Pharm- Class 3 notes 2023 with verified questions and answers

Key terms to focus on for chapter 47 Antibodies (immunoglobulines), antigen, autoimmune disorder, B lymphocytes (B cells), cytokines, cytotoxic T cells, Hematopoiesis, immunostigmant, immunosuppressant, interferon, leukocytes, memory cells, T lymphocytes (T cells), and tumor antigens what are the diff interferons? alpha, beta, and gamma What are the two different immune systems Innate and adaptive innate immune system -body's 1st line of defense -protective defense system -acts immediately- does not require anything to activate it The innate immune system includes what ? -physical barriers such as skin & mucous membrane (MM) -Chemical barriers such as stomach acid and tears -complement proteins -inflammation (redness, warmth, and swelling) -Leukocytes (WBC) What are the different Leukocytes? neutrophils, eosinophils, basophils, macrophages, dendritic cells, and natural killer cells Macrophages and dendritic cells activate what? helper T cells -which produce Cytotoxic T cells and B cells -Cytotoxic T cells release memory T cells and attack pathogens -B cells release memory B cells and antibodies Interferons are released when a sick cell sends out interferon to the healthy cells to warn them of invader where they can go ahead and arm themselves to be better prepared to fight off the pathogen/infection Interferons* indications and side effects -drug that is prescribed for certain cancer. -part of the innate immune system Indications: certain cancers, viral infections (e.g. hep. C) Side effects: flu-like symptoms, fatigue (extreme)* Key terms of chapter 48 (immunosuppressant drugs) autoimmune disease grafts: an organ you can transplant. immunosuppressants: drugs that make immune system less strong why is immunosuppression needed? -needed for organ transplant (e.g. heart, kidney, liver) -autoimmune diseases (e.g. rheumatoid arthritis, systemic lupus, erythematosus, Crohn's disease, multiple sclerosis, psoriasis Azathioprine indications (when to give this med) -prevent organ rejection -rheumatoid arthritis -Crohn's disease -ulcerative colitis Azathioprine side effects -alopecia (hair loss) -leukopenia (destruction of WBCs) -thrombocytopenia (destruction of platelets) -hepatotoxicity -increased risk of cancer Azathioprine nursing concerns and client education Nursing concerns: -baseline assessment needs to be done (renal, hepatic, and hematologic function) -maintain protective isolation as indicated Client ed: -importance of lifelong treatment to prevent transplant rejection -avoid contact with contagious people *Missed doses- once a day dosing? skip dose multiple times a day? take asap Cyclosporine Indications and routes Indications: -prevent organ rejection (preoperative then continuously) -autoimmune diseases -chronic dry eyes Routes -PO (by mouth) -IV -ophthalmic Cyclosporine side effects leukopenia (infections) hypertension hepatotoxic nephrotoxicity Cyclosporine -miracle drug -narrow theraputic index drug (if too little, doesn't work, if too high, you will get sick and die) When do you draw a trough level? right before the next scheduled dose. Cyclosporine nursing concerns and client education nursing concerns: -baseline assessment needs to be done (weight, vitals, surgical site) -lab results (CBC, renal function, liver function, pregnancy) -right of rejection (swelling of hands/ legs, decreased urine, chills, and N/V) Client ed: -emphasize purpose of meds -take meds consistently and at same time each day* -drink all the medication -infection prevention (hand washing, avoid crowds, avoid undercooked meats, and avoid live viruses) -monitor BP Muromonab-CD3 indications and side effects Indications: -prevent organ rejection Side effects: -cytokine release syndrome -hypertension -infection -fluid overload* how can you notice fluid overload in a patient? edema, BP going up, and wet lung sounds Muromonab-CD3 Nursing Considerations & client ed. nursing considerations: -Assess fluid overload. -assess for cytokine release syndrome (CRS) Client ed.: -teach patients purpose of the medicaiton -infection prevention -symptoms of CRS What are the lab tests to test for renal function? -BUN -Creatinine