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NR-NUR124 | Pharmacology > [8] MIDTERMS | ANTINEOPLASTIC DRUGS > Flashcards

[8] MIDTERMS | ANTINEOPLASTIC DRUGS Flashcards

1
Q

A disease process that begins when an abnormal cell is transformed by the genetic mutation of the cellular DNA

A

Cancer

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2
Q

Tumor, Growth, or Neoplasm (2)

A
  • Malignant
  • Benign
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3
Q

Causes of Cancer (5)

A
  • Carcinogens
  • Viruses
  • Genetics and familial factors
  • Dietary factors
  • Hormonal agents
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4
Q

Warning Signs of Cancer (CAUTION)
* Change in ____ habits
* Any ____ that does not heal
* Unusual ____
* Thickening or lump in ____ or elsewhere
* Indigestion
* Obvious change in ____
* Nagging ____

Additional:
* Unexplained weight loss
* Sudden anemia

A
  • Change in bowel or bladder habits
  • Any sore that does not heal
  • Unusual bleeding or discharge
  • Thickening or lump in breast or elsewhere
  • Indigestion
  • Obvious change in wart or mole
  • Nagging cough or hoarseness
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5
Q

Types of Anticancer Drugs
* CCNS Drugs - act on ____ the cell cycle
* CCS Drugs - act on ____ the cell cycle

A
  • CCNS Drugs - act on any of the phase during the cell cycle
  • CCS Drugs - act on a specific phase of the cell cycle
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6
Q

ALKYLATING DRUGS
* Kills cells by ____; CCNS
* INDICATION: leukemia, ____, multiple myeloma, tumors in the ____, ovaries, ____, lungs, ____, and stomach

A
  • Kills cells by forming cross links on the DNA strands; CCNS
  • INDICATION: leukemia, lymphoma, multiple myeloma, tumors in the breast, ovaries, uterus, lungs, bladder, and stomach
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7
Q

ALKYLATING DRUGS: Groups
1. ____ - inspect IV product for particualte matter and discoloration prior to use
2. ____ - monitor for bone marrow suppresion/serial monitoring of HgB and Hct
3. ____ - monitor for seizures and cerebral hemorrhage
4. ____ - photosensitive drug; cover IV bottle including IV tubings to preserve the potency of drugs during IV infusion

A
  1. Nitrogen Mustards - inspect IV product for particualte matter and discoloration prior to use
  2. Nitrosoureas - monitor for bone marrow suppresion/serial monitoring of HgB and Hct
  3. Alkyl Sulfonate - monitor for seizures and cerebral hemorrhage
  4. Alkylating-like Drugs - photosensitive drug; cover IV bottle including IV tubings to preserve the potency of drugs during IV infusion
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8
Q

ALKYLATING DRUGS: Nitrogen Mustards
* ____ - prostate Ca
* ____ - testicular cancer
* ____ - solid tumors, leukemia, and Hodgkin’s Lymphoma

A
  • Cyclophosphamide (Cytoxan) - prostate Ca
  • Ifosamide (Ifex) - testicular cancer
  • Mechlorethamine HCl (Mustragen) - solid tumors, leukemia, and Hodgkin’s Lymphoma
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9
Q

ALKYLATING DRUGS: Nitrosoureas
* ____ - brain tumors
* ____ - panreatic and lung cancer

A
  • Carmustine (BiCNU) - brain tumors
  • Streptozocin (Zanosar) - panreatic and lung cancer
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10
Q

ALKYLATING DRUGS: Alkyl Sulfonate
* Uses: ____
* Busulfan (____)

A
  • Uses: Myelotic Leukemia
  • Busulfan (Myleran)
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11
Q

ALKYLATING DRUGS: Alkylating-like Drugs
* Uses: ____
* ____ (Paraplatin) - ovarian cancer
* ____ (Platinol) - ovarian and testicualar cancer

