Hematopoietic Growth Factors
Definition: These products are used as supportive therapy in patients with some cancers of the blood.
Types: Erythropoetin (Epogen) and filgrastim (Neupogen).
Contraindications: Patients with cardiac problems should use caution when taking these medications.
Pharmacokinetics: Metabolized by the liver.
Side Effects: Hypertension, fluid retention, bone pain, and cardiac changes.
Nursing Care: When patients become neutropenic (WBC <10,000) these products are given to increase white blood cell production and increase immune support. Monitor labs daily. Use neutropenic precautions when caring for these patients.
Antibiotics
Definition: These medications are used to prevent or inhibit bacterial growth that can lead to infections, or to treat existing infections.
Types:
- • Penicillin: Amoxicillin (Amoxil), ampicillin (Principil), car- benicillin (Geocillin), and oxacillin (Bactocill).
- • Aminoglycosides: Streptomycin, gentamicin, tobramycin, and neomycin.
- • Sulfonamides: Trimethoprim/sulfamethoxazole.
- • Cephalosporin: Cephalexin (Keflex), cefdinir (Omnicef), and ceftriaxone (Rocephin).
- • Fluoroquinolone: Ciprofloxacin, levofloxacin, and gemifloxacin.
- • Tetracycline: Doxycycline and minocycline.
- • Macrolides: Azithromycin, erythromycin, and clarithromycin.
Contraindications: Obtain an allergy history before administering, and do not give if there has been a prior allergic response.
Pharmacokinetics: Given PO or IV; metabolized by the liver and excreted through the urine.
Side Effects: Headache, GI upset, hepatotoxicity, nephrotoxicity, allergic reactions, rash, and drowsiness. With sulfonamides, Stevens-Johnson's syndrome can be a side effect.
Nursing Care: Obtain an allergy history before administering. Monitor for side effects. Administer a probiotic to avoid complications such as C. diff. Monitor labs.
