Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
imm/onco questions
immunity and oncology drugs
| Question | Answer |
|---|---|
| First like of defense/Barrier to microbes or environmental hazards | nonspefific body defenses |
| First line of defense, Barrier to microbes or environmental hazards, Deny entrance of pathogens , try to keep it localized | Nonspecific Body Defenses |
| Skin, phagocytes, natural killer cells | Nonspecific Body Defenses |
| Complement system, fever, interferons, inflammation | Nonspecific Body Defenses |
| Second line of defense: specific activation and effectiveness Known as immune response | Specific Body Defenses |
| Lymphocytes interact with antigens | |
| What are the Two major divisions of immune system | Antibody-mediated (humoral-bcells-in plasma) Cell-mediated (tcells) 1st response |
| Self-regulated immune response would be what ? | allergies |
| If you have An inadequate immune response may lead to | immunodeficiency |
| An excess immune response may lead to an | allergic reaction or autoimmune disorders |
| Active immunity response speed? | Long lasting but takes a few days to become effective |
| Passive Immunity immune response speed ? | Short lasting |
| Passive immunity sources | mom/baby |
| Active immunity sources | actively make it, vaccines |
| Antibody-Mediated (Humoral) Immunity is Initiated when | antigen encounters B cell- Activated B cell divides & becomes plasma cell Plasma cells secrete antibodies (immunoglobulins) Memory B cells can speed a future defense against a specific antigen |
| Neutralize foreign agent (antigen), Mark it for destruction, Peak production occurs in about ten days | immunoglobulins |
| Cell-Mediated Immunity occurs when | activation of specific T cells and cytokines secreted by T cells |
| Activation of specific T cells .. what are the specific T cells | Helper T cells (CD4 receptor)-Activate most other immune cells; Cytotoxic T cells (CD8 receptor)---Travel through body, killing bacteria, parasites, viruses, cancer cells |
| What do Helper T cells (CD4 receptor) do | Activate most other immune cells; |
| What do Cytotoxic T cells (CD8 receptor) do ? | ---Travel through body, killing bacteria, parasites, viruses, cancer cells |
| Cytokines are secreted who ? | by T cells |
| Hormone like proteins that regulate intensity & duration of immune response, Mediate cell-to-cell communication | cytokines |
| Examples: interferon, interleukins, & perforin are examples of what ? | cytokines |
| primary immunity by exposing the imm sytm to Microbes tht hav been deactivated MMR)Live microbes that have been weaknd (attenuated)(flu, Hep A);Modified bacter. toxoids(diphteria,tetanus);Recombinant vaccines that contain partial microbes components-Hep B | vaccines |
| To check the Effectiveness of vaccine you can assess | by checking a titer |
| Vaccines route of administration is | May be oral or injectable |
| How long are vaccines good for ? | Some are good for a lifetime and some are temporary |
| High risk groups that need vaccines are | Very young, Very old, High exposure (health care providers, school children and college students), Chronic diseases (esp. DM, Ca, and any immunosuppressant state), Taking immunosuppressant meds |
| VaccinesExamples are | : Flu, Hepatitis B, tetanus |
| Nursing Implications when administering vaccines | Do not adm to those currently ill ; Ask about egg allergies with the flu vaccine; Usually makes injection site sore ; May run fever for 24 hours ; Tylenol will help with fever and soreness ; Use different site and syringe for each ; Keep accurate records |
| Tetanus is good for how long | 10 years |
| Immunostimulants are AKA | AKA Biological response modifiers |
| 2 immunostimulants are | interferons and interleukins |
| Interferons alfa is given to who ? | hiv to battle opportunistic infections |
| Interferons beta is give to who ? | multiple sclerosis |
| Increase b cell and plasma cell production and promotes inflammation | interleukins |
