A.

ANTI-INFLAMMATORY, ANTIARTHRITIS, AND RELATED AGENTS

Assessment
o Assess patient monthly for pain, swelling, and range of motion.
Potential Nursing Diagnoses
o Chronic pain (Indications).
o Deficient knowledge, related to disease processes and medication regimen.
Implementation
o Most agents require regular administration to obtain maximum effects.
Patient/Family Teaching
o Instruct patient to contact health care professional if no improvement is noticed within a few
days.
Evaluation/Desired Outcomes
o Improvement in signs and symptoms of rheumatoid arthritis.

(a) SALICYLATES
o aspirin
o balsalazide
o choline magnesium
o trisalicylate
o diflunisal
o mesalamine
o olsalazine
o salsalate
o sodium thiosalicylate
o indomethacin
o ketorolac
o nabumetone
o sulindac
o tolmetin
o Fenamates
o meclofenamate
o mefenamic acid
Oxicam DerivativesMeloxicam
o piroxicam
Cyclooxygenase-2 Inhibitor
o celecoxib
Related Agent
o acetaminophen
(b) NONSTEROIDAL ANTIINFLAMMATORY AND RELATED AGENTS
Nonsteroidal Antiinflammatory Agents (NSAIDs) Propionic Acids
o fenoprofen
o flurbiprofen
o ibuprofen
o ketoprofen
o naproxen
o oxaprozin
Acetic Acids
o diclofenac
o etodolac

(c) ANTIARTHRITIS AGENTS

Gold Compounds
o auranofin
o aurothioglucose
o gold sodium thiomalate
Other Antiarthritis Drugs
o anakinra
o etanercept
 o hyaluronidase derivatives
o leflunomide
o penicillamine
o sodium hyaluronate

1. IMMUNE MODULATORS
NURSING IMPLICATIONS
Assessment
o Monitor for infection (vital signs, sputum, urine, stool, WBC). Notify physician or other health
care professional immediately if symptoms occur.
o Organ Transplant: Assess for symptoms of organ rejection throughout therapy.
o Lab Test Consideration: Monitor CBC and differential throughout therapy.
Potential Nursing Diagnoses
o Risk for infection (Side Effects).
o Deficient knowledge, related to disease processes and medication regimen (Patient/Family
Teaching).
Implementation
o Protect transplant patients from staff and visitors who may carry infection.
o Maintain protective isolation as indicated.
o Patient/Family Teaching
 o Reinforce the need for lifelong therapy to prevent transplant rejection. Review symptoms of
rejection for transplanted organ and stress need to notify health care professional
immediately if they occur.
o Advise patient to avoid contact with contagious persons and those who have recently taken
oral polio virus vaccine. Patients should not receive vaccinations without first consulting with
health care professional.
o Emphasize the importance of follow-up exams and lab tests.
Evaluation/Desired Outcomes
o Prevention or reversal of rejection of organ transplants or decrease in symptoms of
autoimmune disorders.

(a) IMMUNE STIMULANTS

Interferons
o interferon alfa-2b
o interferon alfacon-1
o interferon alfa-n3
o interferon beta-1a
o interferon beta-1b
o interferon gamma-1b
o peginterferon alfa-2a
 o peginterferon alfa-2b
Interleukins
o aldesleukin
o oprelvekin
Interleukin-Receptor Antagonist
o anakinra
Monoclonal Antibodies
o adalimumab
o alemtuzumab
o basiliximab
o bevacizumab
o certolizumab
o cetuximab
o daclizumab
o eculizumab
o erlotinib

(b) IMMUNE SUPPRESSANTS

T- and B-Cell Suppressors
o abatacept
o alefacept
o azathioprine
o cyclosporine
o glatiramer acetate
o mycophenolate
o pimecrolimus
o sirolimus
o tacrolimus
o gemtuzumab
o ibritumomab
o infliximab
o muromonab-CD3
o natalizumab
o omalizumab
o palivizumab
o pegaptanib
o rituximab
o tocilizumab
o tositumomab
o trastuzumab
 o ustekinumab

