hey guys nurse Mike here and welcome to simplenursing.com check out our brand new app and get access to our new pharmacology and Med surge Mastery courses join for free click the link in our description below all right guys let's begin now for the immune drugs we have immunosuppressants given to help the body stop attacking itself like with clients and autoimmune diseases where the body's own immune system is attacking normal organs and and immunosuppressants are also given with patients with organ transplant so the body doesn't reject that new organ now let the name help you here immunosuppressants are given to suppress that immune system like putting those wbcs those white blood cells to sleep the good news is the body stops attacking itself but the bad news here is we get bone marrow suppression with immunosuppressants meaning we have a big risk for in infections and high risk for bleeding now guys please focus on those two things the two biggest test tips I can give you for immunosuppressants where the immune system is suppressed now the first drug is hydroxychloroquine given to treat lupz where the body's attacking its own skin and Joints so this drug helps to decrease inflammation and fatigue so commonly we'll see patients with increased energy when taking this drug now it's taken for several months to reach that therapeutic level so the benefits are not seen overnight now the key Point comes in the major adverse effects Big Time retinal damage as well as vision problems so we must teach patients for regular eye appointments every key number here 6 to 12 months make sure to write that down so the big memory trick we use here is hydroxychloroquine causes high damage with that high drxy and just think chloroquine sounds like chlorine so we got to check the eyes every single year for that retinal damage now the hessie mentioned in their question that teaching is effective when the client states I need to see the optometrist at least once a year yes technically this is correct because we have to see him every 6 to 12 months for those regular eye appointments now lastly don't let the and clicks trick you there's no need for a medical alert bracelet which is typical for seizure patients and there's no need for osteoporosis vitamins like calcium and even vitamin D those were the two most commonly chosen distractors now our next immunosuppressant is Methotrexate now this one is the drug to know for the enlex as well as your exit exams mainly given for rheumatoid arthritis as mentioned by Kaplan this this is where the body is attacking its own joints and psoriasis where the body is attacking its own skin and even certain types of cancer to slow the growth of that cancer now the mechanism of action is pretty simple it stops folic acid metabolism which stops cellular reproduction in the fastest replicating cells now the bad news like all immunosuppressants the fastest replicating cells in the body are in the blood and immune system as well as pregnant client with the growing fetus so we end up with a very weak immune system leading to infections low platelet count leading to Serious bleeding and even fetal death with our pregnant clients so the memory trick for Methotrexate we just call it Methotrexate no pregnant clients no crowds or live vaccines to avoid infection and no razors or brushing teeth hard huge bleed risk with the low platelets these are the big noos for meth no trexate so the big key points for your exam come in terms of infection and bleeding risk so infection risk The Big Three are we report fever over the key number 10.3 fahit or 38° C and secondly we avoid crowds and sick people and then lastly we avoid fresh fruits as well as flowers now for thrombocytopenia that's technically platelets under 100,000 so just remember under 50 is very risky and under 150 is very iffy so we monitor those platelets under a 100,000 some big key numbers there so report bleeding in these various ways so petii that bleeding under the skin perpa or purple spots under the skin as well as Melina that black T stool could indicate a GI bleed and even hematemesis that vomiting of blood and bleeding gums so we must report these findings to the hcp immediately now the hessy question that was asked for Methotrexate it suppresses B andt lymphocytes basically meaning it suppresses white blood cells in the immune system now the big teaching Point here is we get flu and pneumonia vaccines that are keyword inactivated so flu vaccines are not contra indicated but what is contraindicated is live vaccines like herpes Zer so no live vaccines so don't be tricked guys thanks for watching for our full video and new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube channel last but not least a big thanks to our team of experts helping us make these great videos all right guys see you next [Music] time