Flashcards in Immunosuppressant Drugs Deck (19)
Describe the Mechanism of Action of Immunosupressants.
Immunosuppressants work by suppressing T-lymphocytes, preventing their involvement in the immune response.
What is the primary indication of the immunosuppressant class of drugs?
Prevention of organ rejection
What are the contraindications to the use of Immunosuppressants?
1) Renal Failure
2) Hepatic Failure
4) Radiation Therapy
What are some of the Interactions caused by Tx with Immunosuppressants?
1) ⬇ Effectiveness of vaccines
2) Grapefruit juice may increase the bioavailability of cyclosporine by 20% to 200%.
3) St. John's Wort ⬇ effectiveness of cyclosporine
4) ⬇ effectiveness with concurrent use of Cat's Claw and Echinacea
What are the 3 drugs from the Immunosuppressant class we should focus on?
1) Azothioprine (Imuran)
What are the common adverse effects of cyclosporine?
5) Gingival Hyperplasia
What are the common adverse effects of Azothioprine (Imuran)?
What are the common adverse effects of Muromonab-CD3?
1) Chest Pain
2) Fever, chills and tremors
3) Vomiting, nausea, and diarrhea
4) Dyspnea, wheezing and pulmonary edema
5) Flu-like symptoms and fluid retention
Besides organ rejection, what is the other indication of the drug Muromonab-CD3?
1) The reversal of graft rejection
What is important for the nurse to assess when giving Azathioprine drugs?
1) Requires assessment of WBC and platelet counts with notation of any SxS of infection because and any bleeding tendencies because of the potential for drug related leukopenia and thrombocytopenia.
What is important for the nurse to assess when giving Cyclosporine drugs?
1) Functional level of all organs
2) Cardiovascular, CNS, hepatic and renal disease
3) Oral assessment (because of gingival hyperplasia)
4) Potassium and Uric levels
What is important for the nurse to assess when giving Muromonab-CD3 drugs?
1) Baseline weight
2) Baseline vitals
3) X-ray within 24 hours of beginning the drug to be sure that lung fields are clear and without fluid.
(T/F) Oral immunosuppressants should be taken with food to minimize GI upset?
What are the 5 rules patients should adhere to when taking oral forms of Cyclosporine?
1) Do not use the different formulations of Cyclosporines interchangeably.
2) Do not refrigerate oral forms of Cyclosporines
3) Use a calibrated device to administer oral liquid forms
4) Do not use styrofoam cups
5) Oral solutions may be mixed w/milk, or OJ and served at room temperature (must be served immediately).
It is important to monitor which lab values during IV therapy of Cyclosporine in order to detect possible renal and hepatic impairment?
2) Lactate dehydrogenase
How is a dose of IV Muromonab-CD3 prepared and administered?
1) The medication must be withdrawn from the ampule through a low-protein binding 0.22 micron filter, and the filter must be detached and a new sterile needle applied.
2) IV dose is administered over 1 minute
What should the nurse teach the patient regarding Immunosuppressant drugs?
1) Avoid crowds because they increase the risk for infections
2) Report any fever, sore throat, chills, joint pain, or fatigue (may indicate infection).
3) Female PTs should use contraceptives
4) Drugs should be taken at the same time everyday
The immunosuppressant drug Muromonab-CD3 is contraindicated in patients with what?
1) Patients with hypersensitivity to murine products
2) Patients with fluid volume overload