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Chapter 17

1. A patient has been diagnosed with hairy cell

leukemia. The patient is to begin taking interferon

alfa 2b. What will the nurse include in her

instructions to the patient concerning this drug?

A) Avoid drinking alcohol while taking the

drug.

B) Continue to maintain maximal physical

activity.

C) Increase fluid intake while taking the drug.

D) Treat constipation with over-the-counter

laxatives.

Ans: C

Feedback:

Interferon alfa 2b is metabolized in the kidney so

adequate fluid intake is needed to promote metabolism

and excretion of the drug as well as to minimize

common adverse effects including dry skin and

dizziness. Maintaining maximal physical activity is a

good idea but has no relationship to the use of the

drug. Fluids should be increased not decreased while

taking the drug. Constipation is not an associated

adverse effect of this medication.

2. The health care provider plans to inject an interferon

directly into the patient’s wart. What interferon will the

nurse prepare?

A) Interferon alfa 2a (Roferon-A)

B) Interferon alfacon 1 (Infergen)

C) Interferon alfa n3 (Alferon N)

D) Interferon beta 1a (Avonex)

Ans: C

Feedback:

Interferon alf n3 is used for intralesional treatment of

warts. Interferon alfa 2a is used in the treatment of

leukemia. Interferon alfacon 1 is used in the treatment

of chronic hepatitis C infection in adults. Interferon

beta 1a is used to treat multiple sclerosis in adults.

3. A 30-year-old woman has been diagnosed with

leukemia and will be using an immune modulator for

treatment. What will be important to discuss with the

patient when the nurse provides patient teaching about

her treatment?

A) The need to continue oral contraceptives

B) The need to use barrier contraceptives while

taking the drug

C) The need to avoid sexual intercourse while

taking the drug

D) The importance of taking an aspirin daily to

decrease the adverse effects of the drug

Ans: B

Feedback:

A patient taking an immune modulator would be

advised to use barrier contraceptives to prevent

pregnancy. The interaction of the immune modulator

and the oral contraceptive may interfere with the oral

contraceptive’s ability to work properly. Asking

patients to avoid sexual intercourse is not necessary if

barrier methods are properly used. Daily aspirin would

not decrease adverse effects of this drug.

4. The nurse has an order to administer oprelvekin

(Neumega) to a patient for the first time. Before

administering the drug, what allergy would the nurse

want to specifically question the patient about?

A) Egg products

B) Escherichia coli–produced products

C) Lactose intolerance

D) Penicillin

Ans: B

Feedback:

The interleukins are produced using

deoxyribonucleic acid technology and E. coli

bacteria. Patients with known allergy to E. coli

products should not receive oprelvekin. The

allergies to penicillin, egg products, or lactose

intolerance would not be of concern with this drug.

5. The physician has decided to prescribe T- and B-cell suppressors for a patient diagnosed with psoriasis.

What drug will be ordered for this patient?

A) Alefacept (Amevive)

B) Azathioprine (Imuran)

C) Cyclosporine (Neoral)

D) Glatiramer acetate (Copaxone)

Ans: A

Feedback:

Alefacept is prescribed for patients with severe

chronic plaque psoriasis. Cyclosporine is used to

suppress rejection in a variety of transplant situations.

Azathioprine is used to treat patients with rheumatoid

arthritis and in prevention of rejection in renal

homotransplants. Tacrolimus is used for prevention of

rejection after renal or liver transplantation.

6. A patient who is receiving an immune suppressant has

been admitted to the unit. What would be a priority

action by the nurse?

A) Monitor nutritional status.

B) Provide patient teaching regarding the drug.

C) Protect the patient from exposure to

infection.

D) Provide support and comfort measures in

relation to adverse effects of the drug.

Ans: C

Feedback:

Patients taking immune suppressant drugs are more

susceptible to infection because the patient’s normal

body defenses will be diminished. As a result, the

priority action by the nurse would to protect the

patient from exposure to infection through room

selection, good hand hygiene, and taking care to avoid

exposure to sick staff members. Teaching will need to

include avoiding crowded places and people with

known infection and those working in soil. Nutritional

status is important as are comfort and support

measures and other instructions concerning the drug.

However, protecting the patient from infection should

be the priority action.

7. A nurse is discussing interferon alfa 2b with a patient.

What will the nurse encourage the patient to do while

taking this drug?

