Test 2 Medications: Immune, Oncology, Integumentary

Integrase inhibitor

raltegravir

interleukin

reduces production of cancer cells (kaposis sarcoma)

lamivudine (NRTI) S/E:

seizures, cough, hepatomegaly, pancreatitis, MS pain

Colony stimulating factor: (pegfilgrastim) S/E:

sickle cell crisis, splenic rupture, ARDS, anaphylaxis **Should NOT be given between 14 days before and 24 hours after cytotoxic chemo**

Colony stimulating factor: (filgrastim) S/E:

splenic rupture, (ARDS) acute respiratory distress syndrome, allergic reaction and medullary bone pain Dont give 24 hour before or after chemo!

NNRTI

efavirenz

Efavirenz (Sustiva), an antiviral medication, is prescribed for a client with human immunodeficiency virus (HIV) infection. Which time should the nurse tell the client is best to take this medication? 1.At bedtime 2.With lunch 3.With dinner 4.Before breakfast

1.At bedtime Rationale:Because the medication causes temporary nervous system side effects during the first 2 to 4 weeks of therapy, the client is instructed to take the medication at bedtime. Because of the nervous system effects, options 2, 3, and 4 are not recommended administration times.

Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Which interventions should the nurse include in the plan of care regarding this medication? Select all that apply. 1.Restrict fluid intake. 2.Instruct the client to avoid alcohol. 3.Monitor hepatic and liver function studies. 4.Administer the medication with an antacid. 5.Instruct the client to avoid exposure to the sun. 6.Administer the medication on an empty stomach.

2.Instruct the client to avoid alcohol. 3.Monitor hepatic and liver function studies. 5.Instruct the client to avoid exposure to the sun. Rationale:Ketoconazole is an antifungal medication. It is administered with food (not on an empty stomach), and antacids are avoided for 2 hours after taking the medication to ensure absorption. The medication is hepatotoxic, and the nurse monitors liver function studies. The client is instructed to avoid exposure to the sun because the medication increases photosensitivity. The client is also instructed to avoid alcohol. There is no reason for the client to restrict fluid intake. In fact, this could be harmful to the client.

A client with human immunodeficiency virus (HIV) who is taking an oral solution of ritonavir (Norvir) complains about the taste of the solution. Which response by the nurse is accurate? "Try refrigerating the solution." 2."Take the medication at bedtime." 3."Mix the oral solution with chocolate milk." 4."You need to notify the health care provider."

3."Mix the oral solution with chocolate milk."

Zidovudine (AZT) is prescribed for an adult client with human immunodeficiency virus (HIV). Which statement by the nurse provides the best instruction to the client about the medication?

3."Space the medication doses evenly around the clock."

Indinavir (Crixivan) is prescribed for a client with a diagnosis of human immunodeficiency virus (HIV). Which medication instruction should the nurse reinforce to the client?

3.Increase fluid intake to at least 1.5 L/day.

The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir). The nurse should carefully monitor which laboratory result during treatment with this medication? 1.Blood culture 2.Blood glucose level 3.Blood urea nitrogen 4.Complete blood count

4.Complete blood count Rationale:A common side/adverse effect of therapy with zidovudine is leukopenia and anemia. The nurse monitors the complete blood count results for these changes. Options 1, 2, and 3 are unrelated to the use of this medication.

The nurse notes that a client is receiving lamivudine. The nurse determines that this medication has been prescribed to treat which condition? 1.Pancreatitis 2.Pharyngitis 3.Tonic-clonic seizures 4.Human immunodeficiency virus (HIV) infection

4.Human immunodeficiency virus (HIV) infection Rationale:Lamivudine is a nucleoside reverse transcriptase inhibitor and antiviral medication. It slows HIV replication and reduces the progression of HIV infection. It also is used to treat chronic hepatitis B and is used for prophylaxis in health care workers at risk of acquiring HIV after occupational exposure to the virus. This medication is not used to treat pancreatitis, pharyngitis, or seizures.

ritonavir (protease inhibitor) S/E:

angioedema, rash, anaphylaxis

A client with acquired immunodeficiency syndrome (AIDS) has an opportunistic respiratory fungal infection and is receiving intravenous amphotericin B. The nurse assisting in caring for the client monitors for which sign that indicates an adverse effect of the medication?

Decreased urine output

raltegravir

MI, rhabdomyolysis (muscle pain) and depression

The nurse is assisting in caring for a client who is receiving amphotericin B intravenously (IV) to treat disseminated candidiasis. The nurse reviews the plan of care and implements which action during the administration of the medication?

Monitor urinary output

These antiretroviral medications target activated CD4 cells

NRTIs (Nucleoside Reverse Transcriptase Inhibitor)

These antiretroviral medications: target RESTING CD4 cells -block viral replication (DNA) -prevent RNA to DNA

Nonnucleoside reverse transcriptase inhibitors

integrase inhibitor action

Prevents integration of viral DNA into T cells DNA

efavirenz (NNRTI) S/E:

QT prolongation, hepatotoxicity, rash, suicidal thought

Colony stimulating factors action

Reduction of time for neutrophil recovery Binds to and stimulates immature neutrophils to divide and differentiate and activates mature neutrophils

fusion inhibitor route and outcome

Sub C decreases replication of HIV virus

Lamivudine (Epivir) is prescribed for a client with human immunodeficiency virus (HIV) who is presently taking zidovudine (Retrovir). Which should the nurse reinforce in the medication instructions to the client?

To report vomiting or abdominal pain to the health care provider

enfuviritide (fusion inhibitor)

blocks the infusion of HIV with the host cell

Action of this class of drugs: binds to and stimulates immature neutrophils to divide and differentiate and activates mature neutrophils

colony-stimulating factors

Fusion inhibitor

enfuviritide

Fusion inhibitor

enfuvirtide

Colony stimulating factors

filgrastim pegfilgrastim

S/E of raltegravir

increased amylase or liver functions

Protease inhibitors

indinavir ritonavir

Nonnucleoside Reverse transcriptase inhibitor: action

inhibits HIV reverse transcriptase leading to a disruption of DNA synthesis

protease inhibitor action

inhibits the action of HIV protease and prevents the cleavage of viral polyproteins

indinavir (protease inhibitor) S/E:

ketoacidosis, hyperglycemia

zidovudine (NRTI) S/E:

lactic acidosis, anemia, granulocytopenia **decreases maternal/fetal transmission of HIV

NRTI

lamivudine zidovudine

S/E of efavirenz (NNRTI)

lipodystrophy

Actions of Fusion inhibitors

prevents HIV from entering target cells