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Pharmacology HOSA > Immunomodulating Drugs > Flashcards

Immunomodulating Drugs Flashcards

(105 cards)

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1
Q

Cytokines

A

Proteins, which aid cells, signal the immune response, and stimulate cells to move to the site of inflammation

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2
Q

Erythrocytes

A

Red blood cells, one of several formed elements in the blood

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3
Q

Erythropoiesis

A

Process of making RBCs

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4
Q

Folinic acid rescue

A

In chemo, the technique of administering leucovorin after a large dose of methotrexate, thereby allowing normal calls to survive aka leucovorin rescue

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5
Q

Hematopoiesis

A

Undifferentiated stem cells are stimulated to become specific blood cells

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6
Q

Intrinsic factor

A

Substance produced by the cells in the stomach and necessary for the absorption of vitamin B12

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7
Q

Iron deficient anemia

A

Condition resulting wen the body doesn’t have enough iron to meet its need for iron

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8
Q

Leukocytes

A

White blood cells (WBCs)

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9
Q

Macrocytic anemia

A

Anemia resulting from abnormal formation (enlargement) or erythrocytes

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10
Q

Megakaryocytes

A

Precursor cell to the platelets

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11
Q

Megaloblastic anemia

A

Anemia characterized by large, abnormal, immature erythrocytes circulating in the blood, results from folic acid deficiency

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12
Q

Thrombopoiesis

A

Formation of platelets (thrombocytes)

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13
Q

CSFs MOA

A

Glycoproteins that act on the hematopoietic cells used to stimulate proliferation, differentiation, and maturation of WBCs

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14
Q

CSFs use

A

Used to treat or prevent infection caused by chemo induced neutropenia during solid tumor treatment, neutropenia during bone marrow transplantation, production of stem cells for harvest before bone marrow transplant, neutropenia in those susceptible to symptomatic chronic infection

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15
Q

Filgrastim administrations

A

Started at least 24 hours after chemo and continued until ANC is at least 10,000. It isn’t recommended to use for more than 2 weeks, and should be stopped 1 day before the next chemo cycle

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16
Q

Pegfilgrastim administration

A

Given as a single dose between chemo cycles

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17
Q

Sargamostim use

A

Following BMT, following induction chemo used with leukemia, and stimulate stem cells for harvest

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18
Q

CSFs side effects

A

Bone pain, hypertension, nausea, vomiting, alopecia, hypersensitivity

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19
Q

Filgrastim precautions

A

Hypothyroidism,

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20
Q

CSFs precautions

A

Pregnancy (cat

C) and lactation

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21
Q

Pegfilgrasim precautions

A

Can cause a sickle cell crisis in those with the disease

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22
Q

CSFs interactions

A

Can stimulate cancer cell growth in cancer types that are stimulated by growth factors, and an even higher increase in neutrophil count can occur when taken with lithium

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23
Q

Hypersensitivity reactions from CSFs should be treated by

A

Antihistamines, steroids and bronchodilators

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24
Q

Oprelvekin MOA

A

Stimulates thrombopoiesis (precessions of making platelets)

