Immunosuppressant and chemotherapy drug classes with infection precautions and key nursing safety considerations.
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- What is the primary nursing concern with all immunosuppressant medications?
- Increased risk of infection due to suppressed immune response
- What lab value is used to assess a chemotherapy patient's risk of infection?
- Absolute neutrophil count (ANC)
- An ANC below what value indicates severe neutropenia?
- 500 cells/mm3
- What term describes the point at which blood cell counts reach their lowest level after chemotherapy?
- Nadir
- About how many days after chemotherapy does the nadir typically occur?
- 7 to 14 days
- Name the two calcineurin inhibitor drugs commonly used to prevent transplant rejection.
- Cyclosporine and tacrolimus
- What beverage must patients avoid while taking cyclosporine or tacrolimus?
- Grapefruit juice
- What oral tissue side effect is commonly associated with cyclosporine?
- Gingival hyperplasia (overgrowth of the gums)
- What major organ toxicity requires monitoring in patients taking calcineurin inhibitors like cyclosporine or tacrolimus?
- Nephrotoxicity (kidney damage)
- What neurologic side effects can occur with tacrolimus?
- Tremors and headache
- Why must mycophenolate mofetil never be used during pregnancy?
- It is teratogenic and causes fetal harm
- What drug interaction increases toxicity risk when combined with azathioprine?
- Allopurinol
- What lab test should be monitored regularly in a patient taking azathioprine?
- Complete blood count (CBC), due to risk of bone marrow suppression
- What class of immunosuppressant is sirolimus?
- mTOR inhibitor
- What adverse effect makes sirolimus a concern for patients with recent surgical wounds?
- It impairs wound healing