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62 Cards in this Set
- Front
- Back
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Neupogen
Pharmacotherapeutics Cokinets codynamics Contraindications |
Pharmacotherapeutics
Chemotherapy-induced leukopenia. Pharmacokinetics Well absorbed. Metabolism/excretion unknown; T½ is 3.5 hours. Pharmacodynamics Stimulates and mobilizes the cells that are the progenitor cells for granulocytes (including basophils, eosinophils and neutrophils) into the peripheral circulation. Contraindications and precautions Hypersensitivity to E. coli-derived proteins |
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Neupogen
AE Implementation Drugs |
Adverse effects
Medullary bone pain Drug interactions Simultaneous use with any antineoplastic may have adverse effects on the rapidly proliferating neutrophils. Do not use 24 hrs before or after chemo Implementation Keep it refrigerated. Allow to reach room temperature before administering it. Do not dilute in saline. |
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Neupogen
education |
Patient and family education
Avoid crowds and people with infections |
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Plavix
therapeutics cokinetics codynamics |
Pharmacotherapeutics
Used to reduce atherosclerotic events. Pharmacokinetics Administered: oral. Metabolism: liver. Protein bound. Pharmacodynamics An ADP inhibitor Inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor and the subsequent ADP-mediated activation of the glycoprotein IIb/IIIa complex and thus inhibits platelet aggregation. |
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Plavix
Contrain A/E Education |
Contraindications and precautions
Hypersensitivity and active bleeding disorders Adverse effects GI distress Serious: bleeding, neutropenia (rare) Patient/family education Take once a day without regard to food Take with food to decrease GI problems D/C 5 to 7 days before surgical procedure Report fever, chill, sore throat, usual bleeding and bruising Avoid ASA and NSAIDs Need for periodic lab test: CBC with dif, bleeding time |
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Trental
Therapeutics cokinetics codynamics |
Pharmacotherapeutics
Manage symptomatic PVD (intermittent claudication). Pharmacokinetics Administered: oral. Distribution: dd. Metabolism: liver. Excreted: kidneys. Onset: 2-4 weeks. Pharmacodynamics Increases flexibility of the RBCs by increasing the levels of cAMP levels Decrease blood viscosity by inhibiting platelet aggregation and decreasing fibrinogen |
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Trental
contr. AE Education |
Contraindications and precautions
Intolerance to methylxanthines Adverse effects Effects occur in CNS, CV, and GI systems Serious: Tachycardia Patient/family education Administer with meals for GI irritation Does not have an immediate effect 2-4 weeks Avoid driving until effects of drug are known Avoid smoking Keep all follow-up visits with the prescriber |
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Activase
Therpautics Cokin. Codynamics |
Pharmacotherapeutics
Thromboembolic conditions. Pharmacokinetics Administered: IV. Rapidly cleared from the plasma. t1/2 is 5 minutes. Pharmacodynamics Acts in the same way as endogenous t-PA. Bind to the fibrin in the clot and converts plasminogen to plasmin. Fibrinolysis then occurs. |
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Activase
Contrain A/E |
Contraindications and precautions
Hypersensitivity, active internal bleeding, ICH (hemorrhagic stroke), uncontrolled HTN Adverse effects Internal or superficial bleeding Reperfusion arrhythmias, hypotension Allergic reaction, nausea vomiting |
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Activase
Implementation |
Implementation
Reconstitute with sterile water for injection without preservatives. Two IV lines Avoid invasive procedure Continually monitor vital signs and observe for signs of active bleeding. Cardiac monitoring, during and after treatment Apply pressure to all venipuncture for 30 minutes Concurrent heparin due to short half life |
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Epogen
Therpeutics Codynamics Cokin. |
Pharmacotherapeutics
Anemia associated with end-stage renal disease, AZT therapy for HIV, cancer and reduction in the need for transfusions after surgery Pharmacokinetics Administered: intravenous or subcutaneous. Pharmacodynamics Stimulates erythropoiesis (production of RBCs) |
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Epogen
AE Contrain Imple. |
Contraindications and precautions