2. VACCINES AND SERA

NURSING IMPLICATIONS
Assessment
o Assess previous immunization history and history of hypersensitivity.
Potential Nursing Diagnoses
o Risk for infection (Indications).
o Deficient knowledge, related to disease processes and medication regimen
(Patient/FamilyTeaching).
Implementation
o Measles, mumps, and rubella vaccine, trivalent oral polio virus vaccine, and diptheria toxoid,
tetanus toxoid, and pertussis vaccine may be given concurrently.
o Administer each immunization by appropriate route.
Patient/Family Teaching
o Inform patient/parent of potential and reportable side effects of immunization. Health care
professional should be notified if patient develops fever over 39.4°C (103°F); difficulty
breathing; hives; itching; swelling of the eyes, face , or inside of nose; sudden severe tiredness
or weakness; or convulsions occur.
 o Review next scheduled immunization with parent. Emphasize the importance of keeping a
record of immunizations and dates given.
Evaluation/Desired Outcomes
o Prevention of diseases through active immunity.

(a) VACCINES
Bacterial Vaccines
o bacille Calmette-Guérin (BCG)
o Haemophilus influenza b conjugate vaccine
o Haemophilus influenz a b conjugate vaccine and hepatitis B surface
antigen
o meningococcal polysaccharide vaccine
o meningococcal polysaccharide diphtheria toxoid conjugate vaccine
o pneumococcal vaccine, polyvalent
o pneumococcal 7-valent conjugate vaccine
o typhoid vaccine

(b) Toxoids
o diphtheria and tetanus toxoids, combined, absorbed
o diphtheria and tetanus toxoids and acellular pertussis v accine, absorbed
 o diphtheria and tetanus toxoids and acellular pertussis and influenza virus vaccine,
Haemophilus influenzae b conjugate vaccines
o diphtheria and tetanus toxoids and acellular pertussis and poliovirus vaccine
o diphtheria and tetanus toxoids and acellular pertussis, poliovirus and Haemophilus
influenzae b conjugate vaccines
o diphtheria and tetanus toxoids and acellular pertussis, absorbed, and hepatitis B
(recombinant) and inactivated poliovirus vaccines, combined
o tetanus toxoid

(c) VIRAL VACCINES

o H5N1 influenza vaccine
o hepatitis A vaccine,inctivated
o hepatitis A vaccine, inactivated, with hepatitis B recombinant vaccine
o hepatitis B vaccine
o human papillomavirus recombinant vaccine
o influenza virus vaccine
o influenza virus vaccine, intranasal
o Japanese encephalitis vaccine
o measles virus vaccine, live attenuated
o measles, mumps, rubella vaccine
 o measles, mumps, rubella, varicella virus vaccine
o mumps virus vaccine, live poliovirus vaccine, inactivated
o rabies vaccine
o rotavirus vaccine, live, oral
o rubella virus vaccine
o rubella and mumps virus vaccine, live
o smallpox vaccine
o varicella virus vaccine
o yellow fever vaccine
o zoster vaccine, live

(d) IMMUNE SERA

o antithymocyte immune
o globulin
o botulism immune globulin
o cytomegalovirus immune
o globulin
o hepatitis B immune
o globulin
o immune globulin, intramuscular
 o immune globulin, intravenous
o lymphocyte immune globulin
o rabies immune globulin
o respiratory syncytial virus immune globulin
o RHO immune globulin
o RHO immune globulin, microdose
o tetanus immune globulin
o vaccinia immune globulin IV
o varicella zoster immune globulin

(e) ANTITOXINS AND ANTIVENINS

o antivenin (Crotalidae) polyvalent
o antivenin ( Micrurus fulvius )
o black widow spider antivenin
o Crotalidae polyvalent immune fab