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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
**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)
**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
**HORMONE ANTAGONIST (2)**
* Tamoxifen citrate (Nolvadex) * Toremifene (Fareston)
25
**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
~ 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
**LAMINAR HOOD** * Nitrile gloves * ____ * Goggles * ____ * Caps to include covering of ears * ____
* Nitrile gloves * **Closed method of gowning and gloving** * Goggles * **Mask** * Caps to include covering of ears * **Proper handling of chemotherapeutic drugs**
27
**GENERAL SIDE EFFECTS OF ANTICANCER DRUGS (20)** * ____ (!) * Thrombocytopenia * ____ * N/V * ____ (!) * Constipation * ____ (!) * Rusty taste * ____ * ____ (!) * ____ * Infertility * Wt. loss * Dizziness * ____ * ____ * Rashes * Hypertension * ____ * Gum bleeding
* **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
**ADVERSE EFFECTS OF ANTINEOPLASTICS (5)**
1. Hemorrhagic Cystitis 2. Hepatotoxicity 3. Nephrotoxicity 4. Cardiotoxicity 5. Formation of secondary neoplasm
29
**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
* 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 (16 decks)

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