A) To avoid crowds

B) To increase salt intake

C) To decrease milk intake

D) To eat three meals a day

Ans: A

Feedback:

Potential adverse effects in addition to the types of

conditions interferon alfa 2b is prescribed to

contribute to the need for the patient to take care to

avoid people with infections so the patient should be

taught to avoid crowds whenever possible. Adverse

effects include dizziness, confusion, rash, dry skin,

anorexia, nausea, bone marrow suppression, and

flulike syndrome. Salt, diet, and milk do not interfere

with this drug.

8. A 70-year-old patient with acute myelocytic

leukemia is receiving sargramostim (Leukine). What

is a priority nursing action for this patient?

A) Providing a quiet environment

B) Increasing fluids

C) Providing comfort measures related to

nausea

D) Encouraging appropriate dietary intake

Ans: B

Feedback:

A common adverse effect of this drug is vomiting and

diarrhea. Due to the patient’s age it would be

important to keep him hydrated. Vomiting and

diarrhea can cause dehydration quickly in the elderly.

Providing a quiet environment and comfort measures

for the nausea would be important but not as critical

as increasing fluids. Diet is very important to this

patient; however, usually this drug causes a loss of

appetite. Therefore, increasing fluids would be

extremely important to the patient’s nutritional status.

9. The nurse is caring for a patient in the immediate postoperative period following cardiac

transplantation who is receiving mycophenolate

(CellCept) twice a day IV. What will the nurse teach

the patient regarding drug therapy? (Select all that

apply.)

A) “The drug will be given orally as soon as

possible.

B) “Take the medication three times a day.”

C) “Avoid people with contagious diseases.”

D) “Ask a pharmacist about drug–drug

interactions before taking any over-

thecounter (OTC) drug.”

E) “Never miss a dose of medication.”

Ans: A, C, D, E

Feedback:

The nurse will explain that the IV medication will be

changed to oral therapy when the patient is able to

tolerate oral medications. The patient will take the

medication twice a day, not three times a day. Care

should be taken to never miss a dose. The patient

should avoid other medications that are hepatotoxic

or nephrotoxic due to a risk of increased toxicity so

the patient should be taught to always consult a

doctor or pharmacist before beginning an OTC drug.

Patients who have immune suppression must be

taught how to reduce risk of infection, including

avoiding people with contagious diseases, such as

colds or viruses.

10. The nurse administers aldesleukin to a patient

diagnosed with renal cell carcinoma. When

assessing the patient a few days later, what

abnormal findings would the nurse attribute to the

medication? (Select all that apply.)

A) Increased lymphocyte count

B) Increased red blood cell count

C) Increased platelet count

D) Irregular pulse rate

E) Increased blood pressure

Ans: A, C, D

Feedback:

Aldesleukin activates human cellular immunity and

11. While studying for a pharmacology test, a student

asks his peers about interferons. What statement about

interferons is accurate?

A) They stimulate B-lymphocyte activity.

B) They interfere with multiplication of stem

cells.

C) They stimulate growth and

differentiation of lymphoid cells into

lymphocytes.

D) They interfere with the ability of viruses in

infected cells to replicate.

inhibits tumor growth through increases in

lymphocytes, platelets, and cytokines. Common

adverse effects include hypotension, sinus

tachycardia, arrhythmias, as well as pruritus, nausea,

vomiting, diarrhea, anorexia, GI bleeding, bone

marrow suppression, respiratory difficulties, fever,

chills, pain, mental status changes, and dizziness.

There is no impact on red blood cell count. It does

not raise blood pressure.

Ans: D

Feedback:

Interferons are substances naturally produced and

released by human cells that have been invaded by

viruses. They may also be released from cells in

response to other stimuli, such as cytotoxic T-cell

activity. Interferons do not stimulate B-lymphocyte

activity, interfere with multiplication of stem cells,

nor do they stimulate growth and differentiation of

lymphoid cells into lymphocytes.

12.

How do immune suppressants work when ordered for

a patient who has had an organ transplant?

A) Blocking normal effects of the immune

system

B) Stimulating immune system to fight off

infection

C) Working with corticosteroids to enhance

healing

D) Working with corticosteroids to promote

suppressor cells

Ans: A

Feedback:

Immune suppressants are used to block the normal effects of the immune system in cases of organ transplantation (in which non–self-cells are transplanted into the body and destroyed by the immune reaction) and in autoimmune disorders (in which the body’s defenses recognize self-cells as foreign and work to destroy them) in some cancers.