| Immunostimulants are contraindicated with | renal and liver failure ( increase fluids to prevent renal tox) , pregnancy |
| Immunostimulants Nursing Implications | Keep well hydrated, Assess for encephalopathy (neuro problems ) Many are contraindicated in pregnancy |
| Immunostimulants May interfere with | BCPs |
| CAM Immunostimulants is | Echinacea |
| increase phagocytosis and inhibit the enzyme hyaluronidase | Echinacea |
| Echinacea is Used for | and what are SE’s : colds and other viral infections ;;;; upset stomach, nausea, dizziness, can worsen asthma |
| Echinacea Nursing Implications | Don't take on an empty stomach ; Taken with food or a large glass of water |
| Immune Response in Organ Transplant Transplanted organs have | antigens that trigger immune response |
| Immune response in organ transplant is called and often what kind of response and what happens | Called transplant rejection, humoral response (acute), antibodies destroy transplanted tissue within days |
| Cell-mediated response to organ transplant takes how long | is slower, about two weeks after surgery |
| Chronic rejection can occur in what time | months to years later |
| When a organ transplant takes place give patient meds | before during and after |
| Inhibit immune or inflammatory response | Immunosuppressants |
| Immunosuppressants inhibit what cells and block what ? | Inhibit T cells and Blocks antibody production by B cells |
| Immunosuppressants are Often used to | prevent transplant rejection |
| Suppresses bone marrow | immunosuppressants |
| Immunosupressants example classes | : glucocorticoids, antimetabolites, antibodies, and calcineurin inhibitors |
| Prototypes: Cytoxan, methotrexate, cyclosporine | immunosuppressants |
| immunosuppressants Prototypes: | Cytoxan, methotrexate, cyclosporine |
| Immunosuppressants Nursing Implications | Watch for infections and certain cancers(scarcoma, pcp, pneumonia) , Reverse isolation, Watch CBC (WBC –too low, temp- low grade fever – report any fever, May interfere with BCPs, rejection of heart will look like heart failure |
| Inflammatory Response includes | inflammation and acute response |
| Inflammation is what kind of reaction | Vascular reaction |
| Inflammation Results in a delivery of | fluid, dissolved substances, and cells from the blood into the interstitial space |
| During inflammation fluid shifts out and causes swollen red it is fixed by | vasoconstriction |
| Acute Inflammatory Response is | Immediate response, Nonspecific, Short lived |
| The Purpose of acute inflammatory response and the signs and symptoms are : | |
| 5 Inflammatory Mediators (responsibl for the response ) are | |
| Have analgesic, antipyretic, and anti-inflammatory properties | NSAIDs |
| NSAIDS Action: | Decrease prostaglandin synthesis COX-1 and/or COX-2 |
| NSAIDS Uses are : | |
| Selective nsaids vs nonselective | Selective has COX-2 inhibitors vs Nonselective COX-1 & COX-2 inhibitors |
| Selective NSAID MED | =Celebrex |
| Nonselective NSAID MED | =ASA |
| Nonselective nsaids affect | BP |
| COX 1 = | GI tract, active production, decrease platlet aggrigation |
| NSAIDs Nursing Implications | Be careful giving infants < 6 months ibuprofen Increases bleeding tendencies; Not safe in pregnancy or lactation; Be careful taking OTCs-many contain ASA ; May worsen HTN and CHF |
| NSAIDS can worsen | htn and chf |
| Take Nonselectives NSAIDS | w/ food to decrease GI upset |
| Do not give ASA to those__ because | under 18 r/t Reye’s Syndrome |
| Aspririn is ototoxic as well as | Excedrin, pepto, BC, goodies – warn patients |
| Fish Oils Uses: | Arthritis, HTN, high chol, CVD, asthma, bipolar, Ca, crohn’s dx, cystic fibrosis, dementia, depression, dysmenorrhea, ezcema, lupus, nephrotic syndrome, preeclampsia, graft rejection, psoriasis, schizophrenia, CVA, everything |
| Fish oils Action and side effects include: | contains EPA & DHA ------ SE: increase bleeding tendencies, increase BS, diarrhea, GI discomfort, rash |
