Protective Function Flashcards
(249 cards)
1
Q
one type of immune response
A
fever
2
Q
purpose of chemo agents
A
- immune system is not sufficient to protect the body
- destroys organisms that invade the body
- destroys abnormal cells within body
3
Q
Function of the Immune System
A
protect body from invasion by general hazards
4
Q
action of chemo agents
A
alter cell function or disrupt cell integrity causing cell death
prevent cell reproduction, leading to cell death
may affect normal cells
5
Q
nucleus function
A
contains genetic material
cell reproduction
regulates production of proteins
6
Q
function of proteins
A
allows cell to function
maintains homeostasis
promotes cell division
7
Q
parts of cell membrane
A
lipids
proteins - surface antigens
receptor sites
channels
8
Q
types of lipids
A
phosphlipids
glycolipids
cholesterol
9
Q
function of lipid layer of cell membrane
A
provide barrier
maintain homeostasis
10
Q
where are surface antigens found
A
cell membrane
11
Q
purpose of surface antigen (histocompatibility proteins)
A
role in cell immunity
allows for self identification
immune system recognizes self from non self
12
Q
function of receptor sites on membranes
A
allows interaction with various chemicals, agents
13
Q
function of channels or pores
A
allows for passage of substances in and out of cell
14
Q
G0 phase of cell cycle
A
resting phase
15
Q
G1 phase
A
gathering phase
16
Q
S phase
A
synthesizing phase
17
Q
G2 phase
A
last substances needed for division are collected and produced
18
Q
M phase
A
cell division -> 2 identical DAUGHTER cells
19
Q
what did penicillin come from
A
mold
1920
20
Q
when were sulfonamides introduced
A
1935
bactin sulfer?
21
Q
action of anti infective drugs
A
interferes with formation of bacterial cell wall
prevents cell of organism from using substances essential to their growth
interferes with protein synthesis
interferes with DNA synthesis
alters permeability of membrane, lets cell components leak out
22
Q
define narrow spectrum
A
effective against only few microorganisms with specific metabolic pathway/enzyme
23
Q
med for neisseria gonorrhea
A
spectinomycin (trobcin)
24
Q
define broad spectrum
A
useful for treating a wide variety of infections
25
what is selective toxicity
toxicity to the infecting agent without harming the normal cells of host/body.
26
what procedures use prophylactic drugs
dental work
27
how do microorganisms develop resistance
1. by altering binding sites on membrane or ribosome to prevent drug entering cell
2. by producing enzymes that is antagonist to drug
3. by changing their permeability
28
what is acquired resistance
microorganisms that were once sensitive to particular drug are no longer sensitive due to being exposed to the drug
29
how to prevent acquired resistance
1. only prescribe meds when medically necessary
2. complete taking all meds and don't stop because you "feel better"
3. if duration of the drug use is insufficient
30
define bacteriocidal
kills bacteria
31
define bacteriostatic
SLOWS bacterial growth
32
factors affecting drug choice
1. immune system status
2. local conditions at infection site
3. allergic reactions
4. age
5. genetics
33
significance of age
cannot metabolize medications as well
| increased sensitivity
34
common drug allergies
```
penicillin
sulfa drugs
codeine
aspirin (ASA)
iodine based products (contrast dye)
latex based products
```
35
what is the first priority when administering anti infectives
monitor for allergies BEFORE giving first dose
36
what info must you have to administer anti infectives
1. type of pathogen and its sensitivity
2. monitor WBC, lytes
3. monitor VS
4. monitor for s/e, a/r
5. protect the KD unless c/i due to KD failure - UA
37
how do you protect the KD
encourage fluids
38
other considerations for administering anti infectives
1. hypersensitive reactions
2. Kd Lv fn tests
3. effectiveness of drug
39
s/s of hypersensitive reactions
```
Lu symptoms
anaphylaxis
redness
swelling
SOB
phlebitis
```
40
indications of drug effectiveness
decrease in:
fever, WBC, clinical manifestations of infection
improved lab and diagnostic testing
41
define trough
lowest point?
