ANTI-NEOPLASTIC DRUGS and RA DRUGS
How do we assess for S/S's of infection?
-- Redness, Swelling, Heat, and Pain
What population of pts should not receive DMARDS?
-- Pts with active infections
-- HF
-- Lymphoma
-- MS
What allergy is important to think about when giving a pt Etanercept?
-- LATEX ALLEGY
--SERIOUS INFECTIONS, CANCER, BLOOD CLOTS, MI, STROKE
-- CBC and PLT, Calcium, LFT's, DVT, Vaginal bleeding, Breast exam
What is Rheumatoid Arthritis?
-- Chronic autoimmune disorder: inflammation, degeneration, disrupt metabolic processes of connective tissue.
What drug is used to tx juvenile RA?
-- Etanercept (Enbrel)
What are the AEs associated with Tofacitinib?
-- Diarrhea, URI, HTN, Anemia, and Insomnia
What is the black box warning associated with Tamoxifen?
-- UTERINE, CA, PE, STROKE IN PTS AT HIGH RISK FOR CANCER
How do Biologic Response Modifiers work to tx cancer?
-- Agents or tx methods that alter the pts immune system to fight cancer
What drugs are used to tx Rheumatoid Arthritis?
--Frist NASAIDS or Cortocosteroids
-- Disease-modifying antirheumatic Drugs (DMARDs)
-- Non Biologic DMARDS: Methotrexate, Leflunomide, Hydroxychloroquine, Sulfasalazine
-- Biologic DMARDS: Adalimumab, Anakinra, Certolizumab, ETANERCEPT, Golimumab
What labs do we monitor for infections?
-- Killing of normal cells in the bone marrow results in dangerously low, and possibly life-threatening, blood cell counts. Because of the negative impact on these normal cells, the nurse must carefully assess the patient’s WBCs levels (leukocytes, neutrophils, and band neutrophils), RBC counts, hemoglobin level, hematocrit, and platelet counts. In addition, monitoring of the patient’s absolute neutrophil count (ANC) is needed (ANC = % of neutrophils + % bands × WBC). Monitoring ANC values allows the nurse and other health care providers to identify the nadir—the time of the lowest count when the patient is most vulnerable. An ANC of 500 cells/mm3 or lower indicates high risk for infection.