A
  • Uses: ovarian cancer
  • Carboplatin (Paraplatin) - ovarian cancer
  • Cisplatin (Platinol) - ovarian and testicualar cancer
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12
Q

ALKYLATING DRUGS: Side Effects
* Leukopenia
* ____
* Abdomina upsets
* ____
* Vomiting
* ____

A
  • Leukopenia
  • Skin rashes
  • Abdomina upsets
  • Nausea
  • Vomiting
  • Neurotoxicity
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13
Q

ANTIMETABOLITES
* Action: disrupting the ____ and inhibit ____

A
  • Action: disrupting the metabolic processes and inhibit enzyme synthesis
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14
Q

ANTIMETABOLITES
* ____ - Methotrexate (Ametropterin)
* ____ - Floxuridine (FUDR) and 5-FU (prominent blood vessel after 5-FU use)
* ____ - 6-Mercaptopurine (Purinethol) and Fludarabine (Leustatin)
* ____ - Hydroxyurea (Hydrea)
* ____ - Pentostatin (Nipent)

A
  • Folic Acid Antagonists - Methotrexate (Ametropterin)
  • Pyriimidine Analogues - Floxuridine (FUDR) and 5-FU (prominent blood vessel after 5-FU use)
  • Purine Analogues - 6-Mercaptopurine (Purinethol) and Fludarabine (Leustatin)
  • Ribonucleotide Reductase Inhibitor - Hydroxyurea (Hydrea)
  • Enzyme Inhibitor - Pentostatin (Nipent)
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15
Q

ANTIMETABOLITIES: Side Effects
* ____
* Abdominal Upsets
* ____
* Vomiting
* ____
* Alopecia

A
  • LBM/Diarrhea
  • Abdominal Upsets
  • Nausea
  • Vomiting
  • Neurotoxicity
  • Alopecia
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16
Q

MITOTIC INHIBITORS
* CCS Anticancer Drugs - affects the ____

Four Main Groups: ____

A

MITOTIC INHIBITORS
* CCS Anticancer Drugs - affects the M-Phase

Four Main Groups:
1. Vinca Alkaloids
2. Immunomodulators
3. Epipodophyllotoxins
4. Retinoids

16
Q

MITOTIC INHIBITORS: Vinca Alkaloids
* Uses: solid organ cancer ➡️ breast cancer, ____, Hodgkin’s Lymphoma
* ____ (Oncovin)
* ____ (Velban)
* ____ (Navelbine)

A
  • Uses: solid organ cancer ➡️ breast cancer, Non-Hodgkin’s Lymphoma, Hodgkin’s Lymphoma
  • Vincristine Sulfate (Oncovin)
  • Vinblastine Sulfate (Velban)
  • Vinorelbine Tartarate (Navelbine)
17
Q

MITOTIC INHIBITORS: Immunomodulators
* Uses: leukemia, ____, and ____
* ____ (Thalomid)

A
  • Uses: leukemia, multiple myeloma, and erythema nodosum leprosum (EHL)
  • Thalidomide (Thalomid)
18
Q

MITOTIC INHIBITORS: Epipodophyllotoxins
* Uses: ____ and ____ (small cell lung cancer)
* ____ ( ____, VePesid, ____, Toposar, and ____)

A
  • Uses: testicular cancer and SCLC (small cell lung cancer)
  • Etoposide (VP-16, VePesid, Etopophos, Toposar, and Etoposide)
19
Q

MITOTIC INHIBITORS: Retinoids
* Uses: ____ lymphoma
* ____ (Targretin)

A
  • Uses: Cutaneous T-Cell lymphoma
  • Bexarotene (Targretin)
20
Q

MITOTIC INHIBITORS: Side Effects
* ____
* ____
* Nausea
* Vomiting
* ____

A
  • Stomatitis
  • Alopecia
  • Nausea
  • Vomiting
  • Neurotoxicity
20
Q

ANTITUMOR ANTIBIOTICS
* Inhibits ____ and ____

Examples:
* ____ -1962
* ____ – 1st antitumor
* Doxorubicin HCl (____)
* Doxorubicin (____)
* ____ – 1962; for hypercalcemia