how much drug is in the system before administration
drawn 30 min prior to admin of the drug
42
define peak
when the concentration of the drug is expected to be the highest
30 min after IV
60 min after IM
1-2 hours after PO
43
what to teach patients about infection and anti infectives
```
take entire Rx
cover nose/mouth
dispose of used tissue
rest/sleep
nutrition/fluids
stress effect on immune system
```
44
what is the impact of dehydration
can decrease immunity
45
types of antibiotics
```
penicillins
cephalosporins
sulfonamides
fluoroquinolones
monobactams
animoglycosides
macrolides
lincosamides
tetracyclines
antimycobacterials
```
46
classes of antivirals
```
anitretrovirals
reverse transcriptase inhibitors
protease inhibitors
antiherpes
nucleosides
```
47
what effects to all anti effectives have
nausea
| diarrhea
48
s/s of infection
fever
lethargy
slow wave sleep induction - not fully rested due to no REM sleep
classic signs of inflammation
49
goal of antibx
decrease the population so immune system can deal with bacteria
50
gram positive bacteria characteristics
retains stain or resists decolorization with alcohol
51
gram negative characteristics
loses the stain (is decolorized by alcohol)
52
aerobic bacteria characteristic
needs O2 to survive
53
anaerobic characteristic
doesn't use O2
54
aminoglycosides treat?
gram neg aerobic bacilli
| bactericidal
55
examples of aminoglycosides
```
*gentamicin (garamycin)
amikacin (amikin)
kanamycin (kantrex)
neomycin (mycifradin)
streptomycin
tobramycin (nebcin, Tobrex)
```
56
action of gentamicin
inhibit protein synthesis causing cell death
| treats serious infections
57
interactions of gentamicin
diuretics
| neuromuscular blockers
58
a/r gentamicin
ototoxicity
| nephrotoxicity
59
define ototoxicity
tinnitus
| pain in the ear
60
penicillin action
| amoxicillin/Amoxil
inhibits the synthesis of the cell wall
| treats infections caused by streptococcal, pneumococcal, staphylococcal, etc
61
penicillin c/i and a/r
c/i - Kd dz
a/r - GI effect
interacts with tetracycline and aminoglycosides
62
cephalosporins action
| cefaclor (Ceclor)
interferes with the cell wall building ability during cell division
treats infection
63
c/i of Cephalosporins
Allergies to cephalosporins or penecillins
interaction with aminoglycosides, anticoagulants and ETOH*
64
Fluoroquinolones action
| Ciprofloxacin (Cipro)
Broad spectrum, for gram neg
interferes with DNA replication
for UTI, URTI*, skin infections
65
c/i a/r for fluoroquinolones
c/i - allergy, PREGNANCY, lactation
a/r - h/a, dizzy, GI upset
interactions - antacids, quinidine, theophylline
66
what biological outbreak can you use Cipro for?
anthrax
67
which drug is prophylactic for meningitis
Cipro
68
which antibiotic is most broad of broad spectrum
erythromycin
69
Macrolides action
| Erythromycin (Ery tab)
binds to cell membranes. interferes with protein synthesis.
