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102 Cards in this Set

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immunotx

stimulate the pts immune system to target or eliminate -- ---
tumor cells
immunotx

stimulate the growth and --- of the bl cells after ---
differentiation

myelosuppression
agents used in immunotx
interferons

colony stimulating factors
interferon's aby. .. activates ---- cells and up regualtes th- and cells and macrophages
NK

TH1
thrombopoeitin -- growth factor
platelet
erythropoietin --- growth factor
rbc
interferon a indication
HC leukemia

melanoma

lymphoma

karposi's sarcoma

hep b

hep c
se of interferon a

--- syndrome

--tensio

--ias

--ion
flu like syndrome

hypotension

arrhythmias

depression
interferon b used to tx

relapsing -- ---
multiple sclerosis
interferon b can cause
flu like syndrome
interferon y activates ------

increases ------ ---
phagocytes

oxygen radicals. . . damages cells that's how virus and bact
interferon y prevents serious infections in --- --- --
chronic granulomateous disease

(inherited immunodeficiency)
interferon y causes

--- --- syndrome

-- distress

-- loss

--ion
flu like syndrome

gi distress

weight loss

depression
stem cell growth factor help increase
myeloid stem cells
what leads maturation of myeloid stem cells to platelets
thrombopoietin
stem cell growth factor:

recombinant --- ---
human scf
stem cell growth factor:

used to stimulate --- --- cells for transplant
blood progenitor
stem cell growth factor:

used in combo w/
G-CSF
stem cell growth factor:

increases release of stem cells form --- into ---
marrow

blood
stem cell growth factor:

increase # myeloid stem cells

given before transplant to:
reestablih blood cells component
stem cell growth factor:

used in combo w/
G-CSF
sargramostim route
iv

sub q
sargramostim

bone marrow ---
fibroblast
sargramostim

acts on immature ---, ---, ---, ----
neutrophils

platelets

macrophages

eosinophils

(speeds up maturation)
sargramostim actios

enchance --- ---- ---
maturation

differentiation

proliferation
sargramostim

decrease/increase cell cycle time by 33%
decrease
sargramostim

increased:
rbc

platelets

neutrophils

moncytes

eosinophils

(might run out of precursors)
sargramostim

mature ---
wbc
sargramostim

increased --- metabolism

increased ---sis, ---toxicity
oxidative

phagocytosis

cytotoxicity
sargramostim

increased --- presentation by -- --- --
antigen

apc
sargramostim

--- life span of neutrophils
doubles
sargramostim

enhances ---- production of ----
superoxide

macrophages
sargramostim

indications:

stimulate --- ---- after transplant
bone marrow
sargramostim used for -- after chemo
neutropenia

so you can give chemo more frequently . . . don't have to wait for bone marrow recovery
sargramostim used for
malignant lymphoma

lymphoblastic leukemia

hodgkin's disease

acute myelogenous leukemia
sargramostim tx

--- anemia
aplastic
ae of sargramostim

use caution in -- and -- disease
renal

hepatic
sargramostim ae

--- ---

--- ---

--cia

-- pain
malaise

fever

n/v

alopecia
sargramostim ae

--- ---- syndrome

---

---damage

--- disorders
capillary leak syndrome

edema

liver damage

pulmonary disorder
bone pain where w/ sargramostim
leg

pelvis
bone pain due to
cell stimulation
sargramostim

who receives it
someone already at high risk of death due to se
sargramostim

produced in ---- differ from human ----- for --- at position 23
yeast

leucine

argenine
route of sargramostim
subq
filgrastim

glycoprotein produced by --- and --- cells of bone marrow
fibroblasts

endothelial cells
filgrastim

produced in -----


not ----
E coli

glycosolated
filgrastim stimulates ------ --- ---
proliferation

differentiation

functional activity of neutrophils
filgrastim stimulate activity of
neutrophil
filgrastim increase --- in 2-3 dyas in normal individual
wbc

increased activity; reduce maturation time
filgrastim

for immature neutrophils

reduce -- --- from 5 days to 1 day
maturation time
filgrastim

mature neutrophils:

enhance ----

enhance --- production (kills engulfed cells)

enchanced release from --- ----
chemotaxis

superoxide production

bone marrow (has to be released to be effective)
indications for filgrastim

-- --- transplants

-- after chemo
bone marrow (jump start bone marrow)

neutropenia (acute leukemia, aids, hairy cell leukemia)
filgrastim

decrease -- after chemo
infections. . . keep isolated decrease ability to fight infections
ae of filgrastim