A

ANTITUMOR ANTIBIOTICS
* Inhibits CHON and RNA synthesis and bind DNA

Examples:
* Bleomycin Sulfate (Blenoxane) -1962
* Dactinomycin (Actinomycin D) – 1st antitumor
* Doxorubicin HCl (Cerubidine)
* Doxorubicin (Adriamycin)
* Plicamycin (Mithracin) – 1962; for hypercalcemia

21
Q

ANTITUMOR ANTIBIOTICS: Side Effects
* Red urine output for the next ____ and become lighter, normal urine color output ____ after chemotherapy.
* N/V: ____, ____, leukopenia and thrombocytopenia, ____ (advise to use ____ for uniform infusion and avoid ____), ____

A
  • Red urine output for the next 8 hrs and become lighter, normal urine color output post-24 hrs after chemotherapy.
  • N/V: alopecia, stomatitis, leukopenia and thrombocytopenia, vesication of IV site (advise to use infusion pump for uniform infusion and avoid extravasation), organ toxicities
22
Q

HORMONES
* Chemical messengers that affects the ____ of our body

  1. ____ – inhibits ____ (a substance which initiates a physiological response when combined with a receptor)
  2. ____ – complete with ____ (a substance that interferes with or inhibits the physiological action of another)
A

HORMONES
* Chemical messengers that affects the physiological functioning of our body

  1. Agonists – inhibit tumor cell growth (a substance which initiates a physiological response when combined with a receptor)
  2. Antagonist – complete with endogenous hormones (a substance that interferes with or inhibits the physiological action of another)
23
Q

HORMONE AGONIST (3)
a. Estrogen
1. ____ (DES, Stilbestrol)
2. Corticosteroids (____)
3. ____ (Decadron)
4. Prednisolone (____, Pred5, Pred10, Pred20)

b. Progestins - Hydroxyprogesterone Caproate (____)

c. Androgens
1. ____ (Eulexin)
2. ____ (Lupron)

A

HORMONE AGONIST (3)
a. Estrogen
1. Diethylstilbestrol (DES, Stilbestrol)
2. Corticosteroids (Cortisone)
3. Dexamethasone (Decadron)
4. Prednisolone (Prednisone, Pred5, Pred10, Pred20)

b. Progestins - Hydroxyprogesterone Caproate (Duralutin)

c. Androgens
1. Flutamide (Eulexin)
2. Leuprolide Acetate (Lupron)

24
Q

HORMONE ANTAGONIST (2)

A
  • Tamoxifen citrate (Nolvadex)
  • Toremifene (Fareston)
25
Q

NURSING RESPONSIBILITIES BEFORE GIVING OF ANTICANCER DRUGS/CHEMOTHERAPY
~ Hydration of ____ to run for ____
~ Normal and latest lab results ____ prior to chemotherapy
* CBC with ____ and ____, ____ and creatinine
* CPK-MB (____) and ____

~ No ____
~ For succeeding IV chemotherapy, always select ____ to prevent extravasation. ____ are advisable and use of infusion pump
~ Give pre-chemotherapy drugs ____ before the start of treatment
* ____ (Plasil, Nausil) - Antiemetic
* ____ (Zantac) - H2 Receptor Antagonist/Antacid
* ____ (Zofran,Zuplenz) - nausea and vomiting associated with highly emetogenic cancer chemotherapy (is a selective 5-HT3 receptor antagonist)

~ ____ to client and family

A

~ Hydration of 1L IVF to run for 8 hours
~ Normal and latest lab results on the day or 1 day prior to chemotherapy
* CBC with p.c., AST (SGOT) and ALT (SGPT), BUN and creatinine
* CPK-MB (Creatine Phosphokinase-Myocardial Band) and Troponin

