Term
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Definition
immunologic defects
opportunistic infections, secondary infections, malignant neoplasms. Virus causes CD4 T cells to become disabled. |
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Term
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Definition
| disabled with AIDS virus, these cells are essential to immune system. Normal CD4 count is 8000-1000. AIDS develops when count drops below 200. Risk for opportunistic infections is very high. The higher the viral load the worse the disease. |
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Term
| 3 Enzymes essential for replication of the AIDS virus |
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Definition
| transcriptase, integrase, protease |
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Term
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Definition
| reverse action of two of the 3 enzymes, reverse transcriptase inhibitors and protease inhibitors. |
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Term
AIDS combination therapy
HAART
Goal |
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Definition
Highly Active Antireetorviral Therapy
Decrease viral load, preserve or increase CD4, prevent secondary infections and improve the health of the patient. |
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Term
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Definition
Mutation
Opportunistic infections |
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Term
Antiretroviral Therapy
Reverse Transcriptase Inhibitors |
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Definition
broken into two classes:
Nuceoside analogues
nonnucleoside analogues |
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Term
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Definition
Reverse Transcriptase inhibitors
Protease inhibitors
Entry inhibitors
CCR 5 antagonists
Integrase inhibitors |
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Term
Medication Therapy:
Recommended when CD4 count falls below 500 |
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Definition
| recommended for patients who are symptomatic and before CD4 count falls below 350; or higher if patients are willing to adhere to long term treatment. |
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Term
| AZT Zidovudine (Retrovir) |
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Definition
first nucleoside reverse transcriptase inhibitor developed in 1987. Improves CD4 counts, increases survival decreases disease progression and prevents spread of infection in utero.
Taken on empty stomach and given IV, infused Slowly. |
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Term
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Definition
| numbness, tingling, pain lower extremities, rash, GI upset, fever, arthralgia (joint pain), insomnia and confusion. Great caution with liver or renal problems (can worsen illness) |
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Term
Nonnucleoside Analogues
Efavirenz
Sustiva |
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Definition
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Term
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Definition
act at the end of HIV cycle
(life savying)
Should be given with food |
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Term
Proteases inhibitors
side effects |
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Definition
| increased blood sugar, bleeding, GI upset, ulcers, abdominal pain, weakness, and liver problems. Have multiple drug interactions such as seizure agents Dilantin, phenobarbital, tegretol, and calcium channel blockers and some antianziety medications. |
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Term
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Definition
| patient teaching critical and requires a multidisciplinary team approach. |
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Term
| HIV Opportunistic infections |
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Definition
| when CD4 count falls opprotunistic infections such as Kaposi's sarcoma, pneumocystis carnii, pneumonia, TB, and numerous fungal infections can occur |
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Term
| Antiretroviral therapy in Pregnancy |
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Definition
| pregnant women with HIV are given AZT during pregnancy. |
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Term
Antiretroviral
Assessment, planning, intervention, evaluation |
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Definition
| assessment of viral load and CD4 counts, support systems, knowledge of the disease. Intervention centers around compliance with medication, increasing fluid intake, good nutrition and teaching regarding the spread of HIV |
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Term
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Definition
Raltegravir
Limits virus replication
Not recommended under 16 |
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Term
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Definition
only 1 Enfuvirtide (Fuzeon)
Prevents fusion of HIV and CD4
few side effects |
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Term
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Definition
Maraviroc
Used in combination therapy
Side Effects: |
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Term
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Definition
| occurs when there has bee exposure to the disease and antibodies are formed. |
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Term
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Definition
| antibodies passed on to another such as mother to infant (transient). |
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Term
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Definition
| receive a vaccine triggers antigens, immune response is alerted and antibodies are formed without getting the disease. |
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Term
| Nursing Process: Vaccines |
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Definition
| assessment of allergies, pregnancy and immune system, patient teaching regarding the needs and benefits. |
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Term
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Definition
| certain anticancer agents are cell specific and work on one aspect of the cycle and others are non specific. |
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Term
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Definition
| work on cell cycle, more effective on tumors with a high growth fraction and high doubling as in leukemia. Solid tumors (large % GO state) less resistant to anticancer drugs. |
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Term
| Large doses of anticancer drugs/Chemotherapy |
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Definition
| kill malignant cells, but killnormal cells as well. Normal cells that produce quickly (blook, hair) are at higher risk, (blood disorders, hair loss) |
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Term
Combination Therapy
Anticancer drugs |
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Definition
| enhances tumoricidal effects, and decreases resistance and therefore, intensify but shorten therapy. |
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Term
Anti cancer drug
Alkylating |
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Definition
| work on all phases of the cell cycle and are CCNS. Nitrogen mustards-Cytoxin, Nitrosoureas-CeeNu, Alkyl sulfonate - Myleran, Alkylating like-Platinol |
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Term
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Definition
| Hodgkin's disease, solid tumors, leukemia, breast and ovarian ca. |
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Term
| Cytoxam given with thiazide or allopurinol |
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Definition
