Pharmacology Immunizations & Chemotherapy

vaccines

stimulate the immune system to produce antibodies against specific microbes. They provide protection through active immunity, can take weeks to months to be effective. 

active immunity

immunity where the body produces its own antibodies

natural immunity

immunity from expose to infection

artificial immunity

immunity in response to vaccination

passive immunity

temporary immunity where antibodies are transferred from another source

natural: maternal antibodies (placenta, breast milk)

artificial: immune globulins for post-exposure prophylaxis 

DTaP

immunization series with 5 doses at 2, 4, 6, 15-18 months, and 4-6 years old

Hib

immunization series starting at 2 months old

polio

immunization series with 4 doses before school entry

MMR

immunization series with 2 doses 12-15 months and 4-6 years old

varicella

immunization series with 2 doses

rotavirus

immunization oral series, completed before 8 months 

pneumococcal

immunization series with 4 doses

hepatitis A 

immunization series with 2 doses 6 months apart starting at 12 months old

influenza

annual immunization, inactivated vaccine preferred for high-risk groups 

tdap

immunization booster required every 10 years and given during each pregnancy

zoster

immunization recommended at age 60 or older

HPV

immunization given up to age 26, prevents cervical and other cancers

hepatitis A and B

Immunization given for high-risk adult individuals

methotrexate

antimetabolites (folic acid analog)

methotrexate action

inhibits folic acid metabolism which prevents DNA synthesis (action)

methotrexate uses 

leukemia, lymphoma, breast and lung cancers, rheumatoid arthritis, ectopic pregnancy (therapeutic uses)

methotrexate complications

bone marrow suppression, GI upset, mucositis, hepatotoxicity (complications)

methotrexate monitoring

monitor CBC, liver enzymes, renal function, leucovorin rescue to reduce toxicity (nurse monitoring)

doxorubicin

antitumor antibiotics

doxorubicin action

intercalates DNA, inhibits RNA/DNA synthesis (action)

doxorubicin uses

solid tumors (breast, ovarian, bladder), leukemias, lymphomas (therapeutic uses)

doxorubicin complications

cardiotoxicity, red urine discoloration, alopecia, myelosuppression (complications)

doxorubicin monitoring 

baseline ECG, monitor for heart failure, cumulative dose limits (nurse monitoring)

vincristine

antimitotics

vincristine action

prevents mitotic spindle formation, inhibits cell division (action)

vincristine uses

leukemia, lymphoma, solid tumors (therapeutic uses)

vincristine complications

peripheral neuropathy, constipation, alopecia (complications)

vincristine monitoring

assess neurotoxicity, encourage fluids/fiber, prevent extravasation (nurse monitoring)

cyclophosphamide

alkylating agents

cyclophosphamide action

damages DNA by cross-linking strands, prevents replication (action)

cyclophosphamide uses

leukemia, lymphoma, breast/ovarian cancers (therapeutic uses)

cyclophosphamide complications

hemorrhagic cystitis, myelosuppression, alopecia (complications)

cyclophosphamide monitoring 

ensure hydration, administer mesna to protect bladder, monitor for blood in urine (nurse monitoring)

topotecan/irinotecan

topoisomerase inhibitors

topotecan/irinotecan action

interrupts DNA replication and transcription (action)

topotecan/irinotecan uses

ovarian, colorectal, lung cancers (therapeutic uses)

topotecan/irinotecan complications

bone marrow suppression, GI upset, alopecia (complications)

topotecan/irinotecan monitoring 

monitor CBC, manage GI symptoms, prevent infection (nurse monitoring)