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148 Cards in this Set
- Front
- Back
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a cell type that is capable of becoming a variety of different cell types
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pluripotent stem cell
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a committed stem cell that will produce a cell type
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colony forming unit
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substances that regulate cellular activities by acting as chemical messengers among cells
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cytokines
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a group of cytokines that stimulate pluripotent stem cells to produce a cell type
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colony-stimulating factors
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a colony stimulating cytokine secreted by the kidney to stimulate red blood cell production
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erthyropoietin
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a colony stimulating cytokine secreted by the liver and kidneys to stimulate platelet blood cell production
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thrombopoietin
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disrupts viral replication
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interferon
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multiple cytokines 1-18 that conduct immune system modulations in angiogenesis, inflammation, and creation of C-reactive protein
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interleukins
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cytokines produced by activated macrophages
alpha is associated with debilitation and weight loss in clients with cancer beta is also called lymphotoxin |
tumor necrosis factor
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colorless weakly motile cells originating from stem cells and differentiating in lymphoid tissue
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lymphocytes
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immunity that the organism developed by the immune system in response to environmental antigens
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acquired immunity
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process by which antibodies are formed
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active immunity
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process by which antibodies are formed by another person or animal and transferred to the host
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passive immunity
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substance that initiates immune responses
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antigen
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incomplete antigen
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hapten
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substance produced by immune system after exposure to antigen
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antibody
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proteins that interact with specific antigens that assist in formation of antigen-antibody complexes and opsonization
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immunoglobulins
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also called CD4 cells that produce cytokines
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helper T cells
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secrete interleukin 2 that assists the T cell to bind to an antigen
form holes in target cell membranes especially lethal to viruses |
cytotoxic T cells
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lymphocytes that secrete antibodies
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B lymphocytes
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granulocytes that occur especially in connective tissue and have basophilic granules containing substances which mediate allergic reactions
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mast cells
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thermolabile group of proteins in a normal blood serum and plasma that work alongside antibodies to destroy antigens
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complement
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process by which lymphocytes leave the bloodstream and move into the injured or inflamed tissue
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chemotaxis
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medications that either enhance or restrict immune responses to various disease processes
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biological response modifiers
(also called immunomodulators) |
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suspensions of microorganisms or their antigenic products that have been killed or attenuated so that they can induce antibody formation
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vaccines
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bacterial products that have been modified to destroy toxicity while retaining antigenic properties
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toxoids
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In adults, where is the bone marrow that makes RBCs, WBCs, and platelets?
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in the flat bones (skull, ribs, sternum, vertebrae)
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the most abundant immunoglobulin
works in concert with complement |
IgG
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the main immunoglobulin in mucous membranes and body secretions
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IgA
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immunoglobulin that is specific to one type of bacteria and toxins
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IgM
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immunoglobulin involved in parasitic infections and hypersensitivity reactions (anaphylaxis)
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IgE
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immunoglobulin that is found of the cell membranes of B lymphocytes
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IgD
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What kind of immunizing agent should a person with an active malignant disease (cancer) receive?
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killed vaccines or toxoids
*do NOT give live vaccine to person with cancer |
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What are the recommendations for giving vaccines to a patient who is on a systemic corticosteroid in high doses?
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Wait at least 3 months before being given a live-virus vaccine.
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Which of the following immunizing agents are immune globulins? Which are toxoids?
CytoGam Tetanus Pnu-Immune 23 RespiGam Recombivax HB |
Immune globulins: CytoGam & RespiGam
Toxoid: Tetanus |
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Who should receive the CytoGam immune globulin?
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transplant recipients
women before they become pregnant |
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Who should receive the tetanus toxoid?
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children and adults routinely
people who sustain a potentially contamined wound (trauma) |
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Who should receive the Pnu-Immune 23 vaccine?
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immunosuppressed people over age 65 (those with CV disease, DM, renal failure, cirrhosis, etc.)
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Who should receive the RespiGam immune globulin?
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neonates (children under 2)
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Who should receive the hepatitis B vaccine (Recombivax HB)?