| increases bone marrow suppression |
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Term
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Definition
decreases effect of digoxin
increases effect of insulin (hypoglycemia)
Hydration, monitor labwork(cbc and platelets) use of antiemetic, Patient teaching concerning diet low in purines, oral hygiene, (infection, anemia). |
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Term
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Definition
| cell specific S phase, treat lymphoma, acute leukemia, cancer of GI and breast. |
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Term
Antimetabolites
Folic acid antagonists
Methotrexate |
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Definition
| used for immunosuppression after organ transplants |
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Term
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Definition
Cell specific
Folic acid antagonists-Methotrexate
Pyrimidine analogues-5FU
Purine analogues-Leustatin |
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Term
Antimetabolites
Side effects |
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Definition
| anorexia, GI upset, stomatitis, alopecia, photosensitivity, rash, increased pigmentation and hemotologic disorders |
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Term
Nursing process with Antimetabolites
5FU Pyrimidine analogues |
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Definition
| close monitoring of labwork (cbc, wbc, platelets) administration of antiemetic and proper administration of drug, increasing fluids and teaching regarding side effects. |
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Term
Antitumor Antibiotics
usually given in combinatin therapy
(breast, ovarian, bladder)
Side Effects: |
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Definition
Bleomycin, doxorubicin, plicamycin
inhibit protein and RNA synthesis, CCNS nonspecific except bleomycin. se-GI upset, alopecia, stomatitis, leukopenia, and thrombocytopenia. |
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Term
Mitotic Inhibitors
Vinca alkaloids
Cell specific
Side Effects: |
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Definition
block cell division at the M
Vincristine
(breast,testes,kidney, lymphomas, neuroblastomas)
SE= leukopenia, alopecia, stomatitis, GI upset, neurotoxicity(numbness, tingling, ptosis) |
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Term
Combination therapy:
Hormones: agonist |
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Definition
inhibit cell growth
estrogen (prostate, postmenopausal women with breast ca), androgen (advanced breast ca), progestin |
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Term
combination therapy
hormones
antagonists |
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Definition
compete with endogenous hormones
flutamide, tamoxifen (breast ca, most commonly used) |
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Term
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Definition
Topoisomerase I and II inhibitors
Tyrosine Kinase Inhibitors
Proteasome Inhibitors
Multikinase Inhibitors
Angiogenesis Inhibitors |
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Term
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Definition
Assessment labs, medications finances
Nursing diagnosis-infection, CO, Nutrition.
Planning-labs desired range no cardiac problems
Interventions-medical asepsis, labs, N/V fluids
Teaching skin, sun, GI, CV, infection, blood dyscrasias |
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Term
Biological Response Modifiers
newest agents to fight cancer |
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Definition
enhance immune system
recombinant DNA genetic engineering and hybridoma(process to mass produce monoclonal antibodies) led to mass production of BRM's to enhance immunological function, destroy and interfere with tumor activities and promote differentiation of pf stem cells. |
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Term
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Definition
3 types alpha, beta, gamma.
alpha fda approved, used for leukemia, kaposi' sarcoma, multiple myeloma, leukemia, renal cell ca, malignant melanoma, bladder ca, ovarian ca. |
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Term
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Definition
| flu like symptoms, GI upset, rash neurological, Cardiopulmonary, renal, hepatic and hematologic disorders |
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Term
Erythropoietin
stimulates RBC production |
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Definition
| stimulate or regulate growth of bone marrow, used to treat anemic, chronic renal failure and in chemotherapy. allows for higher doses and decrease of hematologic side effects. |
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Term
| Erythropoietin side effects |
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Definition
| hypertension, headache, arthralgia, GI upset, fatigue, chest pain, weakness, and seizures. |
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Term
Neupogen
Colony stimulating factor |
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Definition
| regulates production of neutrophils and decreases incidence of infections after chemotherapy. |
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Term
Neuopogen Granulocyte (G-CSF)
side effects |
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Definition
gi upset, bone pain, alopecia, fever, fatigue, anorexia, dyspnea, headache, rash and chest pain.
Caution with patients with pleural or pericardial effusion since drug will increase fluid retention. |
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Term
Leukine
GM-CSF (granulocyte macrophage)
another type of white blood cell |
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Definition
| stimulates growth and development of bone marrow. It will decrease duration of antibiotic use, decrease infections post chemo and shorten hospitalizations. |
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Term
Granulocyte macrophage
colony stimulating factor
Leukine
Side Effects |
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Definition
| diarrhea, fatgue, weakness, chills, periperal edema, rash, rigors, gi hemorrhage, and dyspnea(sob). Caution with patients pleural or pericardial effusions. |
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Term
CSF
Neumega- platelet growth factor |
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Definition
| prevent chemotherapy induced thrombocytopenia by stimulating platelet growth. |
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Term
Neumega
platelet growth factor
Side effects |
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Definition
| fluid retention, eye problems, allergic reactions |
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Term
Interleukins
hormone like anti tumor properties |
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Definition
IL-2 proleukin
hormone like glycoprotein
produced by wbc's antitumor activities, helpful in treatment of renal ca and malignant melonoma. |
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Term
IL-2 Proleukin
side effects: |
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Definition
| mental status change, fever, chills, anemia, pulmonary congestion, hepatic damage |
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Term
Monoclonal Antibody
side effect |
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Definition
Herceptin (Taxol) treatment metastatic breast ca.
side effects: flue like symptoms and cardiotoxicity. |
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Term
| Nursing Process for BRM's |
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Definition
| assessment of labwork, cardiac monitoring, potential side effect monitoring, premedicatin with tylenol and anti emetic or benedryl, increase fluids and patient teachings of infection prevention and side effects. |
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