial infections including UTIs, bone/joint infections, respiratory infections, and anthrax

Fluoroquinolone

Side effects of fluoroquinolones

Diarrhea, superinfection (C.diff), tendon rupture, photosensitivity

Fluoroquinolones nursing care

Monitor bowel movements, advise patient to wear sunscreen, monitor liver function (these meds may increase liver lab values)

Trimethoprim/sulfamethoxazole (Bactrim) is an example of a _________ antibiotic indicated for bacterial infections including UTIs, bronchitis, pneumonia, and otitis media

Sulfonamide

Side effects of trimethoprim/sulfamethoxazole (Bactrim)

GI upset, blood dycrasias, photosensitivity, crystalluria, rash, Steven’s-Johnson syndrome

Trimethoprim/sulfamethoxazole (Bactrim) nursing care

Assess for sulfa allergies; monitor CBC; advise patient to wear sunscreen and increase fluid intake (to prevent crystalluria)

Antibiotic used to treat UTIs

Nitrofurantoin (Macrobid)

Side effects of nitrofurantoin (Macrobid)

GI upset, hypersensitivity, pulmonary toxicity, peripheral neuropathy, brown discoloration of urine

Antibiotic indicated for bacterial and protozoan infections

Metronidazole (Flagyl)

Metronidazole (Flagyl) side effects

GI upset, metallic taste, dark urine, dizziness, headache

Metronidazole (Flagyl) patient education

DO NOT drink alcohol

TB medications (HINT: RIPE)

Rifampin, isoniazid, pyrazinamide, ethambutol

Key side effect of all TB drugs

Hepatotoxicity

Rifampin side effects

Orange secretions, GI upset, decreased effectiveness of oral contraceptives

Isoniazide side effect

Neuropathy

Pyrazinamide side effect

Arthralgia (Joint pain)

Ethambutol side effect

Changes in vision

TB meds patient education

NO alcohol; family members will need to be tested for TB; sputum samples needed every 2-4 weeks; patients with active TB will need to wear masks in public

Patients are no longer infectious with TB after ___ negative sputum samples

TB meds nursing consideration

Monitor for signs of liver damage

Amphotericin B (Fungizone), ketoconazole, and fluconazole (Diflucan) are examples of

Systemic antifungals

Key side effect of all antifungals

Hepatotoxicity

Side effects of amphotericin B

GI upset, nephrotoxicity, bone marrow suppression, phlebitis — HIGHLY toxic (only for life threatening fungal infections)

Side effects of ketoconazole

GI upset, arrythmias

Side effects of fluconazole

GI upset, rash

Systemic antifungals nursing care

Monitor for liver dysfunction (pale stools, dark urine, N/V, fatigue, jaundice)

Acyclovir (Zovirax), ganciclovir (Cytovene), oseltamivir (Tamiflu), and zanamivir (Relenza) are examples of

Systemic antivirals

Antiviral indicated for herpes and varicella-zoster viruses

Acyclovir (Zovirax)

Acyclovir (Zovirax) side effects

Phlebitis, GI upset, nephrotoxicity

Systemic antiviral indicated for cytomegalovirus

Ganciclovir (Cytovene)

Side effects of ganciclovir (Cytovene)

Phlebitis, GI upset, nephrotoxicity, bone marrow suppression

Antivirals indicated for influenza A and B

Oseltamivir (Tamiflu) and zanamivir (Relenza)

Systemic antiviral patient education

These meds do not CURE conditions

Oseltamivir (Tamiflu) and zanamivir (Relenza) should be administered within ___ hrs of influenza symptoms

Immune System Medications Flashcards

(100 cards)