Hypersensitivity, uncontrolled hypertension Adverse effects HTN, seizures, thrombotic events (esp. Hbg >12) Implementation Do not shake vial. Allow time for the Hbg level to rise before seeking an order to adjust the dose. Monitor the blood pressure. Monitor hemoglobin |
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Epogen
Edu. |
Patient and family education
Possible return of menses and fertility in childbearing women. Report chest pain, shortness of air, pain in the legs, cool pale arm |
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Neupogen
Therpa. Cokin. Codyn Contrain |
Pharmacotherapeutics
Chemotherapy-induced leukopenia. Pharmacokinetics Well absorbed. Metabolism/excretion unknown; T½ is 3.5 hours. Pharmacodynamics Stimulates and mobilizes the cells that are the progenitor cells for granulocytes (including basophils, eosinophils and neutrophils) into the peripheral circulation. Contraindications and precautions Hypersensitivity to E. coli-derived proteins |
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Neupogen
AE Imple. Drug |
Adverse effects
Medullary bone pain Drug interactions Simultaneous use with any antineoplastic may have adverse effects on the rapidly proliferating neutrophils. Do not use 24 hrs before or after chemo Implementation Keep it refrigerated. Allow to reach room temperature before administering it. Do not dilute in saline. |
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Neupogen
Edu |
Patient and family education
Avoid crowds and people with infections |
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Neumega
Ther. Cokin Codyn Contain |
Pharmacotherapeutics
Chemotherapy-induced thrombocytopenia Pharmacokinetics Peak: 3.2 hours. Platelet counts begin to increase in 5 to 7 days. Eliminated by the kidney. Pharmacodynamics Stimulates production of megakaryocyte progenitor cells and platelets. Contraindications and precautions Hypersensitivity, cautiously in any condition in which sodium and water retention would pose a problem |
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Neumega
AE Drug Imple |
Adverse effects
Fever, chill, nausea, vomiting, fluid retention with weight gain, myalgia, bone pain Serious: Ventricular arrhythmias Drug interactions None Implementation Therapy begin 6 to 24 hours after chemotherapy completed. |
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Inferon alpha-a2
Thera. Cokin |
Pharmacotherapeutics
Hairy cell leukemia, Kaposi sarcoma, malignant melanoma, chronic hepatitis B and C. Pharmacokinetics Administered: parenteral. Metabolism: liver and kidneys. |
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Inferon alpha-a2
Condy. COntrain |
Pharmacodynamics
Proteins capable of modifying the immune response and antiproliferation action against tumor cells Produced by recombinant DNA techniques Contraindications and precautions Pancreatitis, hepatic, renal disease, depressed bone marrow function, and cardiac disease |
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Inferon alpha a2
AE Drug |
Adverse effects
(CNS) Dizziness, confusion, lethargy (GI) flu-like symptoms, anorexia, nausea, malaise, myalgia, changes in taste and weight loss Serious: depression, anemia, thrombocytopenia, suicidal ideation Drug interactions Additive myelosuppression effects with antineoplastic and radiation Increase CNS depression with CNS depressants |
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inferon alpha a2
MAx and Min |
Maximizing therapeutic effects
Reconstitute and store following manufacturers' instructions. Baseline blood counts and chemistries before therapy and monthly during therapy. Minimizing adverse effects Premedicate patients with drugs such as acetaminophen and/or diphenhydramine to reduce the flu-like adverse effects. |
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Inferon alpha a2
Edu |
Patient and family education
Explain that interferon alfa-2a inhibits the growth of tumor cells. How to reconstitute the powder into a solution, date and refrigerate the reconstituted solution. Avoid crowds Report sign of infection and bleeding Soft toothbrushes and electric razors Periodic labs before and at least monthly during therapy. |
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Cyclospoine
Therpeutics cokin Contrain |
Pharmacotherapeutics
Prevention and treatment of rejection in renal, cardiac, and hepatic transplants Severe active RA Graft vs host disease in bone marrow transplants Pharmacokinetics Factors that affect bioavailability include food and enterohepatic recirculation Contraindications and precautions Hypersensitivity to polyoxyethylated castor oil Alcohol |
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Cyclosporine
Codyn. Drug AE |
Pharmacodynamics