both bactericidal and bacteriostatic
tx resp, skin, urinary, GI infections
70
interactions of erythromycin
DIGOXIN - increases toxicity
oral anticoags
theophylline
corticosteroids - decreases immunity
71
which drug do you use if you are allergic to penecillin
1. erythromycin or
2. clindamycin
3. tetracycline
72
what is the difference between macrolides and lincosamides
lincosamides are more toxic
73
Lincosamides action
| Clindamycin (Cleocin)
interferes with protein synthesis by binding to cell membrane
for severe infections (frequent dental/bone infections)
74
c/i of Clindamycin
Lv, Kd impairment
GI reactions - a/r
75
Monobactams action
| Aztreonam (Azactam)
Narrow spectrum, unique structure with little cross resistance
disrupts bacteria cell wall synthesis - promotes leakage of cell content
for UTI, skin, intra abd and gyn infections
76
Aztreonam a/r
GI, Lv enzyme elevation
77
Sulfonamides action
| Sulfasalazine (Azulfidine)
inhibit folic acid synthesis
interferes with cell wall building ability during division
for both gram neg and gram pos bacteria (UTI and ear infections
78
a/r and interactions of Sulfasalzine
a/r - GI s/s, renal effects due to filtration of drug
interacts with thiazide diuretics, sulfonylurea, sulfonamides (bactrim), COUMADIN
79
Tetracyclines action
| Tetracycline (sumycin)
inhibit protein synthesis, prevents cell replication
for acne
can be used in place of penicillin
80
why is tetracycline not for use in children under 8
causes damage to bones and teeth
81
c/i of tetracycline, a/r
c/i - allergy, pregnancy, lactation
| a/r - *Photosensitivity, GI effects (take on empty stomach), bone and teeth damage
82
interactions of tetracycline
penicillin G, BC, methoxyflurane, Digoxin
83
s/s of TB
pink frothy sputum
O2 saturation in the 90's
airborne disease
common in condensed populations
84
what is a common s/e of all TB 1st line drugs
all induce peripheral neuropathy
| patient feels like walking on "pins and needles"
85
what is antidote for "pins and needles"
vit B6
86
what are the 1st line of drugs for TB (4)
Rifampin
Isoniazid (INH)
Ethambutol
Streptomycin
87
TB drugs characteristics
both bacteriostatic and bactericidal
88
2nd line of TB drugs (2)
pyrazinamide (PZA)
| Amikacin
89
what do you inform the client taking Rifampin
may change the color of all bodily fluids PINK
90
Antimycobacterial actions
| Isoniazid (INH) - Nydrazid
act on the DNA of the bacteria, inhibiting growth
treats acid fast bacteria
91
what is another condition caused by mycobacteria and treated by INH
leprosy
92
a/r and interactions of INH
a/r - CNS effects, GI irritation
interactions - Rifampin and INH can cause LV toxicity
93
what nursing teaching do you inform your patient taking INH or Rifampin
NO ALCOHOL due to liver toxicity
94
define virus
NON LIVING intracellular parasite that infects bacteria, plants and animals
95
how do viruses work
take over mechanisms of host cell and use it to replicate their own DNA/RNA/protein
96
most common treatment for virus
most require no pharmacotherapy
rest
fluids
prevent spread of infection
97
which viruses respond to antiviral therapy
```
influenza A and some resp viruses
Herpes
CMV - cytomegalovirus
HIV
warts, eye infections
Hep B, C
```
98
why are viruses difficult to kill
because they live IN our cells - drugs that kill viruses also kill our cells
99
mechanisms of antiviral drugs
1. enter infected cell
2. interfere with DNA/RNA synthesis or regulation
3. interfere with virus binding to cell
4. stimulate host immune system
100
characteristic of RSV - resp syncytial virus
mostly occurs in children
| can cause death
101
s/s of respiratory viruses
cough, fever, inflammation of nasal mucosa, inflammation of mucosa of respiratory tract
102
s/s of herpes virus
painful vesicles that occur in clusters on skin, cornea, mucous membranes
course of primary disease is 2 weeks
duration of recurrance varies
103
definition of vesicle
fluid filled blister
104
s/s of CMV
```
member of herpes family
