VUSN Pharm 2 Final Exam (Week 12) Questions and Answers 100% Pass

assess for allergies and contraindications, assess for baseline organ function (kidney, liver - LFTs, electrolyte levels), assess for active infection/recent viral infection, monitor CBC for possible bone marrow suppression (Hct, Hgb), admin at same time daily as indicated, ensure drug levels are drawn just prior to admin - cyclosporine nursing interventions benefit of treatment MUST outweigh risks - important thing to remember when considering immunosuppressant therapy cyclosporine, prednisone, mycophenolate, IgG - immunosuppressant prototype drugs organ transplant introduces foreign tissue to body, immune system produces IL-2 (type of lymphokine), activation of immune system leads to destruction and rejection of foreign tissue - body's response to organ transplant IL-2 - specific lymphokine produced by immune system when organ transplant occurs used to suppress immune system, prevent organ/tissue rejection, prevent tissue destruction, autoimmune diseases - principals of immunosuppressant therapy increased risk for infection and neoplasms - risks of immunosuppressant therapy appropriate, overactive - immunosuppressants minimize effects of which immune responses? calcineurin inhibitor - cyclosporine class whole organ transplantation (liver, kidney, heart), autoimmune conditions (rheumatoid arthritis, psoriasis) - cyclosporine use inhibits calcineurin (suppresses T-cell proliferation), inhibit production and release of IL-2 - cyclosporine ETAincrease levels: - "azole" antifungals, macrolide antibiotics, Amp-B, grapefruit juice decrease levels: - phenytoin, phenobarbital, carbamazepine, rifampin, terbinafine, trimethoprim/sulfamethoxazole - cyclosporine interactions nephrotoxicity (75%), infection (75%), hirsutism, HTN, gingival hyperplasia, tumor, anemias (s/t suppression of bone marrow) - cyclosporine side effects foods to avoid (don't take w food, decreases absorption), proper med admin (same time daily), warning s/sx of potential problems - cyclosporine client education corticosteroid - prednisone class autoimmune disorders (idiopathic thrombocytopenia purpura), organ transplantation (Renal, liver, bone marrow, heart), acute inflammatory processes (arthritis caused by acute inflammation, allergic reactions, asthma) - prednisone use daily weights, BP, whole blood glucose, check electrolytes (creatinine, sodium, potassium), WBC, monitor bone density, monitor adrenal insufficiency - prednisone nursing interventions suppresses migration of leukocytes, inhibits mitosis of lymphocytes, reduces lymphatic system activity, inhibit production of inflammatory mediators (leukotrienes, prostaglandins, histamines, bradykinins) - prednisone ETA skin thinning, infection, bone dissolution, impaired growth, adrenal insufficiency, increased water retention, polydipsia, increased glucose - prednisone side effects cytotoxic agent - mycophenolate classsevere refractory rheumatoid arthritis, lupus, multiple sclerosis, psoriasis, whole organ transplantation (heart, kidney, liver) - mycophenolate use destroys B and T lymphocytes, non-specific, thus toxic to all proliferating cells (goal is to reduce antibodies in system) - mycophenolate ETA antacids!, cholestyramine (both decrease effectiveness) - mycophenolate interactions monitor CBC! (checking for neutropenia, thrombocytopenia, anemia), educate on GI effects, BNP, cholesterol levels, give meds as indicated, assess and educate for s/sx of infection - mycophenolate nursing interventions bone marrow suppression (neutropenia, thrombocytopenia, anemia), GI disturbances (nausea, diarrhea), alopecia, infection/sepsis, neoplasms (skin, lymphomas) - mycophenolate side effects antibody - IgG class acute phase tissue rejection, exacerbations of autoimmune processes (multiple sclerosis, Crohn's disease, ITP, vasculitis, Guillian-Barre), rabies - IgG use binds to IL-2 receptors, impairs adhesion and transmigration of leukocytes, blocking T-cell proliferation - IgG ETA acute hypersensitivity reactions (flushing, myalgia, wheezing, tachycardia, hypotension), renal failure, hemolytic anemias - IgG side effects vaccine - preparation of a weakened or killed pathogen that when administered stimulates antibody production which will guard against the disease caused by the pathogen active immunity - an immune response that is activated when a pathogen invades the body