-- pain . . .may be severe

--ache

-----

-- --- ----

---penia
bone pain

ha

fatigue

n/v/d

thrombocytopenia
filgrastim

--cia

-- ----
alopecia

rash

fever
filgrastim

cv
arrhythmias

MI
pegfilgrastim

peglyated human G-CSF from ----
e coli

conjuaged to polyethlyene glycol
pegfilgrastim

decreased -- excretion
renal
pegfilgrastim


increased --- ---- --

less --- ----
duration of action

less frequent dosing
interleukin 11 oprelevkin

recombinant human IL-11 made in -----
ecoli
interleukin 11 oprelevkin

route
subq

daily
interleukin 11 oprelevkin

increase ---- maturation in 5-7 days
megakaryocyte
interleukin 11 oprelevkin

used in chem induced ----
thrombocytopenia
ae of interleukin 11 oprelevkin

--- retention

---cardia

---ion

--

----

-- vision
fluid retention

tachycardia

palpitation

edema

sob

blurred vision
thrombopoietin

recombinant ------ ----
human thrombopoeitin
thrombopoietin

selectively increase ------
megakaryocytes
thrombopoietin

clinical trials promising in ---
thrombocytopenia
thrombopoietin

---- increaese by day 4 peaking at --- ---
platelets

12-14 days
thrombopoietin

combined w/ --- or ----

--------
GM

G-CSF

erythropoietin
platelet stimulants:
eltrombopag

romiplostim
eltrombopag

route
oral
eltrombopag

nonpeptide ---- ---- --
thrombopoietine receptor agonist
eltrombopag use:
chronic immune thrombocytopenic purpuria
primary tx of platelet destruction
steroids

immunoglobulins

spleenectomy
eltrombopag

leads to dose dependent rise in
platelets
eltrombopag

cause --- --- rise in platelets
dose dependent
eltrombopag

who shows higher blood levels/toxicity
asians
eltrombopag

chelates
mg

al
eltrombopag

black box warning:

-- toxcity

increased risk of -- --- ----
bone marrow fibrosis
eltrombopag

black box warning

--- malignancies

------

mayd develop --- thrombocytopenia after discontiuation
hematological

cataracts

hemorrhagic
romiplostin

route
subq

weekly
romiplostin

fusion protein linked to two --- that acts as --- receptor agonist
IgI

TPO
romiplostin

activates --- pathways to increase platelets
transcriptional
romiplostin

increase risk of bone marrow ----

and

---- malignancies
fibrosis

hematological
romiplostin tx:
chronic immune thrombocytopenic purpuria
romiplostin

may see -- formation during use
antibody
plerixafor

---- chemokine receptor antagonist
CXCR4
plerixafor

not hiv drug because increase ---- ----- --- -- in blood
CD34+ hematopoietic stem cells in blood
CXCR4 chemokine receptor responsible for anchoring -- --- in --- ---
stem cells


bone marrow
when is plerixafor given
after 4 daily doses of
G-CSF for hematopoietic stem cell collection before radiation in nonhodgkin's and multi myeloma
plerixafor

should not be used for -- --- ---- in leukemia's
stem cell mobilization
plerixafor

t/f

ok to use in pregnancy
f

teratogenic in animals

not used in breastfeeding
plerixafor

causes --- pain

-- tension
abd pain

hypotension
erythropoietin regulated by ---- delivery
oxygen
erythropoietin regualted by O2 delivery to --- and released by --- ---
kidneys

tubular interstitial cells
erythropoietin

enhances ---- --- --- -- of rbc
survival

maturation

proliferation
route of erythropoietin
IV

IM
erythropoietin used in
anemias

dialysis requirement supplemental iron
erythropoietin

monitor
hematocrit
erythropoietin
fds warning to use lowest dose

has been shown to ---- ---- and increaed ----
constrict small arteries

hematocrit. . . can cause chf, mi, stroke
t/f

some evidence of increased -- risk and decreased effeciveness of ----
cancer

chemo
t/f

erythropoietin: less fatigue in ca patients
f

no evidence