may be asymptomatic
fatigue
nausea
jaundice
can result in stillbirth, brain damage, birth defects during pregnancy
associated with weakened immune system
```
105
organs affected by CMV
brain (encephalitis), eyes (retinitis), Lu, St, Intestine
106
s/s of HIV and AIDS
acute infection - fever, rash, myalgia
asymptomatic infection follows acute infection
persistent lymphadenopathy > 3 mo
constitutional sx - fever > 1 mo, weight loss, chron fatigue
dementia
107
what are HIV AIDS secondary infections
pneumocystitis carinii
| disseminated herpes simplex
108
general s/e of HIV meds
flu like symptoms
109
nursing consideration for HIV patients
ask CD 4 count
110
mechanism of HIV AIDS
virus attaches to helper T cells (CD4) -> decrease in CD 4 cells
111
actions of Flu virus meds
prevents shedding of the viral protein coat
112
action for Herpes and CMV meds
inhibit DNA replication by competing with viral substrate to form SHORTER non effective DNA chain
113
Hep B agents action
inhibits reverse transcriptase, causes DNA chain termination
114
HIV meds
* 1. Nevirapine (Viramune) - reverse transcriptase inhibitor
* 2. Zidovudine ATZ (Retrovir) - nucleoside
3. Enfuvirtide - fusion inhibitor
4. Ritonavir (Norvir) - protease inhibitor
115
what is procedure for accidental exposure to HIV
1. Must be given Zidovudine or Ritonavir
2. Must start within 72 hours
3. Must be administered for 4 weeks
116
what is the action of fusion inhibitor
prevents fusion of virus to cell membrane
117
nucleoside action
interferes with replication of HIV by inhibiting cell protein synthesis
118
c/i and a/r for Rimantadine (Flumadine)
c/i - allergy, pregnancy, lactation
a/r - dizziness, insomnia, nausea, orthostatic hypotension
interacts with anticholinergic drugs
119
acyclovir (zovirax) c/i, a/r
c/i - pregnancy and lactation, pt that presents with neurotoxicity
a/r - n/v, h/a*, dizziness* RASH, PRURITIS, hair loss
120
what drugs does acyclovir interact with
nephrotoxic drugs and zidovudine (Retrovir)
121
s/s of neurotoxicity
h/a, acting like hung over or drunk
122
what is procedure for allergic reaction to any medication
first stop administration
give normal saline
then call Dr for benedryl
123
define Hep B and characteristics
potential fatal viral infection of LV
spread by blood and sexual contact
high mortality -> chronic/cancer
treat with interferons, Adefovir (Hepsera) or entecavir (baraclue)
124
Nevirapine (Viramune) c/i and a/r
c/i - pregnancy, lactation
| a/r - h/a, n/v, rash, chills fever, diarrhea
125
concerns about antivirals
all are LV toxic
126
c/i for Ritonavir, a/r
pregnancy, lactation
| a/r - hyperglycemia
127
nursing intervention for Ritonavir
monitor serum alanine aminotransferase (ALT) and bilirubin
128
all protease inhibitors have what characteristic?
they are all teratogenic except for saquinavir
129
zidovudine ATZ (retrovir) a/r
h/a insomnia, dizziness, nauasea, diarrhea, fever, rash
130
enfuvirtide - fusion inhibitor pharmacokinetics
metabolized in LV and recycled in tissue - NOT EXCRETED
131
a/r for Enfuvirtide
| interactions
h/a, dizziness, myalgia, n/v, diarrhea
interactions - pimozide, rifampin, triazolam, midazolam, BC
132
which antivirals are locally active
vidarabine for CMV
| acyclovir
133
c/i for vidarabine, a/r, considerations
allergy
a/r - local burning, stinging, discomfort
do not apply to broken skin
134
opportunistic infections (7)
1. PCP - pnuemocystis carinii pneumonia
2. candida albicans
3. histoplasmosis
4. TB
5. CMV
6. toxoplasmosis
7. herpes simplex
135
treatment for PCP
pentamidine
| bactrim
136
tx for candid albicans
mycostatin
| nizoral
137
histoplasmosis
amph B
| Nizoral
138
tx for TB
INH
Rifampin
Ethambutol
139
tx for CMV
cytovene
| vidarabine
140
tx for toxoplasmosis
pyrimethamine
cleocin
fansidar
141
tx for herpes simplex
acyclovir
142
character of fungus
more complex than bacteria
unaffected by antibx
grows slowly, may be months before manifestations
can cause serious problems in immunocompromised pt