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high-risk groups:
healthcare workers teachers first responders |
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Vaccines provide what kind of immunity?
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active
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Severe immunosuppression is a CI to:
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the use of live bacterial or viral vaccines
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To decrease fever and discomfort after an immunization, adults and children can take:
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actetaminophen every 4-6 hours for at least 24 hours
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For a child receiving an immunization, parents should be informed that common aftereffects include:
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redness and soreness at the injection site
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Adults should be given tetanus toxoid vaccine every ____ years.
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10
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immunostimulant drug given to prevent or treat anemia assoc. with CRF, AZT therapy (ppl who are HIV positive), or chemotherapy; also given to reduce # of blood transfusions in anemic clients
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Epoetin alfa (Epogen)
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People taking _________ after chemotherapy are more likely to develop cancer again.
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Epoetin alfa (Epogen)
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colony-stimulating factor drug given to prevent infection in patients with neutropenia induced by chemo or bone marrow transplantation
not used until WBC <200 |
Filgrastim (Neupogen)
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What is the main AE of Filgrastim (Neupogen)?
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excruciating bone pain
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interleukin drug given to prevent severe thrombocytopenia in clients taking chemo that depresses bone marrow function
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Oprelvekin (Neumega)
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Who should NOT take Oprelvekin (Neumega)?
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people with myeloid malignancies (leukemia or bone cancers)
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drug used in the treatment of chronic hepatitis C
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Interferon alfa-2a (Roferon-A)
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What is the main AE of Interferon alfa-2a (Roferon-A)?
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depression with suicidal thoughts
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immunostimulant vaccine used in the treatment of bladder cancer
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BCG
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How is the BCG vaccine administered?
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intravesical instillation (given though a urinary catheter over 6-7 hours)
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After patients receive ___________ vaccine, they should never take another TB skin test.
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BCG (for bladder cancer)
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Through what route are most immunostimulant and hematopoeitic drugs given?
Where are most of these drugs given? |
sub-q or IV (b/c they are proteins that would be destroyed by digestive enzymes if given orally)
most of these drugs are given at home by the patient or caregiver |
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The expected outcome of administering epoetin afla (Epogen) to a client with chronic renal failure is:
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increased RBC production
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Most clients who take epoetin alfa (Epogen) also need to take:
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iron
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An expected outcome after the administration of filgrastim (Neupogen):
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fewer infections
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When are some times when we want to turn the immune system OFF (with immunosuppressant drugs)?
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autoimmune disease
organ transplantation |
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immunosuppressant used to prevent renal transplant rejection
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Azathioprine (Imuran)
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What is the main problem with immunosuppressant drugs?
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they can cause cancer (esp. Hodgkin's lymphoma)
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immunosuppressant drug used to prevent rejection of solid organ (heart, liver, kidney) transplant
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Cyclosporine (Sandimmune)
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Which immunosuppressant drug should be given in a glass container?
What should you mix it with to improve the taste? |
Cyclosporine (Sandimmune)
apple juice or orange juice; do NOT mix with grapefruit juice |
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immune system suppressor drug used in the treatment of rheumatoid, juvenile and psoriatic arthritis, and ankylosing spondylitis
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Etanercept (Enbrel)
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What should the nurse teach a patient who is taking Etanercept (Enbrel)?
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Teach patient that low-grade fever is very serious (they could die of sepsis).
Teach patient to have job where they aren’t around many people. Teach patient how to mix and inject medicine correctly |
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immune system suppressor drug used in the treatment of severe psoriasis or rheumatoid arthritis unresponsive to other treatments
also used to treat cancer |
Methotrexate (Rheumatrex)
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immune system suppressor drug used to treat renal, cardiac, or hepatic transplant rejection
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Muromonab-CD3 (Orthoclone OKT3)
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Which immunosuppressant drug may only be used once a lifetime?
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Muromonab-CD3 (Orthoclone OKT3)
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Who should NOT take Muromonab-CD3 (Orthoclone OKT3)?
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people allergic to mice
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Which immunosuppressant drug may cause patients to go into heart failure?
