《ISPN学习》2019年11月18日总第560期
Don’t give up, don’t give in, and hang on to your dreams.
不放弃，不言败，追逐梦想
★ From the Programs ★
（From the Programs [课程选粹]栏目摘登奥医及国外NCLEX-RN（ISPN）课程视频讲座，旨在帮助读者了解NCLEX-RN（ISPN）考试内容，指导考生复习，加深考生对考试相关内容的学习、掌握[进一步了解请点击底部阅读原文]。您的需要就是我们的努力方向。
Cancer Classification
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★ ISPN Review ★
CANCER CELL–SPECIFIC AGENTS
癌细胞特异性药
The goal of much of the current antineoplastic drug research is directed at finding drugs that are cancer cell specific. These drugs would not have the devastating effects on healthy cells in the body and would be more effective against particular cancer cells. Three groups of drugs are available for cancer cell–specific actions: protein tyrosine kinase inhibitors, an epidermal growth factor inhibitor, and a proteasome inhibitor.
当前很多抗肿瘤药研究的目的是找到专门针对癌细胞的药。这些药物对身体健康细胞没有破坏作用，对特定癌细胞更加有效。目前的癌细胞特异性药有三类：蛋白酪氨酸激酶抑制剂、表皮生长因子抑制剂和蛋白酶体抑制剂。
The protein kinase inhibitors act on specific enzymes that are needed for protein building by specific tumor cells. Blocking of these enzymes inhibits tumor cell growth and division.
蛋白激酶抑制剂对只对特殊酶起作用，这些酶是特殊肿瘤细胞蛋白质构建所需要的。阻断这些酶就可以抑制肿瘤细胞的生长和分裂。
Each drug that has been developed inhibits a very specific protein kinase and acts on very specific tumors. They do not affect healthy human cells, so the patient does not experience the numerous adverse effects associated with antineoplastic chemotherapy. Imatinib (Gleevec), the first drug approved in this class, is given orally and is approved to treat chronic myelocytic leukemia (CML). Patients who have CML and who have been switched to imatinib after traditional chemotherapy have been amazed at how good they feel and how much they have recovered from the numerous adverse effects of the traditional chemotherapy. Long-term effects are not yet known because the drug is relatively new. Unfortunately, this drug is expensive. It is estimated that 1 year of treatment with the drug (which needs to be taken continually) costs the patient between $30,000 and $35,000. Novartis, the drug company that manufactures Gleevec, has set up a patient assistance program with a sliding-scale price reduction based on income. They do not want patients to have to pay more than 20% of their annual income for the drug. Patients prescribed this drug may need support and assistance in obtaining financial help. The protein tyrosine kinase inhibitors that are available include everolimus (Afinitor), gefitinib (Iressa), imatinib (Gleevec), lapatinib (Tykerb), nilotinib (Tasigna), sorafenib (Nexavar), sunitinib (Sutent), and temsirolimus (Torisel).
研制的每各药物均可抑制极为具体的蛋白激酶，并对这一特殊肿瘤发挥作用。他们不会影响健康的人体细胞，因此，患者不会出现抗肿瘤化疗相关性不良效应。伊马替尼（格列卫）是获得批准的首款药物，口服，并获准用于治疗慢性髓细胞性白血病（CML）。CML患者及传统化疗后转用伊马替尼的患者对其良好感觉和传统化学不良效应中恢复过来的的感觉赞不绝口。药物长期效应尚未可知，因为该药相对较新。不幸的是，这一药品非常昂贵，估计该药一年治疗费用（该药需要连续服用）是$30,000 -- $35,000。格列卫制造商诺华已经建立了一个患者帮助计划，根据收入采取浮动降价办法。他们不想患者拿20%的年收入来支付药物费用。获得该药处方的患者可能需要在获得经济帮助方面提供支持和协助。可供使用的蛋白酪氨酸激酶抑制剂包括依维莫司（飞尼妥）、吉非替尼（易瑞沙）、伊马替尼（格列卫）、拉帕替尼（泰克布）、尼洛替尼（塔西格）、索拉非尼（多吉美）、舒尼替尼（索坦）、坦西莫司（托里瑟尔）。
★ Vocabulary for Today ★
protein tyrosine kinase inhibitors 蛋白酪氨酸激酶抑制剂
epidermal growth factor inhibitor 表皮生长因子抑制剂
proteasome inhibitor 蛋白酶体抑制剂
protein kinase inhibitors 蛋白激酶抑制剂
imatinib – n. 伊马替尼
Gleevec – n. 格列卫
CML -- chronic myelocytic leukemia
慢性髓细胞性白血病
everolimus – n. 依维莫司
Afinitor – n. 飞尼妥
Torisel – n. 托里瑟尔
Eligard – n. 醋酸亮丙瑞林
megestrol – n. 甲地孕酮
Megace – n. 梅格施
mitotane – n. 米托坦
Lysodren – n. 米托坦片剂
nilutamide – n. 尼鲁米特
Nilandron – n. 尼鲁米特商品名