~ No fever
~ For succeeding IV chemotherapy, always select stable veins to prevent extravasation. Central lines are advisable and use of infusion pump
~ Give pre-chemotherapy drugs 15 mins before the start of treatment
* Metoclopramide (Plasil, Nausil) - Antiemetic
* Ranitidine (Zantac) - H2 Receptor Antagonist/Antacid
* Ondansetron (Zofran,Zuplenz) - nausea and vomiting associated with highly emetogenic cancer chemotherapy (is a selective 5-HT3 receptor antagonist)

~ Emotional support to client and family

26
Q

LAMINAR HOOD
* Nitrile gloves
* ____
* Goggles
* ____
* Caps to include covering of ears
* ____

A
  • Nitrile gloves
  • Closed method of gowning and gloving
  • Goggles
  • Mask
  • Caps to include covering of ears
  • Proper handling of chemotherapeutic drugs
27
Q

GENERAL SIDE EFFECTS OF ANTICANCER DRUGS (20)
* ____ (!)
* Thrombocytopenia
* ____
* N/V
* ____ (!)
* Constipation
* ____ (!)
* Rusty taste
* ____
* ____ (!)
* ____
* Infertility
* Wt. loss
* Dizziness
* ____
* ____
* Rashes
* Hypertension
* ____
* Gum bleeding

A
  • Leukopenia (!)
  • Thrombocytopenia
  • Anorexia
  • N/V
  • Diarrhea (!)
  • Constipation
  • Stomatitis (!)
  • Rusty taste
  • Increased BUN Creatinine
  • Red urine out (!)
  • Alopecia
  • Infertility
  • Wt. loss
  • Dizziness
  • Hematuria
  • Impotence
  • Rashes
  • Hypertension
  • Nephrotoxicity
  • Gum bleeding
28
Q

ADVERSE EFFECTS OF ANTINEOPLASTICS (5)

A
  1. Hemorrhagic Cystitis
  2. Hepatotoxicity
  3. Nephrotoxicity
  4. Cardiotoxicity
  5. Formation of secondary neoplasm
29
Q

NURSING RESPONSIBILITIES
* Monitor ____ and report any elevation of temperature that may indicate ____. Low WBC count means low resistance to viral or bacterial infection
* Monitor client’s ____
* Avoid ____ with anticancer drugs. Great precaution on handling and administering anticancer drigs are advised
* Report any abnormal lab findings
* Check the client for signs of ____ (____)
* Offer the client ____ and food that may ____
* Instruct client to avoid eating ____ food
* Check the client for s/sx of ____ (jaundice or dark amber urine)
* Instruct client to perform ____ several times a day using a soft bristled tooth brush. If stomatitis occurs, suggest gargling of ____ or ____
* Advise client not to visit anyone who has ____ for acquiring infection is at high risk
* Encourage client to maintain ____
* Advise client to purchase wig before anticancer therapy begins

A
  • Monitor clients’ VS and report any elevation of temperature that may indicate infection. Low WBC count means low resistance to viral or bacterial infection
  • Monitor client’s urine output
  • Avoid direct skin contact with anticancer drugs. Great precaution on handling and administering anticancer drigs are advised
  • Report any abnormal lab findings
  • Check the client for signs of bleeding (bleeding gums, tarry stools, petechiae, ecchymoses)
  • Offer the client fluids and food that may decrease N/V (crackers)
  • Instruct client to avoid eating dairy products and greasy food
  • Check the client for s/sx of hepatotoxity (jaundice or dark amber urine)
  • Instruct client to perform good oral hygiene several times a day using a soft bristled tooth brush. If stomatitis occurs, suggest gargling of saline solution or baking soda
  • Advise client not to visit anyone who has respiratory infection for acquiring infection is at high risk
  • Encourage client to maintain good nutrition
  • Advise client to purchase wig before anticancer therapy begins

NR-NUR124 | Pharmacology (10 decks)

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