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25
Oprelvekin use
Prevent severe thrombocytopenia associated with chemo for solid tumor treatment, and reduces the need for several platelet transfusions, and ITP (acute or chronic bleeding disorder)
26
Oprelvekin administrations
Started at least 6 hours after a Chemo cycle, and drug is continued until platelet count reaches 50,000. Isn’t recommended for more than 21 days and is stopped 2 days before next chemo cycle
27
ITP signs
Signs of bleeding (purple areas on skin), and fatigue
28
How to treat ITP
Corticosteroids or removal of spleen
29
Eltrombopag use
ITP
30
Romiplostim use
ITP
31
Thrombopoietin side effects
Fluid retention, peripheral edema, dyspnea, syncope, fever, allergic reactions, tachycardia, palpitation, atrial fibrillation, arrhythmias resulting in stroke or pulmonary edema, capillary leak syndrome
32
Eltrombopag side effects
Can be toxic to the liver, LFTs are done prior to starting and every 2 weeks
33
Oprelvekin contraindications
Shouldn’t be used in people getting chemo that is very myelosuppressive
34
Thrombopoietin Drugs precautions
Renal failure, heart failure, or atrial arrhythmia, children under 12, pregnancy (cat C)
35
Eltrombopag discontinuation considerations
Platelet levels may decrease to lower than original diagnoses counts
36
Romiplostim discontinuation considerations
Platelet levels may decrease below original diagnosed counts
37
Ifosfamide interactions
Severe hypokalemia can occur with thrombopoietins
38
Oprelvekin contraindications
Lactation,
39
Oprelvekin pregnancy cat
C
40
Anemia in chronic kidney disease
Anemia resulting from a reduced production of erythropoietin, a hormone secreted by the kidneys that stimulates production of RBCs
41
Pernicious anemia
Anemia resulting from lack of secretion by the gastric mucosa of the intrinsic factor essential to the formation of RBCs and the absorption of vitamin B12
42
Folic acid deficiency
Anemia occurring because of a dietary lack of folic acid, a component necessary in the formats of RBCs
43
Erythopoiesis stimulating agents (ESAs) MOA
Glycoproteins that stimulate and regulate the production of erythrocytes
44
ESAs use
Treat anemia associated with chronic kidney disease, chemo, zidovudine for HIV and post surgical blood replacement in place of allogeneic transfusions
45
Darbepoetin alfa use
Anemia associated with chronic kidney disease in people receiving dialysis and in those not receiving dialysis, and they elevate and maintain RBC levels and decrease need for transfusions
46
Methoxy polyethylene-epoetin B use
Anemia associated with chronic kidney disease in both people receiving and not receiving dialysis, and they also elevate and maintain RBC levels and decrease need for transfusions
47
ESAs side effects
Hypertension, headache, nausea, vomiting, diarrhea, rashes, fatigue, arthralgia and skin reaction at injection site
48
Epoetin Alfa side effects nature
Well tolerated when used to maintain hemoglobin levels no higher than 12
49
Darbepoetin Alfa side effects nature
Well tolerated when used to maintain hemoglobin levels no higher than 12
50
Methoxy polyethylene side effects nature
Well tolerated when used to maintain hemoglobin levels no higher than 12
51
Epoetim Alfa contraindications
Uncontrolled hypertension, those needing an emergency transfusion, and those with an allergy to human albumin
52
Darbepoetin Alfa contraindications
Uncontrolled hypertension
53
ESAs risks
Polycythemia (am overload of RBCs in the circulation) can occur if hemoglobin isn’t monitored
54
What can polycythemia result in
Increased mortality, serious cardio or thromboembolic events, and possible tumor progression in cancer patients
55
Epoetin Alfa precautions
Hypertension, Hearst disease, HF, history of seizures, pregnancy (cat C), and lactation
56
Darbepoetin Alfa precautions
Hypertension, heart disease, HF, history of seizures, pregnancy (cat C), and lactation
57
Iron preparations MOA
Elevating the serum iron concentration, which replenishes hemoglobin and depleted iron stores
58
Iron administration
Usually oral, best absorbed on an empty stomach
59
Iron preparations side effects
GI irritation, nausea, vomiting, constipation, diarrhea, darker stools, headache, backache, allergic reactions
60
Parenteral iron side effectiveness
Soreness and inflammation
61
IM iron side effects
Sterile abscesses at IM site, brown discoloration of skin
62
IV iron side effects
Phlebitis at the injection site
63
Iron contraindications
Hemochromatosis or hemolytic anemia,
64
Iron precautions
Aspirin allergy
65
Iron interactions
Decreased Gi absorption of the antibiotic, decreased absorption of levothyroxine, decreased effect of levodopa and methyldopa absorbed acid (vitamin C) increased iron absorption
