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Immunostimulant Drug
LippinCott Williams and Wilkins Chapter 52
| Question | Answer |
|---|---|
| Red blood cells (erythrocytes) | supply oxygen |
| White blood cells (leukocytes) | protect against microorganisms |
| Platelets (megakaryocytes) | control bleeding |
| Drugs Used in Treatment of Anemia, Bleeding and Prevention of Infection | Colony-stimulating drugs, Oprelvekin Erythropoiesis-stimulating agents Iron Folic Acid Vitamin B12 |
| Drugs used to Stimulate White Blood Cells: Actions and Uses | Colony stimulating factors filgastim pegfilgastim sargramostim |
| Colony stimulating factors (CSF) Action and Uses | glycoproteins act on hematopoetic cells to stimulate proliferation, differentiation, and maturation of white blood cells |
| Drugs used to Stimulate White Blood Cells: Actions and Uses Filgastim | used after a cycle of chemotherapy |
| Drugs used to Stimulate White Blood Cells: Actions and Uses Pegfilgastim | used as single dose between chemotherapy cycle |
| Drugs used to Stimulate White Blood Cells: Actions and Uses Sargramostim | used following BMT, induction chemotherapy used with leukemia, and to stimulate stem cells for harvest. |
| Drugs used to Stimulate White Blood Cells: Adverse Reactions | Bone pain,Hypertension,Nausea and vomitting,Alopecia,Hypersensitivity or allergic reactions |
| Drugs used to Stimulate White Blood Cells: Contraindications | Contraindicated in patients with hypersensitivity,Pregnancy category (C) |
| Drugs used to Stimulate White Blood Cells: Precautions | caution when breast feeding,Filgrastim-caution with hyporthyroid disease |
| Drugs used to Stimulate White Blood Cells:Interactions | Pegfilgrastim-cause sickle cell crisis,Can stimulate cancer cell growth,Increased netrophil when used with Lithium |
| Drugs used to Stimulate Blood Platelets: Actions and Uses | Oprelvekin-acts to stimulate thrombopoiesis, reduces need for multiple platelet transfusion, used to treat or prevent thrombocytopenia, associated with chemotherapy for solid tumor cancer treatments |
| Drugs used to Stimulate Blood Platelets: Adverse Reactions General reactions: | -fluid retention, peripheral edema, dyspnea,syncope, fever, allergic reaction |
| Drugs used to Stimulate Blood Platelets: Adverse Reactions Cardiovascular reactions: | -tachycardia, palpitations, atrial fibrillation, arrhythmias resulting in stroke and pulmonary edema, capillary leak syndrome |
| Drugs used to Stimulate Blood Platelets: Contraindications | Contraindicated to patient hypersensitivity and not used with chemotherapy that is extremely myelosuppressive. |
| Drugs used to Stimulate Blood Platelets:Precautions | Use cautiously in patients with renal, heart failure or atrial arrhythmias |
| Drugs used to Stimulate Blood Platelets: Interactions | Low potassium (hypokalemia) can occur with cancer chemotherapy agent, ifosfamide Pregnancy category (C) and stop breast feeding Anaphylactic-type reactions discontinue use |
| Drugs Used in Treating Anemia Associated With Chronic Illness: Actions and Uses | Epoetin alfa,Darbepoetin alfa |
| Epoetin alfa Actions and Uses | Drug that stimulates erythropoiesis,Used to treat anemia associated with: Chronic renal failure; chemotherapy for cancer treatment; zidovudine therapy for human immunodeficiency virus; postsurgical blood replacement in place of allogeneic transfusions |
| Darbepoetin alfa Actions and Uses | an erythropoiesis-stimulating protein: Used to treat anemia |
| Drugs Used in Treating Anemia Associated With Chronic Illness:Adverse Reactions | Hypertension; headache; nausea; vomiting; diarrhea; rashes; fatigue; arthralgia; skin reaction at injection site |
| Epoetin alfa and Darbepoetin Alfa Precautions | Used with caution in patients with hypertension; heart disease; congestive heart failure; history of seizures |
| Epoetin alfa Contraindicated | Contraindicated in patients with uncontrolled hypertension; those needing emergency transfusion; those with hypersensitivity to human albumin |
| Darbepoetin alfa Contraindicated | Contraindicated in patients with uncontrolled hypertension, those allergic to drug Epoetin alfa darbepoetin alfa: Used with caution in patients with hypertension; heart disease; congestive heart failure; history of seizures |
