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102 Cards in this Set
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- Back
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immunotx
stimulate the pts immune system to target or eliminate -- --- |
tumor cells
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immunotx
stimulate the growth and --- of the bl cells after --- |
differentiation
myelosuppression |
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agents used in immunotx
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interferons
colony stimulating factors |
|
interferon's aby. .. activates ---- cells and up regualtes th- and cells and macrophages
|
NK
TH1 |
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thrombopoeitin -- growth factor
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platelet
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erythropoietin --- growth factor
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rbc
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interferon a indication
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HC leukemia
melanoma lymphoma karposi's sarcoma hep b hep c |
|
se of interferon a
--- syndrome --tensio --ias --ion |
flu like syndrome
hypotension arrhythmias depression |
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interferon b used to tx
relapsing -- --- |
multiple sclerosis
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interferon b can cause
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flu like syndrome
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interferon y activates ------
increases ------ --- |
phagocytes
oxygen radicals. . . damages cells that's how virus and bact |
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interferon y prevents serious infections in --- --- --
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chronic granulomateous disease
(inherited immunodeficiency) |
|
interferon y causes
--- --- syndrome -- distress -- loss --ion |
flu like syndrome
gi distress weight loss depression |
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stem cell growth factor help increase
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myeloid stem cells
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what leads maturation of myeloid stem cells to platelets
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thrombopoietin
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stem cell growth factor:
recombinant --- --- |
human scf
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stem cell growth factor:
used to stimulate --- --- cells for transplant |
blood progenitor
|
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stem cell growth factor:
used in combo w/ |
G-CSF
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stem cell growth factor:
increases release of stem cells form --- into --- |
marrow
blood |
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stem cell growth factor:
increase # myeloid stem cells given before transplant to: |
reestablih blood cells component
|
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stem cell growth factor:
used in combo w/ |
G-CSF
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sargramostim route
|
iv
sub q |
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sargramostim
bone marrow --- |
fibroblast
|
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sargramostim
acts on immature ---, ---, ---, ---- |
neutrophils
platelets macrophages eosinophils (speeds up maturation) |
|
sargramostim actios
enchance --- ---- --- |
maturation
differentiation proliferation |
|
sargramostim
decrease/increase cell cycle time by 33% |
decrease
|
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sargramostim
increased: |
rbc
platelets neutrophils moncytes eosinophils (might run out of precursors) |
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sargramostim
mature --- |
wbc
|
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sargramostim
increased --- metabolism increased ---sis, ---toxicity |
oxidative
phagocytosis cytotoxicity |
|
sargramostim
increased --- presentation by -- --- -- |
antigen
apc |
|
sargramostim
--- life span of neutrophils |
doubles
|
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sargramostim
enhances ---- production of ---- |
superoxide
macrophages |
|
sargramostim
indications: stimulate --- ---- after transplant |
bone marrow
|
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sargramostim used for -- after chemo
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neutropenia
so you can give chemo more frequently . . . don't have to wait for bone marrow recovery |
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sargramostim used for
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malignant lymphoma
lymphoblastic leukemia hodgkin's disease acute myelogenous leukemia |
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sargramostim tx
--- anemia |
aplastic
|
|
ae of sargramostim
use caution in -- and -- disease |
renal
hepatic |
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sargramostim ae
--- --- --- --- --cia -- pain |
malaise
fever n/v alopecia |
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sargramostim ae
--- ---- syndrome --- ---damage --- disorders |
capillary leak syndrome
edema liver damage pulmonary disorder |
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bone pain where w/ sargramostim
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leg
pelvis |
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bone pain due to
