Pharmacology - Immune system drugs full video nursing RN PN NCLEX

Summary

In this educational video, Nurse Mike explains the role of immunosuppressant drugs, commonly prescribed for autoimmune diseases and organ transplant patients. He highlights two key drugs: hydroxychloroquine, used for lupus with potential risks to vision, and methotrexate, used for rheumatoid arthritis, psoriasis, and certain cancers, which can cause immune suppression, bleeding, and harm during pregnancy. Nurse Mike emphasizes the importance of monitoring for side effects like infections and bleeding, and gives critical nursing tips for proper patient care. The video is designed to prepare nursing students for exams, focusing on practical drug knowledge and patient safety.

Takeaways

• 😀 Immunosuppressants are drugs that help the body stop attacking itself, commonly used for autoimmune diseases and organ transplants.
• 😀 The main risk of immunosuppressants is bone marrow suppression, leading to increased risk of infections and bleeding.
• 😀 Hydroxychloroquine is used to treat lupus and helps reduce inflammation and fatigue, but requires regular eye exams for retinal damage every 6-12 months.
• 😀 Key teaching for hydroxychloroquine: No need for a medical alert bracelet or extra calcium/vitamin D, just regular eye checkups.
• 😀 Methotrexate is used for rheumatoid arthritis, psoriasis, and some cancers, but it inhibits folic acid metabolism and can cause immune suppression and bleeding.
• 😀 Methotrexate is contraindicated for pregnant clients due to risks of fetal death and should not be used with live vaccines.
• 😀 Patients on methotrexate should avoid crowds, sick people, fresh fruits, and flowers to reduce infection risk.
• 😀 Key warning signs for bleeding with methotrexate: petechiae, melena (black stools), hematemesis (vomiting blood), and bleeding gums.
• 😀 For both hydroxychloroquine and methotrexate, infection and bleeding risks are critical; fever over 100.3°F (38°C) should be reported immediately.
• 😀 The most important exam tips: Hydroxychloroquine requires eye exams every 6-12 months, and methotrexate requires caution with infections, bleeding, and avoiding live vaccines.

Q & A

What are immunosuppressants used for?

Immunosuppressants are used to help the body stop attacking itself, particularly in autoimmune diseases, and to prevent organ rejection in transplant patients.

What is a major risk associated with the use of immunosuppressants?

A major risk associated with immunosuppressants is bone marrow suppression, which can lead to an increased risk of infections and bleeding.

What is the main therapeutic purpose of hydroxychloroquine?

Hydroxychloroquine is used to treat lupus, an autoimmune disease where the body attacks its own skin and joints, by reducing inflammation and fatigue.

What is the key adverse effect of hydroxychloroquine?

The key adverse effect of hydroxychloroquine is retinal damage, which can lead to vision problems.

How often should patients on hydroxychloroquine have eye appointments?

Patients on hydroxychloroquine should have eye appointments every 6 to 12 months to monitor for retinal damage.

What is the primary mechanism of action of methotrexate?

Methotrexate works by inhibiting folic acid metabolism, which stops cellular reproduction in the fastest replicating cells, including those in the blood and immune system.

Why is methotrexate contraindicated in pregnant patients?

Methotrexate is contraindicated in pregnant patients because it can lead to fetal death due to its suppression of cellular reproduction.

What are some key precautions to take when using methotrexate?

Key precautions when using methotrexate include avoiding crowds, live vaccines, and razors to reduce the risk of infection and bleeding. It's also important to avoid fresh fruits and flowers due to infection risks.

What should be monitored in patients taking methotrexate for bleeding risk?

Platelet counts should be monitored, especially when levels fall under 100,000. Any signs of bleeding, such as petechiae, black stools, or vomiting blood, should be reported immediately.

What is the distinction between inactivated and live vaccines for patients on methotrexate?

Patients on methotrexate can receive inactivated vaccines, such as the flu vaccine, but they should avoid live vaccines, like the herpes zoster vaccine, as they can increase the risk of infection.