By E. Jose. Aquinas College.

Dexa- of infection generic zenegra 50 mg free shipping, patients are treated prophylactically with anti- methasone is commonly used in neurologic disorders buy zenegra 50 mg online. Gemtuzumab, an antibody conjugated with an (eg, anastrozole) that inhibit estrogen synthesis, antiestrogens antitumor antibiotic, is used to treat acute myeloid leukemia. Assess emotional status, coping mechanisms, family relationships, and financial resources. Anxiety and depres- INDIVIDUAL DRUGS sion are common features during cancer diagnosis and treatment. Cytotoxic antineoplastic drugs are listed in Drugs at a Glance: Assess laboratory test results before chemotherapy to es- Cytotoxic Antineoplastic Drugs; hormones and hormone in- tablish baseline data and during chemotherapy to monitor hibitors are listed in Drugs at a Glance: Antineoplastic Hor- drug effects: mones and Hormone Inhibitors. Alpha-fetoprotein is a fetal antigen nor- mally present during intrauterine and early postnatal life CYTOPROTECTANT DRUGS but absent in adulthood. Carcinoembryonic antigen Cytoprotectants reduce the adverse effects of cytotoxic drugs, (CEA) is secreted by several types of malignant cells (eg, which may be severe, debilitating, and life threatening CEA is present in approximately 75% of people with (Box 64–2). A rising level may indicate tumor pro- dosage or frequency of administration, thereby limiting the gression and levels that are elevated before surgery and effectiveness of chemotherapy. Several cytoprotectants are disappear after surgery indicate adequate tumor excision. Other tumor markers are immunoglobulins uling must be precise in relation to administration of the (elevated levels may indicate multiple myeloma) and cytotoxic agent. A cytoprotective agent does not prevent or prostate-specific antigen (elevated levels may indicate treat all adverse effects of a particular cytotoxic agent and it prostatic cancer). A CBC and white blood cell differential are done before Erythropoietin, filgrastim, oprelvekin, and sargramostim each cycle of chemotherapy to determine dosage and fre- are colony-stimulating factors (see Chap.

For ex- Several of these drugs can be given by more than one ample purchase zenegra 50 mg amex, an increased blood sugar level is therapeutic for route; others can be given only orally or topically discount 100mg zenegra free shipping. For the client with adrenocortical insufficiency or an islet example, in recent years there have been several for- cell adenoma of the pancreas, but an adverse reaction mulations developed for oral inhalation in the treatment 338 SECTION 4 DRUGS AFFECTING THE ENDOCRINE SYSTEM of asthma and for nasal inhalation in the treatment of stances from lysosomes. For intra-articular or and thus prevents leakage of fluid into the injured area intralesional injections, acetate salts are used because and development of edema. It also reduces the chemicals they have low solubility in water and provide prolonged that normally cause vasodilation and tissue irritation. Betamethasone and dexamethasone last 48 hours, contributes to the anti-inflammatory and immunosup- methylprednisolone, prednisolone, prednisone and tri- pressant effects of glucocorticoids. The drugs inhibit the ability Mechanisms of Action of these immune cells to increase in number and per- form their functions. Like endogenous glucocorticoids, exogenous drug mole- • Inhibiting tissue repair. The drugs inhibit the growth cules act at the cellular level by binding to glucocorticoid of new capillaries, fibroblasts, and collagen needed for receptors in target tissues. Once inside the cell, they bind with receptors in intracellu- lar cytoplasm. The drug–receptor complex then moves to the Indications for Use cell nucleus, where it interacts with DNA to stimulate or sup- press gene transcription. Corticosteroids are extensively used to treat many different Glucocorticoid drugs increase or decrease transcription of disorders. Except for replacement therapy in deficiency many genes to alter the synthesis of proteins that regulate states, the use of corticosteroids is largely empiric.

Give most oral antiseizure drugs after meals or with a full Most antiseizure drugs cause some gastric irritation cheap 50mg zenegra otc, nausea discount zenegra 50 mg mastercard, or glass of water or other fluid; levetiracetam, oxcarbazepine, top- vomiting. Taking the drugs with food or fluid helps decrease gastro- iramate, and zonisamide may be taken with or without food. To give phenytoin: (1) Shake oral suspensions of the drug vigorously before In suspensions, particles of drug are suspended in water or other pouring and always use the same measuring equipment. Shaking the container is necessary to distribute drug parti- cles in the liquid vehicle. If the contents are not mixed well every time a dose is given, the liquid vehicle will be given initially, and the concentrated drug will be given later. That is, underdosage will occur at first, and little if any therapeutic benefit will result. Over- dosage will follow, and the risks of serious toxicity are greatly in- creased. Calibrated medication cups or measuring teaspoons or tablespoons are acceptable. Regular household teaspoons and tablespoons used for eating and serving are not acceptable because sizes vary widely. Rapid administration must be avoided be- piggybacked into a primary IV line, the primary IV solu- cause it may produce myocardial depression, hypotension, cardiac tion must be normal saline or the line must be flushed with arrhythmias, and even cardiac arrest. To give carbamazepine and phenytoin suspensions by naso- Absorption is slow and decreased, possibly because of drug ad- gastric (NG) feeding tube, dilute with an equal amount of herence to the NG tube. Dilution and tube irrigation decrease such water, and rinse the NG tube before and after administration. To give oxcarbazepine suspension, use the 10-mL oral dos- For accurate measurement and a reminder that the suspension is ing syringe provided by the manufacturer with each bottle. The suspension is stored at room temperature Also check expiration date. When the drug is given on a long-term basis to prevent Therapeutic effects begin later with antiseizure drugs than with seizures, observe for a decrease in or absence of seizure activity.