What should they be monitored for? |
Muromonab-CD3 (Orthoclone OKT3)
S3 heart sound, edema, jugular venous distention |
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immunosuppressant drug used to prevent liver, kidney, and heart transplant rejection
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Tacrolimus (Prograf)
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Who should NOT take Tacrolimus (Prograf)?
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people allergic to castor oil
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The most commmon malignancies that occur with immunosuppression include:
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skin cancers and lymphomas
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antidote used to treat acute iron intoxication and hemochromatosis due to blood transfusions
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Deferoxamine (Desferal)
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antidote used to treat copper intoxication (sometimes in Wilson's disease)
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Penicillamine (Cupramine)
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antidote used to treat lead poisoning in children
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Succimer (Chemet)
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Potassium should be restricted in _________ failure.
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renal
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____________ and _____________ should be restricted in liver failure.
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fat-soluble vitamins
protein |
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__________ should be restricted in pulmonary failure.
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carbohydrates
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Do not give magnesium faster than __________.
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1g/hr
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adrenergic drug used to in the short term treatment of obesity
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Phentermine hydrochloride (Adipex-P)
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Who should not take Phentermine hydrochloride (Adipex-P)?
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clients with HTN or other CV disease
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appetite suppressant and SSRI used to treat obesity
works by inhibiting the reuptake of serotonin and norepinephrine in the brain |
Sibutramine (Meridia)
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When should you take Phentermine hydrochloride or Meridia?
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in the morning to decrease appetite during the day and to avoid interference with sleep at night
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fat blocker used in the treatment of obesity
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Orlistat (Xenical)
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When should you take Orlistat (Xenical)?
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Take 1 capsule with each main meal (up to 3 capsules daily).
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pregnancy category in which adequate studies in pregnant women demonstrate no risk to the fetus
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A
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pregnancy category in which animal studies indicate no risk to the fetus, but there are no adequate studies in pregnant women; or animal studies show adverse effects, but adequate studies in pregnant women have not demonstrated a risk
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B
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pregnancy category in which there is a potential risk, usually because animal studies have either not been performed or have indicated adverse effects, and there are no data from human studies
these drugs may be used when potential benefits outweigh potential risks |
C
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pregnancy category in which there is evidence of human fetal risk, but the potential benefits to the mother may be acceptable despite the potential risk
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D
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pregnancy category in which studies in animals or humans have demonstrated fetal abnormalities; the risk of use in a pregnant woman clearly outweighs any possible benefit
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X
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What factors that occur during pregnancy affect the DISTRIBUTION of drugs in the body?
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1. Increased plasma volume and body water (dilutional factor)
2. Decreased serum albumin (albumin-bound drugs are left free or unbound in the body and produce greater effects) |
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What factors that occur during pregnancy affect the EXCRETION of drugs in the body?
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1. Increased weight and body fat (fat-soluble drugs tend to linger longer in the body)
2. Increased renal blood flow and GFR (increased excretion of drugs by the kidneys) |
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How do opiates affect the fetus?
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they could cause respiratory depression
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Should a pregnant woman take ACE inhibitors or ARBs?
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no!
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What antibiotics are safe during pregnancy?
Which ones are NOT safe? |
Safe: Pencillin, cephalosporins
NOT safe: aminoglycosides, fluoroquinolones, tetracyclines |
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What is the only anticoagulant that is safe to give during pregnancy?
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heparin
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What is the only safe HIV drug to give during pregnancy?
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AZT
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What bacteria is 100% fatal to newborns?
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Group B strep
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What are the 2 uses for Misoprostol (Cytotec)?
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treatment of GERD/stomach ulcers
abortion |
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What is the pharm class of Misoprostol (Cytotec)?
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prostaglandin
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What is the therapeutic classification of magnesium sulfate?
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tocolytic
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drug given primarily in the 2nd and 3rd trimesters to prevent uterine contractions in preterm labor
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magnesium sulfate
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What assessments should you do when giving someone magnesium sulfate?
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check for low blood pressure
count respirations (<12) see if DTRs are less brisk *these findings incidate hypermagnesemia! |
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posterior pituitary hormone given to induce labor and control post-partum bleeding
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Oxytocin (Pitocin)
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A daily vitamin K supplement is recommended during the last month of pregnancy for women receiving long-term drug therapy for what condition?