Options B, C, and D are distracters for this question.

13. A patient has just been told that her cancer has

metastasized to her right kidney. An interferon

(Aldesleukin) has been prescribed to treat this

metastasis. The patient asks why this interferon is

ordered. What is the nurse’s best response?

A) “Aldesleukin has been shown to protect

autologous tumor cells.”

B) “Aldesleukin has been shown to inhibit

D) “Aldesleukin has been shown to have a

direct proliferative effect on renal tumors.”

Ans: B

Feedback:

Aldesleukin is prescribed for metastatic renal cell

carcinoma in adults and treatment of metastatic

melanomas (orphan drug use) working by activating

human cellular immunity and inhibiting tumor

growth through increases in lymphocytes, platelets,

and cytokines. Aldesleukin does not protect

autologous tumor cells, enhance allogeneic stemcell

transplantation, or have a direct proliferative effect

on renal tumors.

14. The nurse admits a patient who was newly

diagnosed with Kaposi’s sarcoma to the unit. The

physician has ordered an IV infusion of an

tumor growth.”

C) “Aldesleukin has been shown to enhance

allogeneic stem-cell transplantation.”

15. The pharmacology instructor is talking about

interferon. The instructor explains that agents, such

interferon. What drug would be appropriate?

A) Interferon beta1a

B) Interferon gamma 1b

C) Interferon alfa 2b

D) Peginterferon alfa 2b

Ans: C

Feedback:

Interferon alfa 2b indications include hairy cell

leukemia, melanoma, AIDS-related Kaposi’s

sarcoma, chronic hepatitis B and C infection,

intralesional treatment of condyloma acuminatum in

patients 18 years of age or older. No other interferons

are indicated for treatment of Kaposi’s sarcoma.

16.

The nursing class is studying monoclonal antibodies.

What monoclonal antibody reacts to human T cells,

disabling them and acting as an immune suppressor?

as interferons, have more than one biologic function. What are the functions of interferons?

(Select all that apply.)

A) Antibacterial

B) Antiviral

C) Immunomodulatory

D) Antiproliferative

E) Anticancer

Ans: B, C, D

Feedback:

A) Adalimumab

B) Cetuximab

C) Rituximab

D) Muromonab-CD3

Ans: D

Feedback:

Interferons act to prevent virus particles from

replicating inside the cells. They also stimulate

interferon receptor sites on noninvaded cells to

produce antiviral proteins, which prevent viruses

from entering the cell. In addition, interferons have

been found to inhibit tumor growth and replication,

to stimulate cytotoxic T-cell activity, and to enhance

the inflammatory response. Options A and E are

incorrect.

Muromonab-CD3, the first monoclonal antibody

approved for use, is a T-cell–specific antibody, that

is available as an IV agent. It reacts as an antibody

to human T cells, disabling the T cells, acting as an

immune suppressor. Adalimumab is an antibody

specific for human tumor necrosis factor.

Cetuximab is an antibody specific to epidermal

growth factor receptor sites. Rituximab is an

17. What monoclonal antibody is used to prevent

respiratory syncytial virus (RSV) in high risk

children?

A) Palivizumab

B) Natalizumab

C) Belimumab

D) Eculizumab

antibody specific to sites on activated B

lymphocytes.

Ans: A

Feedback:

Palivizumab is specific to the antigenic site on

respiratory syncytial virus (RSV); it inactivates that

virus. It is used to prevent RSV disease in high-risk

children. Natalizumab is an antibody specific to

surface receptors on all leukocytes except

18. The nurse is caring for a patient with an allograft

transplant. The physician orders a monoclonal

antibody to prevent rejection of the transplant. What

monoclonal antibody would the nurse expect to be

ordered?

A) Alemtuzumab

neutrophils. Belimumab is a specific inhibitor of

Blymphocyte stimulator that inhibits the survival of

B-lymphocytes and their differentiation into

immune-globulin producing cells. Eculizumab binds

to complement proteins and prevents the formation

of the complement complex.