| If you have a patient hat is already on plavix plus garlic pluse fishout teach them what | bleeding issue put them on something lower like baby aspirin |
| Glucocorticoids are found where | Naturally found steroid hormone |
| suppress histamine and other prostaglandins, inhibit COX-2, suppress phagocytosis and lymphocytes | glucocorticoids |
| glucocorticoids are Used in | : severe inflammation; asthma, Ca, arthritis |
| SE of glucocorticoids : | |
| prednisone, decadron, celeston | glucocorticoids |
| Glucocorticoids Nursing Implications | 1. Take with food 2. Watch for infections-- Reverse isolation3. Monitor blood sugar & BP 4. Don’t abruptly discontinue 5. May impair G & D |
| Monitor for Cushing’s: moon face, etc when giving what ? | glucocorticoids |
| Glucocorticoids are Contraindicated in those | w/ impaired immune function |
| Antipyretics | Ex: Tylenol, Motrin |
| to reduce fever by direct action at level of hypothalamus and dilation of peripheral blood vessels | antipyretics action |
| when giving antipyretics what will you give first | Tylenol |
| what does dilation of the peripheral blood vessels for antipyretics do | Enables sweating and dissipation of heat |
| Tylenol is can be given how often | every 4 hours |
| S/S of tylenol toxicity: | N/V & abd pain ; Hepatotoxic & nephrotoxic ; May cause hypoglycemia |
| Motrin can be given how often | every 6 hours |
| Super high fever give patient | liquid or Can give as a suppository (indocin –cousin) for faster reduction |
| Antipyretics are given based on | weights |
| Try to adm antipyretics | before fever becomes too elevated |
| Pathogens are | Organisms that can cause disease |
| Pathogens Cause disease in two ways | Divide rapidly to overcome body defenses and Disrupt normal cell function---Secrete toxins |
| Ability of organism to cause infection | pathogenicity |
| Measure of disease-producing potential | virulence |
| 3 Methods of Describing Bacteria | basic shapes, ability to use oxygen, staining characteristics |
| Basic Shapes of bacteria is | Bacilli—rod shape, Cocci—spherical shape, Spirilla—spiral shape |
| Ability to use oxygen in bacteria | Aerobic—with O2----Anaerobic—without O2 |
| Staining Characteristics of bacteria | Gram positive----Gram negative |
| Anti-infective Drugs are known as | Known as antibacterial, antimicrobial, antibiotic |
| Anti infective drugs are Classified by | |
| Mechanism of action (e.g., cell-wall inhibitor, protein synthesis inhibitor) ? | anti infective drugs |
| Actions of Anti-infective Drugs | Affect target organism’s structure, metabolism, or life cycle |
| Goal of anti-infective drugs is to | eliminate pathogen |
| Bactericidal | —kill bacteria |
| Bacteriostatic | —slow growth of bacteria |
| 5 Factors affecting anti infective therapy | Microbial resistance;The organism; Site of infection(bone – harder to clear up) ; Other meds in use; Pt’s health |
| Acquired ResistanceOccurs when pathogen | acquires gene for bacterial resistance (mutation or another microbe) |
| Process of mutation | Antibiotics destroy sensitive bacteriaResistant (mutated) bacteria remainMutated bacteria multiplyAntibiotics do not create mutations |
| Resistance not caused by but is worsened by | overprescription of antibiotics |
| Only prescribe when necessary | antibiotics |
| Long-time of antibiotics use | increases resistant strains |
| Nosocomial infections often resistant | antibiotics |
| When taking antibiotics its often needed to be taken | Prophylactic use sometimes appropriate tak in Am and evenly spaced intervals |
| Anti-infectives Problems with therapy are | Toxicity, Resistance , Allergic reactions, Superinfections (yeast infection), Diarrhea (destroys bacteria in GI tract |
| When givien an anti infective and allergic reaction what will it look like and what will you do | rash on torso and call doctor |
| Antibiotic misuses such as | Use with viral infections, Early discontinuation, Stored improperly, Sharing |
