Immunostimulant Agents

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Vaccines
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Used to promote immune response

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Interferons- Interferon Alfa-2a

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Boast to body

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Interferons Pharmacotherapeutics

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Hary cell leukemia
Viral Condistion- can be given boost to fight virus

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Interferons Pharmackinetics

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IM administration, rapid absorption
Subcutation administration, slower absorbtion

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Interferons Pharmacodynamics

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Growth of tumor cells inhibited
Cell multiplication prevented
Home immune response modulated
Viral replication prevented

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Interferons Adverse Effects

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Flu like symptoms
Bone Marrow Depression- cause more depression
Partial alopecia- body image

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Interferons assesment

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Laboratory studies inclue CBC, liver and renal function studies and ECG Fore Baseline.

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Interferons Environments

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Administered at home or clinic
Self administration after proper demonstation of technique

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Interferons Providing Patients and family education

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Advise to use reconstitued solution with 30 days using a clendar to mark of dates, comes in powerder form.
Stress washing and treating any injuries prompltly.

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Interferons Ongoing Assesment

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Monitor CBC and differential, liver and renal function studies at least.

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Interleukins related to Aldesleukin Pharmacotherapeutics

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Renal Cell Cancer
Under Investigation:
Phase I Aids
Advance ARC, Aids related Complex

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Interleukins Pharmacokinetics

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Administered IV
Give Acute Care Setting

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Interleukins Pharodynamics

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Activation of human cellular immunity
Inhibitatino of tumor growth, stimulationg Immune System, attacks cells that break away.

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Interleukins Adverse Effects

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Flue like symptoms

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Interleukins Assessment
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Laboratory studies include CBC, serum electrolytes, and thyroid, renal, and liver function test.
Baseline and ongoing test.
Baseline pulmonary funtion and thallium stress tests

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Interleukins Environment

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Administered in acute care setting, with close monitoring IV

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Interleukins Planning and Outcomes
Maximizing therapeutic Effects

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Administer by IV infusion every 8 hours for 2-5 day cycle, Follow by rest a period of 9 days, then administer 14 more doses.
In between might have chemo, given high doses

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Interleukins Minimizing Adverse Effects

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Use infection control precautions- Immune system down.

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T&B Cell Modulators Levamisole
Oharmacotherapeutics

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Flurouracil given orally
C ccolon cancer

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T&B Pharmacokinetics

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Oral Administration Take home

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T&B Pharacodynamics

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Stimulation of antibody formation
Enhancement of T-Cell response

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T&B Planning Intervention
Maximizing Therapeutic Effects

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Initiate no earlier than 7 days after surgery and no later then 30 days after
Give with fluorouracil (chemo drug) started no earlier than 21 days after surgery and no later than 35 days after
Administer dose exactly as prescribed

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T&B Minimizing Adverse Effects

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Monitor lab studies frequently
Institute safety and infection control precautions
Perform meticulous mouth care

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Immunosuppressant Agents Murmonab cd3 Pharmacotherapeutics

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Preventino of allograft rejection wih renal transplan
treat steriod resistant acute allograft rejection with heart and liver/renal transplants, will help to reverse rejection

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Immunosuppressant Pharmacokinetics

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Administer IV-Acute care

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Immunosupressant Pharmacodynamics

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Murine Monoclonal Antibody to T3 complex- stops T-Cells from functioning.
Acting on T cell as antigen disabling it.

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Immunosupressant Adverse Effects

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Flu Like symptoms
Cytokine release syndrome (flu like symptoms progressing to shock)

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Monoclonal Antibodies Muromonab cd3 Environment

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Administered in acute care setting or clinic

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Monoclonal Planing and Intervention Maximizing Therapeutic Effects

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Start as soon as possible after trasplan rejection diagnosed
Give IV methylprednisolone sodium succinate before administration and hydrocortisone sodium succinate IV 30 minutes after administration, to prevent side effects of drugs.

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Monoclonal Minimizing Adverse Effects

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Watch for evere reaction after dose including high fever, chills, chest congestion and difficulty breathing.

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T/B Cell Inhibitors Azathiorprine Pharmacotherapeutics

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ImRejection prevention (renal homotransplantation)
Classic rheumatoid arthritis unresponsive conventinoal treatment, also for autoimmune disease. Give IV than oral pre went rejection treatment may be for life.

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Azathiorprine Pharmacodynamics

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Suppression of cell mediated hypersensitivities
Alteration in antibody production T&B cells

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Azathiorprine Adverse Effects

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Bone Marrow Depression

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Azathioprine Assessment

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Laboratory tests include including liver and renal function tests, CBC with differential.

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Azathioprine Environment

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IV therapy switched to oral therapy as soon as possible

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Azathioprine Planning and Intervention Maximizing Therapeutic Effects

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Administer smaller doses to elderly patients give smallest dose possible.

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Azathioprine providing patient and family education

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Advise to notify health care provider with any complaints especially fever, sore throat, unusual bleeding or bruising, mouth sores, signs of infection, severe vomiting or diarrhea, or darkend urine or stools. Causitive response and hypersensitivity also signs and symptoms of rejection

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Drugs closely related to Azathloprine

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Cyclosporine (Sandimmune)
Mycophenolate (CellCept)

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Epoetin (Epogen, Eprex, Procrit)
Pharmacodynamics

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Will increase or maintain the RBC level, decreasing the need for blood transfusion

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Epoetin Uses

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Treatment of anemia associated with chronic renal failure
Reduce allogenic blood transfusion in surgery clients

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Epoetin Nursing Consideration

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Given SQ, withdraw one dose per viral, discard the rest
Keep vial refergerated, do not shake
Often given with iron supplement

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Filgastrin (Neupogen)

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Neutrophil boost

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Filgastrin Pharmacodynamics

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neutrophils

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Filgastrin Uses

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To treat neutropenia cause by myelosuppressive anticancer drugs. To reduce infection in severe chronic neutropenia.

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Filgastrin Nursing Considerations

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Given SQ or IV
Refrigerate, Do not Shake
Monitor CBC and Platelets
Monitor for bleeding.

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Oprelvekin (Neumega)Pharmacodynamics

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In increased platelet production

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Oprelvekin Uses

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Prevent thrombocytopenia following myelosuppressive chemotherapy

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Oprelvekin Adverse Reactions

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Flu like symptoms

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Oprelvekin Nursing Considerations

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Given SQ
Monitor CBC and Platelet counts.