| Drugs Used in Treating Iron Deficiency Anemia: Actions and Uses | Iron preparations and Parenteral iron |
| Iron preparations Actions and Uses | Act by elevating serum iron concentration, which replenishes hemoglobin and depleted iron stores |
| Parenteral iron Actions and Uses | Used when patient cannot take oral drugs or when patient experiences gastrointestinal intolerance to oral iron administration; treating iron deficiency anemia |
| Drugs Used in Treating Iron Deficiency Anemia Adverse reactions | Gastrointestinal reactions: GI irritation, vomiting, constipation, diarrhea, darker stools; |
| Drugs Used in Treating Iron Deficiency Anemia with Iron supplements is Contraindicated in... | : Contraindicated in patients with known hypersensitivity to drug, or any component of the drug |
| Drugs Used in Treating Iron Deficiency Anemia with Iron compounds is Contraindicated in | in patients with hemochromatosis or hemolytic anemia |
| Drugs Used in Treating Iron Deficiency Anemia with Iron compounds is used cautiously.... | in patients with hypersensitivity to aspirin |
| Drugs Used in Treating Folic Acid Deficiency Anemia are.... | Folic acid, and Leucovorin |
| Folic Acid Action and Uses | : Used in treating megaloblastic anemia; for women of childbearing age to decrease incidence of neural tube defects |
| Leucovorin Action and Uses | : Used to diminish hematologic effects of methotrexate Used in treating certain types of cancer |
| Folic Acid and Leucovorin Contriindications are | in patients treating pernicious anemia, other anemias in which vitamin B12 is deficient |
| Folic Acid and Leucovorin Used caustiously | within RDA guidelines |
| Folic Acid Deficiency | causes pregnant women to have increaded complications |
| Drugs used in treating Vitamin B12 Deficiency Anemia:Contraindications | Contraindicated in patients allergic to cyanocobalamin |
| Drugs used in treating Vitamin B12 Deficiency Anemia:Precautions | Administered cautiously during pregnancy, in patients with pulmonary disease, anemia |
| Drugs used in treating Vitamin B12 Deficiency Anemia:Interactions | Alcohol, neomycin, colchicine decrease the absorption of oral vitamin B12 |
| Nursing Process: Assessment Preadministration assessment: | Obtain general health history, asks about symptoms of anemia Take vital signs for baseline during therapy Look at patient’s general appearance and, in severely anemic patient, evaluation of patient’s ability to carry out activities of daily living |
| Nursing Process: Assessment Ongoing Assessment: | Monitor patient for adverse reactions; reports any occurrence of adverse reactions to primary health care provider before next dose is due Inform patient that color of stool will become darker or black Assess the patient for relief of symptoms of anem |
| Nursing Process: Implementation Iron | Check reguarding simultaneous administration of iron salts with other drugs, monitor patient for allergice response for at least 1hr after test does and again before giving remainder dose |
| Nursing Process: Implementation Vitamin B12 | patients with vitamin B12 anemia are treated with vitamin administered by parenteral route weekly |
| Nursing Process: Implementation Epoetin alfa | Monitor blood pressure closely; report any rise of 20 mm Hg or more in systolic; diastolic pressure to primary health care provider |
| Monitoring and Managing Patients needs: Diet | Balanced diest with emphasis on foods that are high in iron, folic acid, or vitamin B12 (vegan should have dietary consult) |
| Monitoring and managing Patients needs: Constipation | Increase fluid intake to 10-12 glasses of water daily, high fiber, increase activity |
| Education Iron | take drug with water on empty stomach, if GI upset you may drink mild or with food causes dark stools,sever constipation or diarrhea call MD |
| Education Epoetin alfa | strict complience with antihypertensive drug regimen....adverse reactions include dizziness, headache, fatigue, joint pain, nausea/vomiting, diarrhea |
| Education Folic Acid | avoid use of multivitamin preperations, follow diet bc diet and drug therapy work together |
| Education Vitamin B12 | eat diet high in B12(seafood, eggs, meats, dairy) |
Created by:
molliejae
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