| Anti-infectives Nursing Implications | Determine causative agent prior to initiating therapy ( get culture dont wait Allergies,Must give at scheduled times around the clock,Monitor lab peak and trough, Know whether it needs to be taken on an empty or full stomach, Anaphylaxis, Increase fluids |
| PCN | penicillin |
| First mass produced antibiotic | Penicillin |
| Penicillin is a | Bacteriocidal |
| Penicillin is Used | : DOC against strep, pneumococci, & staph organisms that do not produce penicillinase Also DOC for gonorrhea & syphilis |
| 3 types of penicillin are | Penicillinase-resistent (i.e. Oxacillin); Broad spectrum (i.e. Amoxil); Extended spectrum (i.e. Piperacillin) |
| Be extremely careful of allergies when giving | penicillin |
| When giving penicillin you will see what units and what does it feel like | big units and thick and burns and takes a long time to inject |
| No alcohol when taking | antibiotics |
| Cephalosporins are Similar to __ so watch for ___ | PCN-watch for allergies |
| Prototype drug: cefotaxime (Claforan) | cephalosporins |
| With each generation of cephalosporins there is a increase | Increasing in activity against gram – organisms & anaerobes w/ each generation |
| 4th generation cephalosporins has activity against | gram+ cocci & gram – bacilli |
| Cephalosporins are bacter….. | Usually bacteriocidal |
| Cephalosporins are used for | Uses: STDs, RTIs, UTIs, prophylactically for osteomyelitis |
| Cephalosporins Do not give w/ | antacids, H2 blockers, & Fe supplements |
| When taking cephalosporins Use for | at least 10 days (opportunity for people to mess up ) |
| When giving cephalorsporins Monitor liver & renal functions (increase bleeding tendency ) , Assess for presence or history of bleeding disorders Avoid alcohol | |
| Cephalosporins may reduce what levels | prothrombin levels |
| Some cephalosporins cause | disulfiram (Antabuse)–like reaction with alcohol – warn patients |
| Tetracyclines are bacter… | Bacteriostatic |
| Prototype drug: tetracycline HCL (Achromycin) | tetracyclines |
| Tetracycline is Used for : | |
| A pateitn with Mountain spotted fever, cholera, Lyme dx, H pylori, & Chlamydia you will give | tetracycline |
| Tetracycline is Effective against | broad range of gram-positive & -negative organisms |
| When taking tetracycline | Do not take with milk or iron |
| Oral preps of ______will stain teeth-take with a straw | tetracycline |
| Tetracycline May cause | photosensitivity |
| Macrolides are bacter… | May be bacteriocidal or bacteriostatic |
| Macrolides are Good to treat | strep, haemophilus, STDs, H pylori, bone and GI infections |
| Prototypes: Erythromycin, Zithromax, and Biaxin | macrolides |
| When taking macrolides Do not take with | juices |
| Aminoglycosides are bacter… | Bacteriocidal |
| Aminoglycosides are Effective against | aerobic gram – infections |
| Used to sterilize the bowel prior to surgery | aminoglycosides |
| Used to destroy urease-producing bacteria to prevent absorption of ammonia in hepatic encephalopathy | aminoglycosides |
| Good for E coli, salmonella, pseudomonas, & staph to name a few | aminoglycosides |
| Aminoglycosides can be___so you need to __ | Ototoxic & Nephrotoxic-increase fluids |
| Prototypes: gentamicin & tobramycin | aminoglycosides |
| Fluroquinolones is bacter… | Bacteriocidal |
| Action: inhibits bacterial DNA gyrase Affects bacterial replication and DNA repair | fluroquinolones |
| Fluroquinolones are Used for what organisms | gram- & some gram+ organisms |
| Good for lower resp. infections, bone and jt infections, infectious diarrhea, UTIs, skin & soft tissue infections, intra-abdominal infections, & STDs | fluroquinolones |
| Prototypes: Levaquin & Cipro | fluroquinolones |
| Do not take with antacids, iron, & zinc | fluroquinolones |
| When giving Sulfonamides its important to | increase fluids |
| Action-blocks bacterial synthesis of folic acid, preventing the synthesis of amino acids and nucleic acids | sulfonamides |