B) Daclizumab

C) Erlotinib

D) Omalizumab

Ans: B

Feedback:

Daclizumab is specific to interleukin-2 receptor sites

on activated T lymphocytes; it reacts with those

sites and blocks cellular response to allograft

transplants. Alemtuzumab is an antibody specific

for lymphocyte receptor sites used to treat chronic

lymphocytic leukemia patients who have been

treated with alkylating agents and have been failed

by fludarabine therapy. Erlotinib is effective against

specific malignant receptor sites. Omalizumab is an

antibody to immunoglobulin E, an important factor

in allergic reactions.

19. The pharmacology instructor is explaining

interleukins to the class. What would be the best

definition of interleukins?

A) They are substances naturally produced

and released by human cells that have been

invaded by viruses.

B) They block the inflammatory reaction and

decrease initial damage to cells.

C) They are chemicals used to communicate

between leukocytes and stimulate

immunity.

D) They attach to specific receptor sites and

respond to very specific situations.

Ans: C

Feedback:

Interleukins are chemicals produced by T cells to

communicate between leukocytes and stimulate

cellular immunity and inhibit tumor growth.

Immune suppressants block the inflammatory

reaction and decrease initial damage to cells.

Interferons are naturally produced and released by

human cells that have been invaded by viruses.

Monoclonal antibodies attach to specific receptor

sites and respond to very specific situations.

20. The nurse is caring for a female patient, aged 62,

who has been admitted for treatment of metastatic

melanoma. What agent would the nurse anticipate the

physician is likely to order?

A) Aldesleukin

B) Interferon alfa 2b

C) Cyclosporine

D) Ipilimumab

Ans: D

Feedback:

Ipilimumab is a human cytotoxic T-cell antigen-4

blocking antibody. By blocking this site, T cells are

activated and proliferate at a faster rate. It is used to

treat patients with unresectable or metastatic

melanoma. Aldesleukin is an interleukin, used for

metastatic renal cell carcinoma in adults; a treatment

of metastatic melanomas. Interferon alfa 2b is

indicated for hairy cell leukemia, melanoma, AIDS-

related Kaposi’s sarcoma, chronic hepatitis B and C

infections, intralesional treatment of condyloma

acuminatum in patients 18 years of age or older.

Cyclosporine is a T and B cell suppressor and is

indicated for prophylaxis for organ rejection in

kidney, liver, and heart transplants (used with

corticosteroids); treatment of chronic rejection in

patients previously treated with other

immunosuppressants; treatment of rheumatoid

arthritis; and recalcitrant psoriasis.

21. While studying the T- and B-cell immune

suppressors, the nursing students learn that the most

commonly used immune suppressant is what?

A) Cyclosporine (Sandimmune)

B) Azathioprine (Imuran)

C) Pimecrolimus (Elidel)

D) Glatiramer (Copaxone)

Ans: A

Feedback:

Several T- and B-cell immune suppressors are

available for use. Of the numerous agents available,

cyclosporine is the most commonly used immune

suppressant. Options B, C, and D are all T- and Bcell

immune suppressors, they are simply not the most

commonly prescribed.

22. What interleukin receptor antagonist would the nurse

anticipate is most likely to be ordered for a patient,

25 years old, who has not responded to traditional

antirheumatic drugs?

A) Natalizumab (Tysabri)

B) Anakinra (Kineret)

C) Eculizumab (Soliris)

D) Adalimumab (Humira)

Ans: B

Feedback:

Anakinra is used to reduce the signs and symptoms

of moderately to severely active rheumatoid arthritis

in patients 18 years of age and older who have not

responded to the traditional antirheumatic drugs.

Options A, C, and D are monoclonal antibodies,

therefore they are incorrect answers.

23. A patient with chronic hepatitis C has been prescribed peginterferon alfa 2b (PEG-INTRON).

By what route would the nurse administer this drug?

A) Subcutaneously (SQ)

B) Intramuscularly (IM)

C) Intralesionally (IL)

D) Orally

Ans: A

Feedback:

PEG-INTRON, like many of the interferons, is

administered subcutaneously. Avonex is given

intramuscularly. Interferon alfa n3 is given

intralesionally. There are no interferons given

orally.

24. The patient has arrived in the short stay unit for an

infusion of tositumomab with 131 tositumomab

Bexxar). Before beginning the infusion, the nurse (

assesses the patient’s vital signs and finds the patient has a temperature of 101.5ºF, What is the

nurse’s priority action?