Inhibits normal immune response (cellular and humoral) by inhibiting interleukin-2 a factor necessary for initiation of T-cell activity Adverse effects Moderate HTN, neurotoxic including tremors, hirsutism, and gum hyperplasia Serious: renal toxicity, hepatic toxicity, bone marrow suppression Drug interactions Drugs metabolized by P-450 system |
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Cyclosporine
Max Min |
Maximizing therapeutic effects
Start as soon after transplantation as possible. Use oral form -as soon as possible. Minimizing adverse effects Arrange for periodic blood tests to monitor for renal, hepatic, and hematologic effects of the medication. |
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Cyclosporine
Education |
Patient and family education
Life-long therapy to prevent rejection Importance of preventing infection. Avoid food and grapefruit juice. Caution not to discontinue taking this drug without consulting with their prescribers. |
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Prednisone
therpautics cokin codyn Contrain |
Pharmacotherapeutics
Anti-inflammatory and immunosuppressive Pharmacokinetics Absorbed from GI track. Metabolized: liver. Excreted: urine. Pharmacodynamics Suppresses inflammation and normal immune response, numerous metabolic effects, endogenous cortisol replacement, minimal mineralocorticoid activity Contraindications and precautions Active untreated infections |
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Prednisone
AE |
Adverse effects
CNS (anxiety, mood swings, insomnia, headache); CV (HTN); EENT (cataracts); GI complaints (anorexia, nausea, vomiting, peptic ulceration); Derm (decreased wound healing, hirsutism, ecchymosis); Endo (adrenal suppression, hyperglycemia) F and E (fluid retention, hypokalemia); MS (muscle wasting, osteoporosis); cushingoid appearance and susceptibility to infection Serious: acute adrenal insufficiency due to HPA axis suppression following prednisone withdrawal |
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Prednisone
Drug Imple. |
Drug interactions
May increase the need for insulin or oral agents Additive hypokalemia with K+ wasting diuretics Increase risk for dig toxicity GI with NSAIDs and ASA Implementation Administer daily doses or alternate-day doses of glucocorticoids early in the morning. Increase the dosage in times of stress Monitor the patient, especially the surgical patient, carefully for signs of infection. Give with meals or antacids |
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Prednisone
drug Imple. |
Assessments
Signs of adrenal insufficiency Hypotension, weight loss, nausea, vomiting, anorexia, lethargy, hypoglycemia Monitor I/O, daily weight |
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Prednisone
Education |
Patient and family education
Once a day dosing in the morning Do not abruptly stop taking the drug . Avoid crowds and people with infection Notify all health care providers about glucocorticoid therapy. Bone health and prevention of falls Wear medical identification Report unusual swelling, weight gain visual disturbances Diet high in protein, calcium and potassium and avoid alcohol |
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Fludrocortisone
Ther Cokin Codyn |
Pharmacotherapeutics
Sodium loss and hypotension associated with adrenocortical insufficiency (given with hydrocortisone). Pharmacokinetics Administered: oral. Peak: 1.7 hours. T½: 3.5 hours. Pharmacodynamics Acts on the distal renal tubule to enhance the reabsorption of sodium and to increase the urinary excretion of both potassium and hydrogen ions. |
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Fludrocortisone
Contrin Adverse Drug |
Contraindications and precautions
Systemic fungal infections. CHF Adverse effects Dizziness, headache, HTN, edema, anorexia, hypokalemia, muscle weakness Drug interactions Hypokalemia with K wasting diuretics Ampho B increase risk of hypokalemia May increase risk dig toxicity with hypokalemia |
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Fludrocortisone
Edu Assessment |
Patient and family education
Take as prescribed. Don not stop abruptly Encourage patients to wear a medical identification bracelet. Eat potassium-rich foods and moderate sodium intake. Ongoing assessment and evaluation Monitor for edema, weight gain, hypertension, cardiac arrhythmias, or muscular weakness. |
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5-fluorouracil (5-FU)
Therpa Cokin Codyn |
Pharmacotherapeutics
Wide spectrum of solid tumors. Pharmacokinetics Administered: IV. Metabolism: liver. Excreted: kidneys & lungs. Pharmacodynamics Inhibits DNA and RNA synthesis by preventing thymidine production—cell cycle s phase specific |