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seizure disorders
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For a client receiving a continuous IV magnesium sulfate infusion for tocolysis, what medication needs to be readily available at the bedside?
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calcium gluconate
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What are some of the side effects of taking birth control pills?
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weight gain (about 5 lbs)
skin clears up sun-sensitivity irritability (when estrogen is either high or low) |
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Who should NOT take birth control pills?
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women who:
are pregnant smoke are older than 35 have a family history of breast or uterine cancer |
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What is the pharm class of megestrol acetate (Megace)?
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progestin
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drug given to people with anorexia or cancer to encourage appetite
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megestrol acetate (Megace)
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herbal treatment for menopause
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black cohosh
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What are the AE of black cohosh?
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hypotension
visual disturbances |
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How does combined estrogen-progestin therapy affect women with diabetes?
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it may increase blood sugar
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estrogen prototypes given to treat menopause
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Premarin (pill)
Climara (patch) |
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estrogen/progestin drug given to prevent pregnancy or regulate the menstrual cycle
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Levonorgestrel ethinylestradiaol (Preven)
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What is the pharm class of Clomiphene (Clomid)?
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ovulation inducer
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ED drug that moves blood under the influence of nitric oxide into the penis
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Viagra
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What two drugs should not be taken at the same time as Viagra? Why?
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nitrates --> can't pool blood in the heart and penis at the same time
alcohol --> will cause profound hypotension |
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Will giving testosterone help ED?
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no!
all it will do is increase libido |
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When are androgens legally prescribed?
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when a man has an orchidectomy b/c of cancer or injury
to treat hair loss in both sexes to increase libido in post-partum women |
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What organ is central to making you male or female?
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liver
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What are the 2 testosterone prototypes we need to know?
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Depo-testosterone (IM)
Androderm (patch) |
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dietary supplement marketed as a safe, natural, alternative androgen for building muscle
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DHEA
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The most common eye disease in the U.S. is _____________.
Second most common is ___________. |
diabetic retinopathy
glaucoma |
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alpha adrenergic drug used to treat glaucoma by causing pupil dilation (mydriasis)
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Phenylephrine (Neo-Synephrine)
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beta blocker used to treat glaucoma by lowering intraocular pressure
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Betaxolol (Betoptic)
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diuretic used to treat severe glaucoma and also metabolic alkalosis
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Acetazolamide (Diamox)
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antiviral agent used to treat herpes infections in the eye
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trifluridine (Viroptic)
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If a penetrating object is in the eye, should you remove it?
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No! Go to the ER...
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immune system suppressor drug used to treat dry eyes (most commonly caused by autoimmune diseases)
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cyclosporine (Restatsis)
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What is a major purpose of occluding tear ducts after administering eye drops?
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to prevent systemic absorption of the drug
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When a client has 2 eye drops ordered at the same time, how should the nurse administer them?
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Wait 5-10 minutes between drops.
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a general term denoting an inflammatory response of the skin
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dermatitis
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chronic, inflammatory skin disorder that results in excessively rapid turnover of epidermal cells
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psoriasis
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antifungal agent used in the treatment of candidiasis in the fat folds of very obese people
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nystatin (Mycostatin)
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What is the pharm class of Accutane?
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retinoid
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What assessment should you do on patients taking Accutane?
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depression inventory screening (to make sure they are not going to commit suicide)
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antipyretic used to treat itching (chicken pox, hives, etc.)
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Aveeno
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What is the antidote for anticholingergic drugs (Atropine)?
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Physostigmine
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What is the antidote for beta blockers?
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Glucagon
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What is the antidote for calcium channel blockers?
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calcium gluconate
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What is the antidote for cholinergic drugs?
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Atropine
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What is the antidote for Isoniazid (INH)?
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Pyridoxine
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What is the antidote for phenothiazine antipsychotic agents?
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Benadryl
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What is the antidote for tricyclic antidepressants?
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sodium bicarbonate
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