A) Holding the infusion until patient is

afebrile

B) Notifying the physician

C) Starting the infusion and inform the

physician

D) Treating the fever before beginning the

therapy

Ans: D

Feedback:

Monoclonal antibodies should be used cautiously

with fever (treat the fever before beginning therapy).

This makes Options A, B, and C incorrect.

25. A 72-year-old male patient has arrived at the outpatient unit to receive an infusion of alemtuzumab (Compath). The patient tells the nurse this is the second time his chronic lymphocytic leukemia has relapsed and the second time he will receive this drug because he failed alemtuzumab therapy after being treated with an alkylating agent.

What is the priority nursing action?

A) Calling the physician and questioning the

order

B) Washing your hands

C) Beginning an intravenous infusion

D) Canceling the infusion

Ans: A

Feedback:

Monoclonal antibodies should be used cautiously in patients who have had previous administration of the monoclonal antibody (serious hypersensitivity reactions can occur with repeat administration). The nursing priority would be to question the order because the patient has already received

alemtuzumab (Compath) previously and if the order

26. The nurse is writing a plan of care for a patient

receiving immune suppressants for leukemia. What

would be an appropriate nursing diagnosis for this

patient?

A) Anxiety related to diagnosis and drug

therapy

B) Acute pain related to central nervous

system (CNS), gastrointestinal (GI), and

flu-like effects

C) Risk for infection related to immune

stimulation

D) Imbalanced nutrition: More than body

requirements

Ans: B

Feedback:

is verified, this patient should be monitored very

carefully, perhaps starting to infuse more slowly

until the patient’s reaction can be determined. Only

after questioning the order and having it verified

would the nurse perform hand hygiene and begin

the infusion.

Nursing diagnoses related to drug therapy might

include: Acute pain related to CNS, GI, and flu-like

effects. Anxiety related to diagnosis and drug therapy

is a nursing diagnosis for a patient on an immune

stimulant. There is no risk for infection related to

immune stimulation unless an adverse effect occurs.

Imbalanced nutrition would be less than body

requirements due to flu-like symptoms resulting in

diminished appetite.

27. The nurse is preparing a patient to receive

immunosuppressant drugs on an outpatient basis.

What is the priority for the nurse to arrange for this

patient in the home environment?

A) A caregiver who is skilled in

cardiopulmonary resuscitation (CPR)

B) A caregiver who will provide adequate

nutrition

C) Supportive care and comfort measures

D) Arrange for a home care nurse to

28. The nurse is caring for a patient who has a diagnosis

of chronic hepatitis B infection and has been

prescribed an immune stimulant. After teaching the

patient about the treatment plan, how might the nurse

evaluate the effectiveness of teaching?

A) The patient can state where to go to get the

medication.

B) The patient can state who will administer

the medication.

C) The patient can state what positive

effects to watch for.

D) The patient can state specific measures to

avoid adverse effects.

administer injections

Ans: C

Feedback:

Arrange for supportive care and comfort measures

for flu-like symptoms (rest, environmental control,

acetaminophen) to decrease patient discomfort and

increase therapeutic compliance. Patients may also

need support and comfort measures related to

diagnosis and drug therapy. Although knowledge of

CPR and providing appropriate nutrition are always

positive actions, they are not related to

administration of immunosuppressants. The patient

or caregiver can be taught to administer injections

unless the medication is to be given IV, in which

case the patient would go to an infusion center.

Ans: D

Feedback:

The nurse would evaluate that the teaching plan was

successful if the patient can name drug, dosage,

adverse effects to watch for, and specific measures to

avoid adverse effects. Knowing where to get the

medication, who will administer it, and the positive

effects to watch for would not be an adequate

assessment of the teaching plan.

29. The patient underwent an allograft renal transplant 48

hours earlier and is showing signs of rejection. What

drug would the nurse expect the physician to order?

A) Muromonab

B) Anakinra

C) Mycophenolate

D) Sirolimus

Ans: A

Feedback:

Muromonab is indicated for the treatment of acute

allograft rejection in patients undergoing renal

transplantation. It also is indicated for the treatment of

steroid-resistant acute allograft rejection in those

receiving heart or liver transplants. Anakinra,

mycophenolate, and sirolimus are useful for

preventing renal or liver transplant rejection.

30. The nurse, working with a nursing student, is caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins.

What is the nurse’s best response?

A) “It really helps the patient!”

B) “The patient has increases in the number of

natural killer cells.”

