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IMMUNOMODULATORS, PART 1/2 | ||
DRUG NAME | peginterferon alfa-2a (Pegasys); interferon alfa-2b; interferon beta-1a (Avonex); interferon beta-1b (Betaseron, Extavia) | aldesleukin (Proleukin) *High Alert Medication* |
CLASS | Interferons | Interleukin |
MECHANISM of ACTION |
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INDICATIONS |
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ROUTE(S) of ADMINISTRATION |
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SIDE EFFECTS | All:
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CONTRAINDICATIONS & CAUTIONS |
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Caution in clients with prior cardiac disease, severe renal or hepatic impairment, myelosuppression, and compromised CNS function | Caution in clients with cardiac arrhythmias, respiratory disorders, renal or hepatic impairment |
IMMUNOMODULATORS, PART 2/2 | ||
DRUG NAME | trastuzumab (Herceptin); infliximab (Remicade); rituximab (Rituxan) *High Alert Medications* | imatinib (Gleevec); dasatinib (Sprycel) *High Alert Medications* |
CLASS | Monoclonal antibodies | Small-molecule inhibitors |
MECHANISM of ACTION | Bind to specific antigens on the cell surface, signalling the immune system to attack and destroy targeted cells | Bind to and inhibit extracellular and intracellular proteins involved with cell growth and death |
INDICATIONS |
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ROUTE(S) of ADMINISTRATION | All: IV | All: PO |
SIDE EFFECTS | All:
trastuzumab:
rituximab:
infliximab:
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CONTRAINDICATIONS & CAUTIONS |
Caution:
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NURSING CONSIDERATIONS for IMMUNOMODULATORS | ||
ASSESSMENT & MONITORING | Assessment and monitoring: interferon alpha-2b Assessment
Monitoring
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CLIENT EDUCATION |
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Immunomodulators are medications that modify the body’s immune response. According to their main effect, immunomodulators can be subdivided into immunostimulants, which are used to enhance the immune response against a specific pathogen or cancer cell; and immunosuppressants, which include monoclonal antibodies used in the targeted treatment against certain types of cancer; and tyrosine kinase inhibitors used for diseases such as leukemias and gastrointestinal tumors.
Now, let’s begin with immunostimulants, which include interferons and interleukins, among other agents. Interferon medications mimic the effects of natural interferons, which are tiny proteins released by virally infected cells. As their name implies, they “interfere” with viral replication, thereby helping cells fight off viral infections. Additionally, they inhibit tumor growth and enhance the immune response.
Interferon medications can be administered subcutaneously or intramuscularly, and they include interferon alpha-2b, which can be used for the treatment of disorders like hairy cell leukemia or AIDS-related Kaposi sarcoma, as well as interferon beta-1a and interferon beta-1b, which can be used for the treatment of relapsing multiple sclerosis.
Moving on, interleukins are tiny signaling proteins that are similar to interferons; they communicate between cells to stimulate cellular immunity, inhibit tumor growth, and increase the production of platelets. One medication called aldesleukin is a human recombinant interleukin 2 agent, which means it acts like interleukin 2 would, promoting the proliferation and activity of various types of lymphocytes. Aldesleukin is administered intravenously, and can be used for treatment of metastatic melanoma or metastatic renal cancer.
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