| Prototype: Bactrim | sulfonamides |
| Sulfonamides are Used for | -UTIs, gram- & gram + bacteria, malaria |
| Many people are allergic to this class so check for Allergies | sulfonamides |
| Nitroimidazoles | Prototype: Flagyl |
| Action: active against anaerobic organisms, especially intestinal, b/c it is reduced by anaerobic processes to a short lived metabolite that directly damages DNA and leads to cell death | nitromidazoles |
| Uses: anaerobic infections | nitroimidazoles |
| Lincosamine | Prototype: Cleosin |
| Action: Inhibits the action of bacterial ribosomes Halts bacterial protein synthesis | lincosamine |
| Lincosamine May bebacter… ? | both bacteriostatic or bacteriocidal |
| Uses: anaerobic organisms, particularly Bacteroides fragilis | lincosamine |
| Glycopeptides | Prototype: Vancocin |
| Glycopeptides | Action: prevents synthesis of bacterial cell walls by blocking peptidoglycan strands formation |
| Uses: serious, life-threatening strep or staph infections | glycopeptides |
| Only use when absolutely necessary to prevent bacterial resistance | glycopeptides |
| Must do a peak and trough when giving this med | glycopeptides |
| Ototoxic and Nephrotoxic | glycopeptides |
| TuberculosisCaused by | Mycobacterium tuberculosis |
| What has Cell wall resistant to anti-infectives | TB |
| Body’s immune response attempts to isolate TB pathogen by | walling it off |
| Tuberculosis may remain dormant in walled-off areas called | tubercles |
| Decreased immune system can give tuberculosis | opportunity to become active |
| Long-Term Therapy of TB | 6–12 months of drug therapy, Needed to reach isolated pathogens in tubercles, Therapy must be continued even if no symptoms, Patients with multidrug-resistant infections require therapy for 24 months |
| Multidrug Therapy of TB | 2–4 antibiotics administered concurrently, Diff combos used during therapy, Nece bc mycobacterium grows slow and is resistant, Therapy initiated with first-choice drugs, When resistance develops, second-choice drugs used, More toxic and less effective |
| Chemoprophylaxis are | Antituberculosis drugs used to prevent disease in high-risk populations |
| High risk populations of TB | Close contacts and family members of recently infected tuberculosis clients, Patients with AIDS, Patients who are HIV-positive or are receiving immunosuppressant drugs |
| Characteristics of Fungi can be | Are single-celled or multicellular organisms, More complex than bacteria, Include mushrooms, yeasts, molds |
| Fungi Purpose is to | decompose dead organisms |
| Humans exposed to fungi by | handling contaminated soil or inhaling spores |
| Two types of Fungal Infections | superficial and systemic |
| Superficial fungal infection affects and treated with | Affect hair, skin, nails, mucous membranes Treated with topical agents – jock itch, athletes foot |
| Systemic fungal infections Affect | internal organs |
| Which fungal infections are Are less common | systemic |
| What fungal infection Can be fatal in immunosuppressed clients, Treated with oral or parenteral agents | systemic fungal infection |
| Fungi unaffected by most | antibiotics |
| Antifungal Drugs— for Superficial Infections | Prototype drug: nystatin (Mycostatin) |
| Action: binds to sterols in the fungal-cell membrane, allowing leakage of intracellular contents | nystatin – antifungal |
| Uses: Candida infections of intestines, vagina, skin, mouth Also treats candidiasis of intestine | antifungal |
| SEs of antifungals include | : minor skin irritation, nausea, vomiting, diarrhea |
| Protozoan Infections Cause disease in | Africa, South America, and Asia |
| Thrive in areas of poor sanitation | protozoan |
| Travelers may transmit these organisms | protozoan |
| Drugs used to treat bacterial and fungal infections are ineffective against | protozoans |
| Amebiasis, toxoplasmosis, giardiasis, cryptosporidiosis, trichomoniasis, trypanosomiasis, and leishmaniasis | Other protozoal diseases |