66
Folic acid use
Treating megaloblastic anemias caused by a deficiency of folic acid, can decrease risk of neural tube defects (given to pregnancy and lactating women)
67
What to do if patient with folic acid deficiency can’t take oral meds
Leuvcovorin
68
Folic acid side effects
Few side effects, but parenteral administration can rarely cause an allergic reaction
69
Folic acid contraindications
Pernicious anemia or other anemia where vitamin B12 is deficient
70
Folic acid pregnancy cat
A
71
Leucovorin contraindications
Pernicious anemia or other anemias where vitamin B12 is deficient
72
F9ic acid interactions
Increases in seizure activity with hydantoins, signs of folate deficiency with sulfasalazine
73
Vitamin B12 uses
For patients with a vitamin B12 deficiency which is seen in people with a strict vegetarian lifestyle, total gastrectomy or subtotal gastric resection, intestinal diseases (ulcerative colitis or sprue), gastric carcinoma, congenital decrease in the number of gastric cells that secrete intrinsic factor, and is also used to perform the schilling test, which is used to diagnose pernicious anemia
74
Vitamin B12 side effects
Mild diarrhea and itching, and signs that signal a marked increase in RBC production
75
Marked increase in RBC production side effects
Acne, peripheral vascular thrombosis, HF, and pulmonary edema
76
Vitamin B12 contraindications
Allergy to cyanocobalamin
77
Vitamin B12 oral pregnancy cat
A
78
Vitamin B12 parenteral pregnancy cat
C
79
Vitamin B12 precautions
Pregnancy, pulmonary disease and anemia
80
Vitamin B12 interactions
Alcohol, neomycin, and colchicine decrease oral vitamin B12 absorption
81
Immunosuppressive Drugs MOA
Reduces the strength of the body’s own immune system
82
Immunosuppressive Drugs use
Psoriasis, multiple sclerosis, crohn disease, or ulcerative colitis or rheumatoid arthritis, and as anti rejection drugs
83
Drugs used to suppress immunity include
Corticosteroids, calcineurin inhibitors, mTOR inhibitors, IMDH inhibitors, biologics, and monoclonal antibodies
84
Anti-organ rejection agents ex
Azathioprine, basiliximab, belatacept, cyclosporine, mycophenolate mofetil, sirolimus, tacrolimus,
85
Immunosuppressive agents for crohn disease and ulcerative colitis ex
Adalimumab, certolizumab pegol, golimumab, infliximab, vedolizumab
86
Immunosuppressive Drugs for hepatitis C ex
Peginterferon Alfa-2B, interferon alfacon-1
87
Immunosuppressive Drugs for hepatitis B ex
Peginterferon Alfa-2a, peginterferon Alfa-2b
88
Immunosuppressive Drugs for multiple sclerosis ex
Adalimumab, dimethyl fumarate, fingolimod, glatiramer, interferon beta-1A, peginterferon beta-1A, interferon beta-1B, natalizumab, teriflunomide,
89
Immunosuppressive drugs for plaque psoriasis ex
Adalimumab, alefacept, apremilast, cyclosporine, efalizumab, etanercept, golimumab, infliximab, secukinumab, ustekinumab
90
Rheumatoid arthritis immunosuppressive drugs ex
Abatacept, adalimumab, anakinra, azathioprine, canakinumab, certolizumab pegrol, cyclosporine, etanercept, golimumab, infliximab, rilonacept, tocilizumab
91
Immunosuppressive Drugs side effects
Headache, chills, and fever, itching, dizziness, and myalgias
92
Calcineurin inhibitors side effects
Gum hyperplasia, hair growth, tremors
93
Monoclonal antibodies side effects
Nauseated, or GI distress, acute infusion reactions (typically 1st dose and within 30 mins)
94
Immunosuppressive agents contraindications
Live virus vaccines,
95
People on monoclonal antibodies should be monitored for
Neutropenia
96
IMDH inhibitors interactions
Severe decreases in WBCs, RBCs and platelets are seen with ACE inhibitors
97
Calcineurin inhibitors interactions
Increased risk of arrhythmia with antiarrhythmics,
98
People on calcineurin inhibitors should be monitored for
Blood urea nitrogen levels should be monitored because calcineurin inhibitors are nephrotoxic
99
Immunosuppressants interactions
Grapefruit and other citrus
100
Increased hemoglobin can cause an increased risk of
Myocardial infarction and stroke
101
Iron anaphylactic reactions signs
Dyspnea, urticaria, rashes, itching and fever
102
Hematopoietic factors for infection ex
Filgrastim, pegfilgrastim, sargramostin,
103
Hematopoietic factors for bleeding ex
Eltrombopag, oprelvekin, romiplostim
104
Adjuvant immunostimulant agents
Plerixafor
105
Hematopoietic factors for anemia ex
Darbepoetin Alfa, epoetin Alfa, methoxy polyethylene, peginesatide, ferrous, folic acid, iron dextran, iron sucrose, leucovorin, sodium ferric gluconate complex, vitamin B12,

Pharmacology HOSA (37 decks)

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