- Information
- AI Chat
Immune System Drugs - Dfgghh
Nursing Fundamentals (Nurs 100)
West Coast University
Recommended for you
Preview text
IMMUNOLOGIC AGENTS: VACCINES & TOXOIDS
WHAT DO THEY DO?
The weakened or killed antigens contained in the vaccine do not have sufficient strength to cause disease. Although it is a rare occurrence, vaccination with any vaccine may not result in a protective antibody response in all individuals given the vaccine. A toxin that is attenuated (or weakened) but still capable of stimulating the formation of antitoxins is called a toxoid.
INDICATIONS
❖ Routine immunization of infants and children ❖ Immunization of adults against tetanus ❖ Immunization of adults at high risk for certain diseases (e., pneumococcal and influenza vaccines) ❖ Immunization of children or adults at risk for exposure to a particular disease (e., hepatitis A for those going to endemic areas) ❖ Immunization of prepubertal girls or nonpregnant women of childbearing age against rubella
ADVERSE REACTIONS
❖ Chills, fever ❖ muscular aches and pains ❖ Rash ❖ lethargy
CONTRAINDICATIONS
❖ Immunologic agents are contraindicated in patients with known hypersensitivity to the agent or any component of it. Allergy to eggs is a concern with some vaccines. ❖ The measles, mumps, rubella, and varicella vaccines are contraindicated in patients who have had an allergic reaction to gelatin, neomycin, or a previous dose of one of the vaccines ❖ Vaccines and toxoids are contraindicated during acute febrile illnesses, leukemia, lymphoma, immunosuppressive illness or drug therapy, and non localized cancer. Always ask about allergy history before preparing a vaccine for administration
INTERACTIONS
Vaccinations containing live organisms are not administered within 3 months of immune globulin administration, because antibodies in the globulin preparation may interfere with the immune response to the vaccination. Corticosteroids, antineoplastic drugs, and radiation therapy depress the immune system to such a degree that insufficient numbers of antibodies are produced to prevent the disease. When the salicylates are administered with the varicella vaccination, there is an increased risk of Reye’s syndrome developing.
NURSING MANAGEMENT
❖ Most vaccine preparations require refrigeration. Always have a backup plan for storage of the vaccine should the health care facility lose power. Temperature fluctuations can harm the vaccines. ❖ Monitor the patient before allowing them to leave after administering any vaccine. ❖ State agencies, drug companies, and immunization organizations all provide standardized forms for parents or caregivers that document immunization history. In addition to your facility documentation, provide or record on the document presented by the parent or caregiver the following information: ❖ Date of vaccination ❖ Route and site, vaccine type, manufacturer ❖ Lot number and expiration date ❖ Name, address, and title of individual administering vaccine ❖
IMMUNOLOGIC AGENTS: IG & antivenin
WHAT DO THEY DO?
Immune globulins are solutions obtained from human or animal blood containing antibodies that have been formed by the body to specific antigens. Because they contain ready-made antibodies, they are given for passive immunity against disease. Antivenins are used for passive, transient
protection from the toxic effects of bites by spiders
(black widow and similar spiders) and snakes
(rattlesnakes, copperhead and cottonmouth, and
coral). The most effective response is obtained
when the drug is administered within 4 hours after
exposure.
CONTRAINDICATIONS
The immune globulins are contraindicated in patients with a history of allergic reactions after administration of human immunoglobulin preparations and in individuals with isolated immunoglobulin A (IgA) deficiency (individuals could have an anaphylactic reaction to subsequent administration of blood products that contain IgA). Human immune globulin intravenous (IGIV) products have been associated with renal impairment, acute renal failure, osmotic nephrosis, and death. Individuals with a predisposition to acute renal failure (e., those with pre-existing renal disease), those with diabetes mellitus, individuals older than 65 years of age, or patients receiving nephrotoxic drugs should not be given human IGIV products.
INTERACTIONS
Antibodies in the immune globulin preparations may interfere with the immune response to live virus vaccines, particularly measles, but including others such as mumps and rubella. It is recommended that the live virus vaccines be administered 14 to 30 days before or 6 to 12 weeks after administration of immune globulins. No known interactions have been reported with antivenins.
Antineoplastics” cell cycle specific”: ANTIMETABOLITES
WHAT DO THEY DO?
Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division. This interferes with the synthesis of RNA and DNA, making it impossible for the cancerous cell to divide into two daughter cells. These drugs are used for many of the leukemias, lymphomas, and
solid tumors as well as autoimmune diseases.
INDICATIONS
❖ Treatment of cancer
ADVERSE REACTIONS
❖ Bone marrow suppression (anemia , leukopenia , thrombocytopenia ) ❖ stomatitis ❖ Diarrhea ❖ and hair loss. ❖ The most common reactions are leukopenia and thrombocytopenia
CONTRAINDICATIONS
Antineoplastic drugs are contraindicated in patients with leukopenia, thrombocytopenia, anemia, serious infections, serious renal disease, or known hypersensitivity to the drug, and during pregnancy
INTERACTIONS
❖ Digoxin: Decrease serum level of digoxin ❖ Phenytoin: Decreased need for anti seizure medication ❖ Nonsteroidal anti-inflammatory drugs (NSAIDs): Methotrexate toxicity
NURSING MANAGEMENT
❖ Wear personal protective equipment when preparing any of these drugs for parenteral administration. ❖ Administer any prophylactic medications or fluids in a timely manner to prevent reactions. ❖ Observe the patient closely before, during, and after the administration of an antineoplastic drug. ❖ Observe the IV site closely to detect any signs of extravasation (leakage into the surrounding tissues). Tissue necrosis can be a serious complication. Discontinue the infusion and notify the oncology health care provider if discomfort, redness along the pathway of the vein, or infiltration occurs. ❖ Continually update nursing assessments, nursing diagnoses, and nursing care plans to meet the changing needs of the patient. ❖ Notify the oncology health care provider of all changes in the patient’s general condition, the appearance of adverse reactions, and changes in laboratory test results. ❖ Provide the patient and family with both physical and emotional support during treatment. ❖ Institute neutropenic precautions to prevent infections. ❖ Immediately report a temp higher than 100 or higher, cough, sore throat, chills, frequent urination, or a white blood cell count of less than 2500/mm 3. ❖ Immediately before administering the first dose of an antineoplastic drug, take the patient’s vital signs and obtain a current weight ❖ Get a baseline CBC before first dose ❖ Monitor ongoing blood results ❖ You may need to hydrate the patient before administration of cisplatin. ❖ You may need to administer antiemetics prior to administration. ❖ Educate the patient on side effects including weight loss and alopecia. ❖ Provide support and comfort. ❖ Teach the patient to report to you or to the health care provider immediately any of the following: bleeding gums, easy bruising, petechiae (pinpoint hemorrhages), increased menstrual bleeding, tarry stools, bloody urine, or coffee-ground emesis.
HERBAL CONSIDERATIONS
The shiitake mushroom, an edible variety of mushroom, is associated with general health maintenance but not with any severe adverse reactions. Mild side effects, such as skin rashes and GI upset, have been reported. Lentinan, a derivative of the shiitake mushroom, is proving to be valuable in boosting the body’s immune system and may prolong the survival time of patients with cancer by supporting immunity. In Japan, lentinan is commonly used to treat cancer. Additional possible benefits of this herb include lowering cholesterol levels by increasing the rate at which cholesterol is excreted from the body. Under no circumstances should shiitake or lentinan be used for cancer or any serious illness without consulting a primary health care provider (DerMarderosian, 2003).
Generic Side effects Use
Methotrexate Immediate: nausea, vomiting (high dose) During therapy cycles: anemia, leukopenia, thrombocytopenia, stomatitis, diarrhea, renal damage Long term: hepatotoxicity
Leukemia/lymphomas; ALL, non-Hodgkin’s lymphoma Solid tumors: breast, head/neck, choriocarcinomas, osteosarcomas Nonmalignant: mycosis fungoides, severe psoriasis, rheumatoid arthritis Unlabeled use: multiple sclerosis, inflammatory bowel disease
Fluorouracil (5-FU) During therapy cycles: anemia, leukopenia, thrombocytopenia, nausea, vomiting, stomatitis, diarrhea, alopecia
Palliative treatment for solid tumors: breast, stomach, pancreas, colon, rectum
NURSING ALERT
Radiation recall is a skin reaction in which an
area that was previously irradiated becomes
reddened when a patient is administered
certain specific chemotherapy drugs. This is
well differentiated from a reaction exclusive to
the drugs, because of the defined outline of
the previous radiation treatment field on the
body.
Antineoplastics” cell cycle NONspecific”: Alkylating agents
WHAT DO THEY DO?
