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29 Cards in this Set
- Front
- Back
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What are the CD4+ lymphocytes?
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1. T-helper cells
2. T4 cells |
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What is the impact of HIV infection on CD4+ lymphocytes?
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1. Decreased number of circulating CD4+ lymphocytes
2. Decreased response to antigen 3. Decreased helper activity of B cell immunoglobulin production 4. Decreased lymphokine production 5. Reverse of normal CD4:CD8 ratio (instead of 2:1, its 1:2) |
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What are the CD8+ lymphocytes?
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1. T-suppressor cells
2. T-cytotoxic cells |
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What is the impact of HIV infection on CD8+ lymphocytes?
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1. Normal to increased number of circulating CD8+ lymphocytes
2. Decreased specific cytotoxicity 3. Normal suppressor function |
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What is the impact of HIV infection on Natural Killer (NK) cells?
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Decreased non-specific cytotoxicity
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What is the impact of HIV infection on B cells?
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1. Increased production of immunoglobulin (hypergammaglobulinemia)
2. Increased autoantibody formation —> increased number of circulating immune complexes —> autoimmune responses 3. Increased number of circulating B cells —> can evolve to malignancy 4. Increased ability to mount humoral response to new mitogens |
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What is the impact of HIV infection on monocytes/macrophages?
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1. Decreased number of circulating monocytes
2. Decreased parasite killing 3. Defective antigen presentation 4. Impaired function of tissue macrophages 5. Monocytes act as "HIV factories" |
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What are the goals of HIV therapy?
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1. Maximal and durable suppression of viral load
2. Restoration and/or preservation of immunologic function 3. Improvement of quality of life 4. Reduction of HIV-related morbidity and mortality |
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What are the tools to achieve the goals of therapy?
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1. Maximize adherence to the antiretroviral regimen
2. Rational Sequencing of drugs 3. Preservation of future treatment options 4. Use of resistance testing in selected clinical settings |
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What drug is used to treat HIV-drug-induced anemia?
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Epoetin Alfa (Epogen) 50-100 units/KG subcutaneously or IV
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What are the side effects of Epoetin Alfa (Epogen)?
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1. Headache
2. Arthralgia (joint pain) 3. Hypertension |
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What are the nursing considerations of Epoetin Alfa (Epogen)?
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1. Use requires adequate iron stores
2. Evaluate carefully prior to therapy |
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What drugs are used to treat neutropenia?
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Neutropen (Filgrastim, G-CSF)
Recommended starting dose: 5 mcg/kg/day, SQ or IV in single dose; doses vary |
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What are the side effects of Neutropen?
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1. Bone pain
2. Reversible elevations in uric acid, lactate dehydrogenase & alkaline phosphatase 3. Transient decreases in blood pressure (hypotension) |
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What drug is used to treat diarrhea?
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Loperamide (Imodium)
Dose: 4 mg after first loose stool followed with 2 mg after succeeding loose stools; do not exceed 16 mg per day |
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What are the side effects of Loperamide (Imodium)?
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1. Drowsiness
2. Dizziness 3. Fatigue 4. Abdominal cramping/pain/distention 5. Constipation 6. Dry mouth 7. Nausea 8. Rash |
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What are the nursing considerations of Loperamide (Imodium)?
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Use with caution in hepatic impairment, ulcerative colitis or young children
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What drug is used to enhance weight gain in HIV infected persons?
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Megace
Dose: varies widely according to patient response and physician preference |
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What are the side effects of Megace?
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1. Nausea & vomiting
2. Alopecia 3. Hypertension 4. Rash |
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What are the nursing considerations of Megace?
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Do not use in first 4 months of pregnancy
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What drug is used to treat anorexia?
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Dronabinol (Marinol)
Dose: 2.5 mg PO bid before lunch and supper; patient should stay on therapy for at least 30 days |
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What are the side effects of Dronabinol (Marinol)?
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1. Drowsiness
2. Dizziness 3. Confusion 4. Impaired coordination, sensory & perceptual functions 5. Easy laughing or a "high" |
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What are the nursing considerations of Dronabinol (Marinol)?
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Use with caution in patients with hypertension, heart disease, and mania, depression or schizophrenia
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What drugs are used to treat pain in HIV infected persons?
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1. MS Contin (morphine sulfate) 30 mg PO bid
2. Duragesic patches (Fentanyl) Dose: 25, 50, or 75 mg patch 3. Oxycodone hydrochloride (Percoset) Dose: 5 mg PO q6h P.R.N. for pain |
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What are the side effects of morphine sulfate Contin?
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1. Gastrointestinal disturbance
2. Nausea & vomiting 3. Respiratory depression 4. Sedation 5. Potential for dependence is high 6. Dry mouth 7. Orthostatic hypotension 8. Diaphoresis 9. Constipation 10. Drug tolerance |
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What are the nursing considerations of morphine sulfate Contin?
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1. Time released, take on a regular schedule, NOT P.R.N.
2. May be broken in half or powdered 3. Take with food |
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What are the side effects of Duragesic patches (Fentanyl)?
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1. Sedation
2. Orthostatic hypotension 3. Hallucinations 4. Drowsiness |
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What are the nursing considerations of Duragesic patches (Fentanyl)?
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1. Replace every 2-3 days
2. Replace on set schedule |
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What are the side effects of Oxycodone hydrochloride (Percoset)?
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1. Gastrointestinal upset
2. Sedation 3. Respiratory depression 4. Dizziness 5. Euphoria 6. Nausea & vomiting 7. Orthostatic hypotension 8. Dry mouth 9. Constipation 10. High potential for dependence |