|
cell stimulation
|
|
sargramostim
who receives it |
someone already at high risk of death due to se
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sargramostim
produced in ---- differ from human ----- for --- at position 23 |
yeast
leucine argenine |
|
route of sargramostim
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subq
|
|
filgrastim
glycoprotein produced by --- and --- cells of bone marrow |
fibroblasts
endothelial cells |
|
filgrastim
produced in ----- not ---- |
E coli
glycosolated |
|
filgrastim stimulates ------ --- ---
|
proliferation
differentiation functional activity of neutrophils |
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filgrastim stimulate activity of
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neutrophil
|
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filgrastim increase --- in 2-3 dyas in normal individual
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wbc
increased activity; reduce maturation time |
|
filgrastim
for immature neutrophils reduce -- --- from 5 days to 1 day |
maturation time
|
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filgrastim
mature neutrophils: enhance ---- enhance --- production (kills engulfed cells) enchanced release from --- ---- |
chemotaxis
superoxide production bone marrow (has to be released to be effective) |
|
indications for filgrastim
-- --- transplants -- after chemo |
bone marrow (jump start bone marrow)
neutropenia (acute leukemia, aids, hairy cell leukemia) |
|
filgrastim
decrease -- after chemo |
infections. . . keep isolated decrease ability to fight infections
|
|
ae of filgrastim
-- pain . . .may be severe --ache ----- -- --- ---- ---penia |
bone pain
ha fatigue n/v/d thrombocytopenia |
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filgrastim
--cia -- ---- |
alopecia
rash fever |
|
filgrastim
cv |
arrhythmias
MI |
|
pegfilgrastim
peglyated human G-CSF from ---- |
e coli
conjuaged to polyethlyene glycol |
|
pegfilgrastim
decreased -- excretion |
renal
|
|
pegfilgrastim
increased --- ---- -- less --- ---- |
duration of action
less frequent dosing |
|
interleukin 11 oprelevkin
recombinant human IL-11 made in ----- |
ecoli
|
|
interleukin 11 oprelevkin
route |
subq
daily |
|
interleukin 11 oprelevkin
increase ---- maturation in 5-7 days |
megakaryocyte
|
|
interleukin 11 oprelevkin
used in chem induced ---- |
thrombocytopenia
|
|
ae of interleukin 11 oprelevkin
--- retention ---cardia ---ion -- ---- -- vision |
fluid retention
tachycardia palpitation edema sob blurred vision |
|
thrombopoietin
recombinant ------ ---- |
human thrombopoeitin
|
|
thrombopoietin
selectively increase ------ |
megakaryocytes
|
|
thrombopoietin
clinical trials promising in --- |
thrombocytopenia
|
|
thrombopoietin
---- increaese by day 4 peaking at --- --- |
platelets
12-14 days |
|
thrombopoietin
combined w/ --- or ---- -------- |
GM
G-CSF erythropoietin |
|
platelet stimulants:
|
eltrombopag
romiplostim |
|
eltrombopag
route |
oral
|
|
eltrombopag
nonpeptide ---- ---- -- |
thrombopoietine receptor agonist
|
|
eltrombopag use:
|
chronic immune thrombocytopenic purpuria
|
|
primary tx of platelet destruction
|
steroids
immunoglobulins spleenectomy |
|
eltrombopag
leads to dose dependent rise in |
platelets
|
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eltrombopag
cause --- --- rise in platelets |
dose dependent
|
|
eltrombopag
who shows higher blood levels/toxicity |
asians
|
|
eltrombopag
chelates |
mg
al |
|
eltrombopag
black box warning: -- toxcity increased risk of -- --- ---- |
bone marrow fibrosis
|
|
eltrombopag
black box warning --- malignancies ------ mayd develop --- thrombocytopenia after discontiuation |
hematological
cataracts hemorrhagic |
|
romiplostin
route |
subq
weekly |
|
romiplostin
fusion protein linked to two --- that acts as --- receptor agonist |
IgI
TPO |
|
romiplostin
activates --- pathways to increase platelets |
transcriptional
|
|
romiplostin
increase risk of bone marrow ---- and ---- malignancies |
fibrosis
hematological |
|
romiplostin tx:
|
chronic immune thrombocytopenic purpuria
|
|
romiplostin
may see -- formation during use |
antibody
|
|
plerixafor
---- chemokine receptor antagonist |
CXCR4
|
|
plerixafor
not hiv drug because increase ---- ----- --- -- in blood |
CD34+ hematopoietic stem cells in blood
|
|
CXCR4 chemokine receptor responsible for anchoring -- --- in --- ---
|
stem cells
bone marrow |
|
when is plerixafor given
|
after 4 daily doses of
G-CSF for hematopoietic stem cell collection before radiation in nonhodgkin's and multi myeloma |
|
plerixafor
should not be used for -- --- ---- in leukemia's |
stem cell mobilization
|
|
plerixafor
t/f ok to use in pregnancy |
f
teratogenic in animals not used in breastfeeding |
|
plerixafor
causes --- pain -- tension |
abd pain
hypotension |
|
erythropoietin regulated by ---- delivery
|
oxygen
|
|
erythropoietin regualted by O2 delivery to --- and released by --- ---
|
kidneys
tubular interstitial cells |
|
erythropoietin
enhances ---- --- --- -- of rbc |
survival
maturation proliferation |
|
route of erythropoietin
|
IV
IM |
|
erythropoietin used in
|
anemias
dialysis requirement supplemental iron |
|
erythropoietin
monitor |
hematocrit
|
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erythropoietin
fds warning to use lowest dose has been shown to ---- ---- and increaed ---- |
constrict small arteries
hematocrit. . . can cause chf, mi, stroke |
|
t/f
some evidence of increased -- risk and decreased effeciveness of ---- |
cancer
chemo |
|
t/f
erythropoietin: less fatigue in ca patients |
f
no evidence |