Alkylating agents make the cell a more alkaline environment, which in turn damages the cell. Malignant cells appear to be more susceptible to the effects of alkylating drugs than normal cells.
INDICATIONS
❖ Treatment of cancer
ADVERSE REACTIONS
❖ Bone marrow suppression (anemia , leukopenia , thrombocytopenia ) ❖ stomatitis ❖ Diarrhea ❖ and hair loss. ❖ The most common reactions are leukopenia and thrombocytopenia
CONTRAINDICATIONS
Antineoplastic drugs are contraindicated in patients with leukopenia, thrombocytopenia, anemia, serious infections, serious renal disease, or known hypersensitivity to the drug, and during pregnancy
INTERACTIONS
❖ Phenytoin: Increased risk of seizures ❖ Aminoglycosides: Increased risk of nephrotoxicity and ototoxicity ❖ Loop diuretics: Increased risk of ototoxicity
NURSING MANAGEMENT
❖ Wear personal protective equipment when preparing any of these drugs for parenteral administration. ❖ Administer any prophylactic medications or fluids in a timely manner to prevent reactions. ❖ Observe the patient closely before, during, and after the administration of an antineoplastic drug. ❖ Observe the IV site closely to detect any signs of extravasation (leakage into the surrounding tissues). Tissue necrosis can be a serious complication. Discontinue the infusion and notify the oncology health care provider if discomfort, redness along the pathway of the vein, or infiltration occurs. ❖ Continually update nursing assessments, nursing diagnoses, and nursing care plans to meet the changing needs of the patient. ❖ Notify the oncology health care provider of all changes in the patient’s general condition, the appearance of adverse reactions, and changes in laboratory test results. ❖ Provide the patient and family with both physical and emotional support during treatment. ❖ Institute neutropenic precautions to prevent infections. ❖ Immediately report a temp higher than 100 or higher, cough, sore throat, chills, frequent urination, or a white blood cell count of less than 2500/mm 3. ❖ Immediately before administering the first dose of an antineoplastic drug, take the patient’s vital signs and obtain a current weight ❖ Get a baseline CBC before first dose ❖ Monitor ongoing blood results ❖ You may need to hydrate the patient before administration of cisplatin. ❖ You may need to administer antiemetics prior to administration. ❖ Educate the patient on side effects including weight loss and alopecia. ❖ Provide support and comfort. ❖ Teach the patient to report to you or to the health care provider immediately any of the following: bleeding gums, easy bruising, petechiae (pinpoint hemorrhages), increased menstrual bleeding, tarry stools, bloody urine, or coffee-ground emesis.
HERBAL CONSIDERATIONS
The shiitake mushroom, an edible variety of mushroom, is associated with general health maintenance but not with any severe adverse reactions. Mild side effects, such as skin rashes and GI upset, have been reported. Lentinan, a derivative of the shiitake mushroom, is proving to be valuable in boosting the body’s immune system and may prolong the survival time of patients with cancer by supporting immunity. In Japan, lentinan is commonly used to treat cancer. Additional possible benefits of this herb include lowering cholesterol levels by increasing the rate at which cholesterol is excreted from the body. Under no circumstances should shiitake or lentinan be used for cancer or any serious illness without consulting a primary health care provider (DerMarderosian, 2003).
Generic Side effects Use
Cyclophosphamide Immediate: nausea, vomiting During therapy cycles: leukopenia, hemorrhagic cystitis, thrombocytopenia Long term: fertility problems, secondary cancers
Leukemia/lymphomas: ALL, AML, CLL, advanced lymphomas, Hodgkin’s disease Solid tumors: breast, ovary, neuroblastoma, retinoblastoma Nonmalignant: mycosis fungoides, nephrotic syndrome (children), rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis
Chlorambucil During therapy cycles: anemia, leukopenia, thrombocytopenia Long term: fertility problems
Leukemia/lymphomas: chronic lymphocytic leukemia (CLL), lymphomas, Hodgkin’s disease
NURSING ALERT
Radiation recall is a skin reaction in which an area
that was previously irradiated becomes reddened
when a patient is administered certain specific
chemotherapy drugs. This is well differentiated
from a reaction exclusive to the drugs, because of
the defined outline of the previous radiation
treatment field on the body.
Immune System Drugs - Dfgghh
Course: Nursing Fundamentals (Nurs 100)
University: West Coast University