tamoxifen – n. 他莫昔芬
Nolvadex – n. 诺瓦得士
Soltamox – n. 他莫昔芬商品名
toremifene – n. 托瑞米芬
Fareston – n. 法乐通
triptorelin – n. 曲普瑞林
triptorelin pamoate – n. 双羟萘酸曲普瑞林
Trelstar Depot – n. 曲普瑞林缓释剂
| 尽快地从茫然中理清复习思路，准确地抓住复习重点，这是每一个考试复习者的一大愿望。“ISPN考试复习要点提示”即是帮您实现这一愿望的利器！该教程已在www.omedin.com陆续上线。 |
★ Video ★
Cancer Cell-Specific Agents
★ NCLEX-RN Experience ★
考试从来不易，前行者的经验可以使后来者少走不少弯路！
看书、做题，这是NCLEX-RN复习的套路，对于做题，有相当一部分的做法是，答案对的，过；答案不对的，看Rationale!那么，这种复习方法对不对呢？其实，在很多参加并考试的经验分享里，都会涉及到这个问题，今天这位考试成功者的看法应该很能说明问题。
UK Trained Nurse attempting NCLEX-RN for 3rd time!
by o.poole
Hi all
Please can anyone help/ give advise?
I am UK trained Nurse. I have been for over 6 years!
I have attempted the NCLEX-RN exam now twice this year, and both failed.
I plan to take in again in May - which I think will be my board’s final chance of letting me do this without taking a further review course!
I have bought the books (Kaplan, Saunder & LaCharity), I have read through these books twice, still no luck. I even did the review course via Kaplan, with all the lesson contents, questions and decision tree, and still no luck.
Can anyone give any advice on how or what I can do. I'm finding it very difficult now with what areas I should focus on, how I should go about it and even should I even bother!
Maybe there’s someone out there with some advice on this - which I would GREATLY appreciate.
Thanks guys!
Responded by Silverdragon102, BSN
(Silverdragon102 has 31 years experience as a BSN and specializes in Medical and general practice now LTC.)
Having experience is a pain when it comes to sitting the NCLEX. I too UK trained passed on my third attempt and that was after I found Saunders comprehensive and just concentrated on doing questions. I only read the chapters if I was struggling in a certain area. My suggestion would be to keep practicing questions and read the rationale. Even if you get the question right I would read the rationale as it would confirm whether I was on the right track as well as what keywords to look for in the question to point towards the right answer
★ Test ★
1. The client diagnosed with chronic kidney disease is prescribed erythropoietin (Procrit). Which intervention should the nurse implement? Select all that apply.
A. Administer it intramuscularly in the deltoid.
B. Have the client take Tylenol, an analgesic, for pain.
C. Monitor the client’s complete blood count.
D. Teach the client to pace activities.
E. Inform the client not to drive for 90 days.
2. Which statement is the scientific rationale for administering the biologic response modifier interferon (Intron A) to a client diagnosed with hepatitis C?
A. Intron A suppresses cell proliferation in proliferative diseases.
B. Intron A decreases the production of cytotoxic macrophages.
C. Intron A increases the production of suppressor genes.
D. Intron A reprograms virus-infected cells to inhibit virus replication.
（答案见页底）
答案
1. B. Have the client take Tylenol, an analgesic, for pain.
The medication stimulates the bone marrow to produce red blood cells. The bone marrow is located inside the bones. The client may experience aches and pains of the bony areas as a result. Tylenol usually will remedy this side effect.
2. D. Intron A reprograms virus-infected cells to inhibit virus replication.
Intron A reprograms virus-infected cells to inhibit viral replication. This is the reason that it is useful in treating hepatitis.
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