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5-fluorouracil (5-FU)
Contrain Adverse |
Contraindications and precautions
Pregnancy and lactation, poor nutritional status, decreased bone marrow reserve, or a potentially serious infection Adverse effects GI (diarrhea, nausea, stomatitis); Derm (alopecia, rash, photosensitivity) Heme (myelosuppression) Dose limiting effects: myelosuppression, evidenced by anemia, leukopenia, and thrombocytopenia |
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5-fluorouracil (5-FU, Adrucil
Drug Max Min |
Drug interactions
Additive bone marrow suppression with other antineoplastic and radiation. Maximizing therapeutic effects Potentiate antineoplastic activity of 5-FU by the addition of reduced folates, such as leucovorin calcium. Make sure that the solution is stored at controlled temperature. Minimizing adverse effects Monitor the patient closely because hematologic and GI toxicities can be fatal despite dosage reductions |
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5-fluorouracil (5-FU, Adrucil
edu |
Patient/family education
Good oral care Monitor for s/s of stomatitis and infection. Avoid crowds Advise the possibility of transient alopecia Report blood in the urine, stool or emesis Sun protection Contraception plan during treatment Periodic monitoring of CBC |
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Vincristine (Oncovin)
Thera cokin Codyn |
Pharmacotherapeutics
Leukemia, Hodgkin's disease Pharmacokinetics Administered: IV. Protein bound. Metabolism: liver. Excreted: bile, feces and urine. Pharmacodynamics Binds to proteins of mitotic spindle causing arrest of the metaphase. Cell cycle M specific. Little or no effect on bone marrow. |
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Vincristine (Oncovin)contraino
Adverse |
Contraindications and precautions
Pregancy, lactation, infection and decrease bone marrow reserve, hepatic impairment decrease dose. Adverse effects Nausea, vomiting, alopecia, tissue necrosis from extravasation, constipation and ileus, ascending peripheral neuropathy |
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Vincristine (Oncovin)
Imple edu |
Implementation
Protect drug from light. Give an initial bolus through a new and patent free-flowing IV access. Infuse over 1 minute Implementation Protect drug from light. Give an initial bolus through a new and patent free-flowing IV access. Infuse over 1 minute |
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Paclitaxel (Taxol
Therpa Cokin Codyn |
Pharmacotherapeutics
Ovarian, breast cancers, AIDS related Kaposi’s sarcoma Pharmacokinetics Crosses the placenta/enters breast milk. Metabolized: liver. Excreted: bile & urine. Pharmacodynamics Interferes with the normal cellular microtubular function required for interphase and mitosis |
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Paclitaxel (Taxol
Contr AE Drug |
Contraindications and precautions
Hypersensitivity, ANC <1,500/mm3, pregnancy, lactation, hepatic impairment Adverse effects Nausea, vomiting, alopecia, joint pains, peripheral neuropathies, bone marrow suppression, elevated liver enzymes, risk of severe hypersensitivity reaction including anaphylaxis, Steven-Johnson and TEN Drug interactions Bone marrow suppression with other antineoplastic drugs |
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Paclitaxel (Taxol
Imple |
Implemention
Give premedication consisting of a steroid, antihistamine, and an H2-antagonist Do not use PVC containers or tubing Infuse over 3 to 24 hours Monitor VS during first hour of infusion |
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Paclitaxel (Taxol
Edu |
Patient/family education
Explain drug delivery methods. Report s/s of infection, bleeding, weakness, paresthesias, gait disturbances Avoid crowds Avoid ASA and alcohol Monitor the patient’s CBCs frequently. |
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Topotecan (Hycamtin)
Thea. Cokin Codyn |
Pharmacotherapeutics
Ovarian and small cell lung cancer Pharmacokinetics T½: 3 hours. Metabolized: liver. Excreted: kidneys. Pharmacodynamics Interferes with DNA synthesis by inhibiting the enzyme topoisomerase-I. Action is in the S phase |
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Topotecan (Hycamtin)
Contrain AE Drug |
Contraindications and precautions
Pre-existing myelosuppression, pregnancy and lactation Adverse effects Nausea, vomiting, diarrhea, headache, and alopecia Serious: myelosuppression, Drug interactions Additive myelosuppression |
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Topotecan (Hycamtin)
IMple |
Implementation
Nausea and vomiting common-pretreatment with antiemitics Assess for signs of bone marrow suppression |
