VUSN Pharm 2 Final Exam (Week 12)
assess for allergies and contraindications, assess for baseline organ function (kidney, liver - LFTs,
electrolyte levels), assess for active infection/recent viral infection, monitor CBC for possible bone
marrow suppression (Hct, Hgb), admin at same time daily as indicated, ensure drug levels are drawn just
prior to admin - cyclosporine nursing interventions
benefit of treatment MUST outweigh risks - important thing to remember when considering
immunosuppressant therapy
cyclosporine, prednisone, mycophenolate, IgG - immunosuppressant prototype drugs
organ transplant introduces foreign tissue to body, immune system produces IL-2 (type of lymphokine),
activation of immune system leads to destruction and rejection of foreign tissue - body's response
to organ transplant
IL-2 - specific lymphokine produced by immune system when organ transplant occurs
used to suppress immune system, prevent organ/tissue rejection, prevent tissue destruction,
autoimmune diseases - principals of immunosuppressant therapy
increased risk for infection and neoplasms - risks of immunosuppressant therapy
appropriate, overactive - immunosuppressants minimize effects of which immune responses?
calcineurin inhibitor - cyclosporine class
whole organ transplantation (liver, kidney, heart), autoimmune conditions (rheumatoid arthritis,
psoriasis) - cyclosporine use
inhibits calcineurin (suppresses T-cell proliferation), inhibit production and release of IL-2 -
cyclosporine ETA
, increase levels:
- "azole" antifungals, macrolide antibiotics, Amp-B, grapefruit juice
decrease levels:
- phenytoin, phenobarbital, carbamazepine, rifampin, terbinafine, trimethoprim/sulfamethoxazole -
cyclosporine interactions
nephrotoxicity (75%), infection (75%), hirsutism, HTN, gingival hyperplasia, tumor, anemias (s/t
suppression of bone marrow) - cyclosporine side effects
foods to avoid (don't take w food, decreases absorption), proper med admin (same time daily), warning
s/sx of potential problems - cyclosporine client education
corticosteroid - prednisone class
autoimmune disorders (idiopathic thrombocytopenia purpura), organ transplantation (Renal, liver, bone
marrow, heart), acute inflammatory processes (arthritis caused by acute inflammation, allergic reactions,
asthma) - prednisone use
daily weights, BP, whole blood glucose, check electrolytes (creatinine, sodium, potassium), WBC, monitor
bone density, monitor adrenal insufficiency - prednisone nursing interventions
suppresses migration of leukocytes, inhibits mitosis of lymphocytes, reduces lymphatic system activity,
inhibit production of inflammatory mediators (leukotrienes, prostaglandins, histamines, bradykinins) -
prednisone ETA
skin thinning, infection, bone dissolution, impaired growth, adrenal insufficiency, increased water
retention, polydipsia, increased glucose - prednisone side effects
cytotoxic agent - mycophenolate class