C) “The patient has decreased cytokine

activity.”

D) “The patient gets really sick from flu-like

symptoms and then they get better.”

Ans: B

Feedback:

When interleukins are administered, there are

increases in the numbers of natural killer cells and

lymphocytes, in cytokine activity, and in the number

of circulating platelets. Options A, C, and D are

incorrect.

31. The nurse is caring for a child requiring cyclosporine

to prevent rejection. Cyclosporine is given to adults

using a dosage of 15 mg/kg. The nurse calculates the

child’s dosage is 20 mg/kg.

32. When caring for older adults receiving immune modulators, what are the nurse’s priorities of care?

(Select all that apply.)

What is the nurse’s priority action?

A) Administer the drug.

B) Hold the dose and question the ordering

provider.

C) Complete an incident report if this dosage

has already been given before.

D) Notify the nursing supervisor of the

medication error.

Ans: A

Feedback:

The nurse would administer the medication as

ordered because doses larger than those given to

adults are often needed when cyclosporine is

administered to children. This is not an error so the

nurse would not hold the drug, question the

provider, complete an incident report, or notify the

nursing supervisor.

A) Assess carefully for infection.

B) Obtain baseline liver function studies and

monitor follow-up studies.

C) Determine dosage based on renal and

liver function.

D) Minimize teaching to avoid causing

confusion.

E) Encourage the family to visit often,

especially young children.

Ans: A, B, C

Feedback:

Older patients may be more susceptible to the

effects of the immune modulators, partly because

the aging immune system is less efficient and less

responsive. These patients need to be monitored

closely for infection, GI, renal, hepatic, and central

33. The nurse teaches the female patient receiving

immune modulating drugs about the need to use

barrier contraceptives. The patient says, “I hate using

barrier contraceptives. Why can’t I just take oral

contraceptives?” What is the nurse’s best response?

A) “Effects of oral contraceptives may be

altered by liver changes or changes in

immune response.”

B) “Oral contraceptives increase the action of

immune modulating drugs so dosage

needs to be reduced.”

C) “Immune modulators make oral

contraceptives ineffective because of

hormonal impact of drugs.”

nervous system effects. Baseline renal and liver

function tests can help to determine whether a

decreased dosage will be needed before beginning

therapy. Because these patients are more susceptible

to infection, they need to receive extensive teaching,

not less teaching, about ways to avoid infection and

injury. Contact with young children and large groups

of people increase the risk of infection.

D) “Oral contraceptives are acceptable if

barrier contraceptives are distasteful, but

only high-estrogen pills can be used.”

Ans: A

Feedback:

The use of barrier contraceptives is advised because

the effects of oral contraceptives may be altered by

liver changes or by changes in the body’s immune

response, potentially resulting in unexpected

pregnancy. The other options conflict with this

information and are incorrect.

34. The nurse is caring for a young adult woman taking

immune modulating medications who has been

advised to use barrier contraceptives but she wants

to start her family. What information can the nurse

provide about these drugs to help this patient with

her decision-making?

A) “Discuss the desire to start a family with

the provider so risk can be minimized.”

B) “Immune modulating drugs will need to

D) “Pregnancy is not an option when taking

immune modulating drugs but adoption

is an option.”

Ans: A

Feedback:

If a patient taking immune modulators becomes

pregnant or decides that she wants to become

pregnant, she should discuss this with her health

care provider and review the risks associated with

use of the drug or drugs being taken. Monoclonal

antibodies should be used with caution during

pregnancy and lactation. Because results of

longterm studies of most of these drugs are not yet

available, it may be prudent to advise patients taking

these drugs to avoid pregnancy if possible. Immune

modulating drugs do not need to be discontinued,

but the safest drug should be prescribed. Most

immune modulating drugs have not been studied

and there is not enough information to know

whether they are teratogenic. The nurse cannot tell a

patient that pregnancy is not an option.

35. The nurse is caring for a patient diagnosed with

rheumatoid arthritis (RA) who recently underwent a

liver transplant. What immunosuppressant could

this patient be prescribed that would treat both

diagnoses?

A) Anakinra (Kineret)

be discontinued if pregnancy occurs.”

C) “Immune modulating drugs have been

proven to be highly teratogenic.”

B) Adalimumab (Humira)

C) Sirolimus (Rapamune)

D) Cyclosporine (Sandimmune)

Ans: A