143
candida is secondary to what diseases
HIV
| Cancer
144
intervention for candida in the throat
have to scrape it out
145
what is fungal wall composed of
chitin
various polysaccharides
cell membrane containing ergosterol
146
why is fungus resistant to antibx
protective layers of cell
147
what pt are at risk for fungal infection
1. AIDS and AIDS related complex
2. pt on immunosuppressant drugs
3. recent transplant surgery or cancer tx
4. elderly who are no longer protected from environmental fungi
148
consideration for antifungal pt
immunocompromised at onset
149
systemic fungals action
alter cell permeability
150
topical fungal action
alter cell permeability
151
systemic fungal drug
fluconazole (diflucan)
| amphotericin B
152
topical fungals
clotrimazole (lotrimin, mycelex)
153
what are topical fungals used for
jock itch
| athletes foot
154
antifungal cautions
high toxicity
do not use if allergic
not during pregnancy and lactation (except terbinafine)
NOT WITH KD LV DZ - check function before systemic fungal agents
monitor drug serum levels
155
interactions with Amphoterican B
nephrotoxic drugs and corticosteroids
| can affect levels of cyclosporine, digoxin, oral hypoglycemic, phenytoin, anticoags
156
patient teaching for antifungals
have patient report unusual bruising or bleeding
157
amphtericin B indications
```
broad spectrum -
aspergilliosis
leishmaniasis
cryptococcosis - cryptococcal meningitis
blastomycosis
moniliasis
coccidiomycosis
histoplasmosis
mucormycosis
candida infections - topical
```
158
replacement drug for fluconazole
terbinafine (lamisil)
159
c/i for amphotericin B
| a/r
Kd dz
a/r - Kd failure
160
what values do you check for amphotericin B
Na, Cl, Bun, Creatinine
161
Which antifungal is used for aspergilliosis
Caspofungin (Cancidas)
162
Why do you use flucytosine (ancobon) oral for systemic Candida or Cryptococcus infections?
less toxic
163
which agent do you use for intestinal candidiasis both topically and oral
Nystatin (Mycostatin, Nilstat)
| swish and spit
164
indication of Voriconazole (Vfend)
invasive aspergilliosis and serious infections caused by Scedosporium apiospemum and Fasarium species
165
action of Terbinafine (lamisil)
blocks the formation of ergosterol
inhibits a CYP2D6 enzyme system
for onychomycosis of toenail or fingernail
166
Fluconazole (Diflucan) indications
candidiasis, cryptococcal meningitis, systemic fungal infections
prophylactic agent for reducing the incidence of candidiasis in bone marrow transplant recipient
167
c/i for Fluconazole
| interactions
c/i - renal dysfx
| inhibits CYP450 and may be associated with drug interactions
168
why are antifungals c/i with Kd Lv dz
drug metabolism or excretion may be altered or condition may worsen as a result of actions of drug
169
s/e of systemic antifungals
```
h/a, dizzy, fever, shaking, chills
n/v, dyspepsia, anorexia
LV dysfx
Rash, PRURITIS assoc with local irritation
KD dysfx
```
170
tinea infections
tinea - ringworm
tinea pedis - athlete's foot
tinea cruris - jock itch
tx with spectazole
171
topical fungal infections are caused by?
dermatophytes
172
candida infection is?
yeast infection of mouth and vagina
173
Clotrimazole (lotrimin, mycelex) indication
only for local treatment of mycoses, including tinea infection
174
teaching for antifungal medication
1. wash affected area with soap and water. apply topical after.
2. can use drying agent (baby powder)
3. for feet, cover with clean white socks
4. avoid occlusive dressings
5. for vaginal meds, remain in recumbent for 15 min
6. troches should be dissolved in mouth slowly
7. nystatin swish and spit
8. if patient has mycosis, and rash develops with blisters, STOP meds
175
insect bites can lead to what kind of infection
protozoal infections
1. malaria
2. trypanosomiasis
3. leishmaniasis
176
what is vector for malaria
mosquito
177
what is vector for trypanosomiasis and leishmaniasis
water
178
what protozoa infection is due to ingestion or contact?