| Helminths are | : parasitic worms that cause significant disease in certain regions of world |
| 3 types of helminthes are | Roundworms (nematodes), Flukes (trematodes), Tapeworms (cestodes), |
| Most common helminth infection in US and how do you get it | Enteriobiasis (pinworm), walking bearfoot, come out of rectum at night |
| Most helminths enter body through | skin or gastrointestinal tract |
| Goals of Pharmacotherapy for helminths | Kill parasites locally ,Disrupt their life cycles ,Resistance not yet a problem |
| Antiprotozoal Drugs for Nonmalarial Antiprotozoal Agents are | flagyl |
| Action: to act as antiprotozoal drug that also has antibiotic activity against anaerobic bacteria | Antiprotozoal Drugs for Nonmalarial Antiprotozoal Agents |
| Use: Treats most forms of amebiasis | antiprotozoal |
| SEs of Antiprotozoal Drugs for Nonmalarial Antiprotozoal Agents : | |
| Antihelminthic Drugs | Prototype drug: mebendazole (Vermox) |
| Action of mebendazole ( vermox ) : | |
| mebendazole ( vermox ) Use: t | to treat wide range of helminth infections |
| SEs mebendazole ( vermox ) : | as worms die, abdominal pain, distension, and diarrhea may be experienced |
| Most common protozoal disease Second most fatal infectious disease in world | Malaria |
| Caused by protozoan Plasmodium | malaria |
| Transmitted by bite of female Anopheles mosquito | malaria |
| Requires multidrug therapy due to complicated life cycle of parasite | malaria |
| Goals of Antimalarial Therapy | prevention, treatment, prevention of relapse, eleimation of latent forms residing in the liver |
| Antimalarials interrupts what stage | erthrocytic – rbc so cant reproduce |
| Antiprotozoal Drugs—Antimalarial Agents | Prototype drug: chloroquine (Aralen) |
| concentrates in food vacuoles of Plasmodium residing in red blood cells | antipfotozoal anti malarial agents |
| Believed to prevent metabolism of heme, which then builds to toxic levels within parasite | |
| Use: as prototype medication for treating malaria for over 60 years | chloroquine (aralen) |
| SEs of chloroquine (aralen): | |
| CNS and cardiovascular toxicity at higher doses of what medicine | chloroquine (aralen) |
| Nonliving agents that infect bacteria, plants, animals | virus |
| Intracellular parasite | Must be in host cell to replicate and cause infection |
| Primitive Structure of Viruses | Surrounded by capsid (protein coat); Contain a few dozen genes, either RNA or DNA; DNA contains information needed for replication |
| Therapy for Viral Infections | Most self-limiting; require no pharmacotherapy |
| Some viruses cause serious disease and require aggressive therapy such as | HIV, herpes |
| Challenges of Antiviral Therapy are | 1.Viruses mutate rapidly, and drug becomes ineffective2. Difficult for drug to find virus without injuring normal cells3. Each antiviral drug specific to one particular virus |
| Usually do not initiate HIV antivirals until | CD4s are < 350 or pt becomes symptomatic due to the expense of meds |
| Goals of therapy: HIV ANTIVIRALS : | Reduce viral load to an undectable level or < 50 copies/ml, Increase lifespan, Higher quality of life, Decrease transmission form mother to child |
| Check CD4’s every | 3-6 months |
| Test used to test for HIV | PCR –polymer chain reaction |
| HIV Antivirals Highly Active Antiretroviral Therapy (HAART) Five drug classes used in various combinations | 1. Nucleoside reverse transcriptase inhibitor (NRTI) 2. Nonnucleoside reverse transcriptase inhibitor (NNRTI) 3. Protease inhibitor (PI) 4. Nucleotide reverse transcriptase inhibitor (NtRTI) 5. Fusion (entry) inhibitor |
| HIV Antivirals need to be taken for how long ? | May have to change regimen d/t viral adaptation & must continue for a lifetime |
| Pt should not take OTC w/o consulting MD d/t med interactions when taking | HIV antivirals |
| Lots of SEs | hiv antivirals |
| Do labs on viral loads and CD4s every | 3-6 months to track progression |