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Topotecan (Hycamtin)
edu |
Patient and family education
Importance of careful monitoring of blood counts Avoidance of risk factors that might expose patient to sources of bleeding and infection. Small and frequent meals and take antiemetics if needed. If patient vomits after taking, do not replace dose Review the signs and symptoms & which ones should be reported to a prescriber. |
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Cyclophosphamide (Cytoxan)
Thera cokin Codyn |
Pharmacotherapeutics
Hodgkin's disease, leukemia, multiple myeloma, ovarian and breast cancer Pharmacokinetics Administered: oral. Metabolism: liver. Excreted: kidneys & lungs. Pharmacodynamics Inhibits DNS replication and RNA transcriptase and disrupts protein synthesis. |
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Cyclophosphamide (Cytoxan
Contrain AE Drug |
Contraindications and precautions
Bone marrow depression, infections, pregnancy and lactation Adverse effects Resp (pulmonary fibrosis); CV (myocardial fibrosis): GI; GU (Hemorrhagic cystitis, hematuria) Derm( alopecia) Dose-limiting effect: leukopenia Drug interactions Drugs that cause bone marrow depression |
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Cyclophosphamide (Cytoxan)
Imple. |
Implementation
Give on empty stomach unless severe GI irritation Give over 30 to 60 minutes Vigorous hydration regimen of at least 3 L of fluid a day. Monitor urine output vigilantly to ensure an output of at least half of the intake. Dose modification may be considered in patients with impaired renal, hematologic, or hepatic function. |
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Cyclophosphamide (Cytoxan)
edu |
Patient/family education
Drink large amounts of fluid, at least 3 L daily. Contraception plan Avoid crowds Report s/s infection, bleeding, yellow discoloration of skin Avoid alcohol No vaccination Periodic lab monitoring renal function and hematopoietic reserve. |
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Doxorubicin (Adriamycin)
Thea Cokin COdyn |
Pharmacotherapeutics
Hematologic cancers and solid tumors. Pharmacokinetics Distribution: body tissues. Metabolism: liver. Excreted: bile and renal system. Pharmacodynamics Intercalation between specific base pairs within the cancer cell’s DNA inhibiting DNNA and RNA synthesis; S-phase-cycle specific |
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Doxorubicin (Adriamycin)
Contrain AE Drug |
Contraindications and precautions
Severe CHF or any existing cardiomyopathy, bone marrow depression Adverse effects Nausea, vomiting, alopecia, hyperuricemia Serious: bone marrow suppression, cardiomyopathy Drug interactions Drugs that cause bone marrow depression |
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Doxorubicin (Adriamycin)
Imple |
Implementation
Cardioprotectant (dexrazoxane) in conjunction with anthracycline therapy. Use large veins, with a new peripheral line for vesicant administration. Monitor VS during administration Encourage fluids or 2 to 3 l/d May use allopurinol Monitor cardiac toxicity |
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Doxorubicin (Adriamycin)
Edu |
Patient and family education
Report s/s infection, bleeding, shortness of breath edema, chest pain Avoid crowds Reddish urine for 1-2 days Alopecia, which is reversible Report pain at infusion site. Contraception should be used during and for at least 4 months after therapy Care givers precaution with body fluids for 5 days |
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Tamoxifen
Therpa. Cokin Codyn |
Pharmacotherapeutics
Breast cancer. Pharmacokinetics Highly protein bound. Metabolism: liver. Absorption: into the tissues. Excreted: bile and feces. Pharmacodynamics Competes with estrogen for binding sites in tissues high in estrogen receptors, such as breast tissue. Reduces DNA synthesis and estrogen response |
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Tamoxifen
Contrain AE DRUG |
Contraindications and precautions
Hypersensitivity Adverse effects CV (PE, CVA, edema); GI (nausea, vomiting) GU (uterine malignancies); Metabolic (hot flashes); Heme (leukopenia, thrombocytopenia); hypercalcemia Drug interactions Increased anticoagulant effect with warfarin |
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Tamoxifen
Implement |
Implementation
Administer with food or fluids id GI irritation is an issue Do not give with antacid Do not crush, break or chew Monitor CBC, calcium, liver function and thyroxine levels |
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Tamoxifen
education |
Patient/family education
Contraceptive plan and hot flashes Report bone pain Report swelling of leg, shortness of air |