amebiasis
giardiasis
trichomoniasis
179
malaria character
most common protozoa dz
requires multi drug tx
tx acute stage and prevent relapse and infection
180
parasites causing malaria
```
plasmodiums:
falciparum - the most dangerous
vivax - milder form, rarely results in death
malariae - tropical countries, mild sx
ovale - rarely seen, being eradicated
```
181
s/s of malaria
related to destruction of RBC
toxicity of LV
chills due to rupture of merozoites into RBC
182
tx of malaria
attacks parasite at various stages of development
183
antimalarial drugs
1. chloroquine (aralen)
2. halofantrine (halfan)
3. hydroxychloroquine (plaquenil)
4. Mefloquine (lariam)
5. Primaquine (generic)
6. Pyrimethamine (Daraprim)
7. Quinine (generic)
184
chloroquine action
prevents, tx, malaria and tx extraintestinal amebiasis
interrupts reproduction of protein synthesis
agents that don't affect the sporozoites are used for prophylaxis
185
halofantrine action
tx malaria in combo with other drugs
186
hydroxychloroquine action
tx malaria is combo with others esp primaquine
187
what is teaching for pt of mediterranean descent and antimalarial drugs
if G6PO deficient, may experience hemolytic crisis as a result of medication
188
mefloquine action
prevent, tx malaria in combo with other drugs
189
c/i of mefloquine
avoid during pregnancy - check date of last menses
190
primaquine action
prevent relapses of vivax and malaria infections
| radical cure of vivax
191
pyrimethamine action
prevent malaria in combo with others to suppress transmission
tx toxoplasmosis
192
quinine action
tx chloroquine resistant infection
193
recommended tx with chloroquine
preventative - take before, during and after trips
194
c/i of antimalarial
allergy
LV dz
alcoholism
lactation
caution - retinal disease or damage; psoriasis
195
a/r of antimalarial
h/a, fever, chills, malaise, vertigo, n/v, Lv dysfx, disturbed visual perception
196
interactions of quinine and derivatives
risk for cardiac toxicity
associated with cinchonism (vomiting, tinnitus, vertigo)
antifolate drugs with pyrimethamine can increase risk of bone marrow suppression
197
what organ affected in giardiasis
intestine from contaminated water
| diarrhea
198
what is affected with leishmaniasis
skin, mucous membranes
199
trypanosomiasis is?
african sleeping sickness
| chagas disease
200
trichomoniasis is?
vaginal infection
201
pneumocystis carinii pneumonia PCP is?
disease affecting lungs secondary to AIDS
202
risk factors for protozoal infections
unsanitary conditions
poor hygiene practices
weak immune system
203
what is amebic dysentery
a severe form of diarrhea
204
metronidazole (flagel) actions
inhibits DNA synthesis
| for protozoals, pathogens in GI, H pylori. also used as an antibx
205
c/i for metronidazole
LV DZ, allergy, pregnancy, CNS DZ
a/r - h/a, dizzy, ataxia, n/v, diarrhea
206
metronidazole interactions
ETOH
207
helminth
tissue invading parasitic worm
208
trichinosis cause
caused by ingestion of the encysted larvae of roundworm (trichinella spiralis) in undercooked pork
209
trichinosis affects?
lymphatic tissue, lungs, CNS, heart, liver
210
filariasis
infection of the blood and tissue by worm embryos, injected by insects
211
schistosomiasis
infection by a fluke that is carried by a snail
212
how to assess for ingested worm infections
stool sample
213
nematodes aka roundworms types
```
pinworms
whipworms
threadworms
ascaris
hook worms
```
214
platyhelminthes or flatworms
cestodes (tapeworms)
| flukes (schistosomes)
215
most common helminth infection in children?
pinworms
216
transmission of pinworms
fecal - oral
217
mebendazole (vermox) action indications
affects metabolic process that is different in worms vs humans
interferes with normal fn of the worm
most commonly used
for pinworms, round worms, whipworms, hook worms
218
what is significance of bright spots on CT scan of brain
neurocystic sarcosis - aka "worms in the brain"
| due to uncooked pork
219
c/i of mebendazole
pregnancy
| few adverse effects
220
a/r of antihelminthics
```
abd discomfort
diarrhea
pain
h/a
dizzy
fever,
chills
loss of hair
```
221
c/i of antihelminthics
allergy to any
lactation and pregnancy
caution - LV KD dz or severe diarrhea and malnourishment
222
teaching for antihelminthics
```
strict hand washing and hygiene
keep nails short, hands clean
shower in a.m.