| Inhibits viral replication by acting on the enzyme reverse transcriptase | Nucleoside Reverse Transcriptase Inhibitors |
| Virus mistakenly uses zidovudine as nucleoside, thus creating defective DNA strand | Nucleoside Reverse Transcriptase Inhibitors |
| Stops nucleosides from being added & Used also for postexposure prophylaxis in HIV-exposed health-care workers & Reduce transmission rate from HIV-positive mother to fetus | Nucleoside Reverse Transcriptase Inhibitors |
| Nucleoside Reverse Transcriptase Inhibitors SEs: | N/V/D, HA, fatigue, mitochondrial dysfunction, lipodystrophy |
| Nucleoside Reverse Transcriptase Inhibitors | Prototype: Retrovir |
| Non-Nucleoside Reverse Transcriptase Inhibitors Same as Nucleoside Reverse Transcriptase Inhibitors except it also | stops the process of copying the virus’s RNA to DNA |
| Non-Nucleoside Reverse Transcriptase Inhibitors SEs: | |
| Prototypes: Sustiva, Viramune | Non-Nucleoside Reverse Transcriptase Inhibitors |
| Protease Inhibitors | Inhibits protease, preventing the construction of new viruses and their final maturation |
| Protease Inhibitors SEs: | GI upset, lipid abnormalities |
| Prototype: Kaletra | protease inhibitors |
| HIV Antivirals 2 new classes | Nucleotide reverse transcpritase inhibitors & Fusion (entry) inhibitors |
| Nucleotide reverse transcpritase inhibitors Action: | Similar to AMP; works similar to NRTIs |
| Nucleotide reverse transcpritase inhibitors drugs | EX: Viread |
| Fusion (entry) inhibitors Action: | blocks fusion of HIV virion to the CD4s |
| Fusion (entry) inhibitors drugs | EX: Fuzeon |
| HIV Antivirals Nursing Implications | Compliance often an issue (Expense,Complicated regimen,SEs), Monitor CD4 and viral load level to track progress,Stay up on meds-they are constantly changing, Meds must be taken exactly as ordered, Many can cause Steven-Johnson’s syndrome |
| What is given during pregnancy to prevent transmission of HIV | Zidovudine |
| after exposure of a client who has known HIV Postexposure prophylaxis should be started | 24-36 hours |
| Includes AZT, Zerit, and Videx for 4 weeks after exposure to HIV it’s a cocktail | |
| Herpes family includes: | HSV-1, HSV-2, CMV, Varicella-zoster, EBV, and Herpes virus-6 |
| Tx Goal Herpes Antivirals | Relieve acute symptoms,Prevent recurrences ,Does not cure herpes |
| Herpes Antivirals --Acyclic Nucleotide Analogs drugs | Prototypes: Zovirax, Famvir, Valtrex |
| Action: activated by viral thymidine kinase, therefore inhibiting viral DNA polymerase and halting viral production | Acyclic Nucleotide Analogs |
| Acyclic Nucleotide Analogs Uses: | all the herpes viruses, and other viruses |
| Acyclic Nucleotide Analogs SEs: | nephrotoxic, nephrotoxic, thrombocytopenia, GI upset |
| Nursing Implications when giving Acyclic Nucleotide Analogs (Zovirax, Famvir, Valtrex ) | Must be given around the clock and Take w/ food |
| Influenza Antivirals --- Neuroaminidase Inhibitors drugs Prototypes: | |
| Neuroaminidase Inhibitors drugs Action: | |
| Neuroaminidase Inhibitors drugs Must be started | w/i 2 days of the onset of s/s, Reduces the duration of the illness-does not cure or prevent transmission |
| Influenza Antivirals --- Amantidines | Prototypes: Symmetrel & Flumadine |
| Action: blocks early phases of viral replication, mechanism unclear | Influenza Antivirals --- Amantidines |
| Amantidines are Useful in | preventing illness post-exposure is used w/i 24 hours |
| Neoplasia= | “new growth” |
| Cell Cycleis Responsible for | DNA replication, Aligns the duplicated information for each daughter cell, Duration depends on the cell type |
| Four phases of cell cycle : | |
| Cell proliferation- | cells divide and reproduce |
| Cell differentiation- | proliferated cells become different and specialized |
| Benign- | slow, progressive, localized, well defined, resembles host, grow by expansion, do not usually cause death |
| Malignant- | rapid, spreads quickly, kills, highly undifferentiated; |
| Two categories of malignant | Solid or Hematologic ( blood cancers – leukemia ) |
| Rate of Tumor Growth Depends on 3 Factors: | Number of cells that are actively dividing or moving through the cell cycle, Duration of the cell cycle ; Number of cells that are being lost as compared with the number of new cells being produced |
| Growth Fraction | -dividing cells:resting cells |
| Gompertzian Model- | initial rapid growth until reaching maximum capacity of the blood supply, then leveling off ( only grow as big as blood supply allows so you need to cut off blood supply |
| 3 options to remove cancer | surgery, radiation and chemo |
| Surgery is performed on tumors when | Performed to remove tumor; When localized; When pressing on nerves, airways, or other vital tissues |
| What is more successful in removing tumors | Radiation and drug therapy more successful |
| If tumors affect blood cells and If surgery would not extend lifespan or improve quality of life | then surg is not an option |
| Radiation can do what to tumor | Can destroy tumor cells May follow surgery Used as palliation for inoperable cancers Shrinks size of tumor Relieves pain, difficulty breathing or swallowing |
| Ionizing radiation is | aimed directly at tumor |
| Too much radiation causes | bone marrow depression |
| Chemotherapy Usually used | in conjunction with radiation and surgery |
| General SEs of chemo | : anemia, neutropenia, thrombocytopenia, anorexia, N/V/D, alopecia, fatigue, infections, stomatitis, cardiotoxicity |
| Chemotherapy General Nursing Implications | Must handle with gloves, Must dispose in a yellow container |
| Manage SEs of chemo by | Oral care, Infection control measures, Avoid immunizations, Nutritional support, Adm antiemetics 30-40 minutes before |
| Chemotherapy --Alkylating Agents drugs | cytoxan |
| Chemotherapy --Alkylating Agents drugs | cytoxan Interferes with DNA replication & Cytotoxic regardless to the cell cycle stage |
| Additional SEs of Chemotherapy --Alkylating Agents drugs cytoxan | : ototoxic, sterility |
| Additional Nursing Implications for Chemotherapy --Alkylating Agents drugs cytoxan | Increase hydration; Avoid citric acid & foods high in purines , Discontinue if RBC, WBC, and platelet counts fall |
| Chemotherapy ---Antimetabolites drugs | Ex: Methotrexate |
| Inhibits protein synthesis which prevents DNA synthesis; Inhibits aspects of lymphocyte replication | Chemotherapy ---Antimetabolites drugs |
| Chemotherapy ---Antimetabolites drugs | Ex: Methotrexate Additional SEs: |
| Additional Nursing Implications Chemotherapy ---Antimetabolites drugs | Avoid citric acid & foods high in purines , Avoid pregnancy for at least six months after therapy with category X drug |
| antimetabolites | |
| Chemotherapy --- Antitumor Antibiotics drugs | Ex: Adriamycin |
| Chemotherapy --- Antitumor Antibiotics drugs Ex: Adriamycin action | Inhibits nucleic acid, RNA, and DNA synthesis |
| Chemotherapy --- Antitumor Antibiotics drugs Obtained from | bacteria that have the ability to kill cancer cells |
| Additional Nursing Implications for Chemotherapy --- Antitumor Antibiotics drugs | Be on the watch for extravasation , More at risk for anaphylactic reaction |
| Chemotherapy---- Plant Extracts | periwinkle plant Oncovin |
| Chemo-plant extracts work by | Inhibit mitosis |
| Plant extracts – chemo | Uses: pediatric leukemias, lymphomas, & solid tumors |
| Additional SEs Plant extracts – chemo | : bronchospasm, rashes |
| Plant extracts – chemo Contraindicated in many disorders such as | COPD, Szs, etc don’t give to people with resp problems |
| Additional Nursing Implications Chemotherapy---- Plant Extracts (oncovin ) | |
| Chemotherapy----- Hormone modulators drugs | megace tamoxifen |
| Hormone modulators are give to | suppress hormone dependant tumors, Will alter secondary sex characteristics, Fewer SEs , Used more for palliation |
| Biological response modifiers are used to | Enhance the immune system |
Created by:
ameliarae
Popular Nursing sets