change and launder undergarments, bed linens, pjs daily
disinfect toilet seat daily
handwash after using restroom
```
223
Pyrantel (antiminth, pin rid, pin x, reese's pinworm)
```
single dose
for pin and round worms
not for pregnancy, lactation
safety not established for young children
a/r - GI and diarrhea
```
224
cancer
uncontrolled growth of cells that invade normal tissues, often fatal
caused by chem, physical or biological
large # of factors can cause/promote
225
treatment/prognosis of cancer
treated through surgery, radiation therapy, and drugs
| the growth fraction (% of cancer cell undergoing mitosis) is major factor determining success of chemo
226
anaplasia
cancer cells lose cellular differentiation and organization and are unable to function normally
227
autonomy of cancer cells
cancer cells grow without usual homeostatic restrictions that regulate cell growth and control.
this allows cells to form a tumor
228
metastasis
cancer cells travel from place of origin to develop new tumors in other areas of body
229
angiogenesis of cancel
abnormal cells release enzymes to generate blood vessels and supply oxygen and nutrients to the cells generating growth
cancer cells use new blood vessels to multiply
cancerous cells rob the host cells of energy and nutrients and block normal lymph
230
s/e of antineoplastics
```
neurovascular disease
alopecia (capitus /totalis)
stomatitis
nephrotoxicity /hepatotoxicity
bone marrow suppression
blood dyscrasias - leukopenia, thrombocytopenia, agranuloycytosis
```
231
nursing considerations for cancer
```
monitor CBC/WBC
monitor i/o - UA
monitor renal - BUN, Cr, K
monitor for bleeding - prevent injury
monitor s/s - infection
be aware of herbal interactions with meds - asian/pacific islanders
```
232
what is the problem with alkylating agents such as cytoxan?
lethargy
| malnourish
233
what is the problem with antimetabolites (methotrexate) for cancer
bone marrow suppression
234
what are other considerations for antineoplastics agents regarding bleeding
no IM injections
use a soft toothbrush
no shaving
235
why should you not allow fresh fruit, flowers or plants for a pt taking antineoplastics
because patient is immunosuppressed.
236
what type of room should be use for patients taking chemo
reverse/protective isolation
237
action of chemo
given IV to prevent cell replication in both benign and malignant neoplasms
treats variety of cancer
attacks cancer from several different mechanisms
THE MOST TOXIC MEDS used for pharmacotherapy
238
which chemo is used for management of uric acid levels for ped patients with leukemia
rasburicase
239
which drug is used for patients who have received cardiotoxic meds
zinecard (cardioprotective)
240
which chemo is used to rescue cells for patients due to bone marrow suppression
leucovorian (active form of folic acid)
241
replacements for RBC and WBC caused by bone marrow suppression (3)
1. epogen RBC
2. neupogen WBC
3 blood transfusion
242
categories of antineoplastics
1. alkylating agents
2. antimetabolites
3. antineoplastic antibiotics
4. mitotic inhibitors
5. hormones and hormone modulators
6. cancer cell specific agents
6. biological response modifiers
243
alkylating agents and action
chlorambudil (leukeran) - boosts WBC
react with portions of RNA, DNA and other cellular proteins - affect synthesis of DNA
other agents -
1. 5 FU
2. Cysplatin
3. Cytoxan
244
antimetabolites and actions
Metotrexate (folex)
chem structure is similar to natural metabolites
replaces normal protein required for DNA synthesis, interferes with DNA and RNA synthesis.
245
antineoplastic antibiotics and action
doxorubicin (adriamycin)
toxic to human cells - not selective for bacteria only
interferes with DNA and RNA synthesis
246
mitotic inhibitors and actions
Vincristine (oncovin)
aka spindle poisons
kills cells as the process of mitosis begins
247
hormone modulators and action
tamoxifen (nolvadex)
used in cancers that are sensitive to estrogen stimulation
affects reproductive system
also Megace
248
cancer cell specific agents and action
1. Imatinib Myesylate (Gleeve) - for chron myeloid luekemia & GI stromal tumors
2. Bortezomib (Velcade) - for multiple myeloma
tx CML and CD117 + unserectable or metastatic malignant GI stromal tumors (GIST)
249
Biological response modifiers and action
Aldesleukins - Interleukins - stim immunity by increasing the activity of natural killer cells.
T & B cell modulators
