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Pharm > Antineoplastic Agents (Chemotherapy) > Flashcards

Antineoplastic Agents (Chemotherapy) Flashcards

1
Q

What are antineoplastic agents?

A

Drugs used to treat cancer

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2
Q

Principles of chemotherapy:
- _________ because cancer cells will ______ if chemo is given at _____ dose. Genetic factors may also contribute to resistance.
- _______ drugs are used to avoid _______. Different drugs are used for different parts of the cell cycle phases.
- Cannot administer drugs for too _______ because of how they affect the ______ _____, thus affecting the white blood cells, thus affecting _______.
- Must wait for white blood cell cycle to ____ _____ immune cells before __________ _____ to avoid ______

A

Principles of chemotherapy:

  • Resistance because cancer cells will mutate if chemo is given at low dose. Genetic factors may also contribute to resistance.
  • Multiple drugs are used to avoid toxicity. Different drugs are used for different parts of the cell cycle phases.
  • Cannot administer drugs for too long because of how they affect the bone marrow, thus affecting the white blood cells, thus affecting immunity.
  • Must wait for white blood cell cycle to produce more immune cells before administering more to avoid toxicity.
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3
Q

Steps to safely administering chemotherapy: (5)

A
  • Know patient’s actual height and weight
  • With another nurse, calculated patient’s body surface area
    -Check labs/tests (LFT, kidney, wbc)
    -Check blood (CBC, peak, and trough)
    -Check for adequate blood return before administering chemo
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4
Q

Personal protective equipment (PPE) for the nurse.

A

Gloves- must be latex or nitrile, change every 30 min. 2 pairs used

Gown- disposable, line free. 2nd pair of glove over cuff

Eye and face mask- (PR mask, not surgical)

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5
Q

G0

A

Resting phase, cells are not replicating

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6
Q

G1

A

Enzymes necessary for DNA synthesis are produced (first gap phase or postmitotic phase)

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7
Q

S

A

DNA synthesis phase; DNA synthesis takes place, from DNA strand separation to replication of each strand to create duplicate DNA molecules.

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8
Q

G2

A

RNA and specialized proteins are made (second gap phase or premitotic phase)

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9
Q

M

A

Mitotic phase; prophase, metaphase, anaphase, and telophase. Cell divied and reproduces into two daughter cells.

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10
Q

Antimetabolite drugs are ____ ____ ___.

What phase are they?

What do they do?

A

Cell Cycle specific (S PHASE) inhibit protein synthesis.

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11
Q

Antimetabolites include

A

Methotrexate and Fluorouracil

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12
Q

Antimetabolites
-Methotrexate (IV, IM, PO, Intrathecal)
o Treats Cancer: _________________________________________________
o Non cancer treatment: _____________
o Side effects: ___________________________________
o Do not take with ______, , or _____________________
o Monitors _____

A

o Treats Cancer: Head, neck, breast, testicular, ovarian, bladder, lymphomas
o Non cancer treatment: rheumatoid arthritis
o Side effects: photosensitivity, liver dysfunction, myelosuppression, mucositis,
o Do not take with alcohol, NSAIDS, or salicylates (liver toxicity)
o Monitors LFT

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13
Q
  • Fluorouracil (5-FU) – (IV, IA, Topical)
    o Treats cancer: ___________________________________________________
    o Side effects: Myelosuppression, alopecia, mucositis, _________,________
A

Treats cancer: Head, neck, breast, gastric
o Side effects: Myelosuppression, alopecia, mucositis, diarrhea, vein discoloration

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14
Q

Vinca alkaloid

A

Cell cycle specific, prevents Mitosis (METAPHASE)

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15
Q

Vinca alkaloid – Cell cycle specific, prevents Mitosis (METAPHASE)
- 3 types: ________,______,_____
o Side effects: ________ (______ neuropathies, foot ____, _______ in hands and feet, paralytic ileus), myelosuppression, nausea, and vomiting
o _______ agents

A

Vinca alkaloid – Cell cycle specific, prevents Mitosis (METAPHASE)
- 3 types: Vincristine, Vinblastine, Vinorelbine
o Side effects: Neurotoxic (peripheral neuropathies, foot drop, tingling in hands and feet, paralytic ileus), myelosuppression, nausea, and vomiting
o Vesicant agents

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16
Q

c. Taxanes –
- Paclitaxel and docetaxel
- Side effects: _________ (peripheral neuropathies, foot drop, tingling in hands and feet, _______ ______), ________, _________,
_________ (common to vinca alkaloid),
- __________ reactions- premeditate with steroids, antihistamine, h2 blocker,

A

Taxanes –
- Paclitaxel and docetaxel
- Side effects: Neurotoxic (peripheral neuropathies, foot drop, tingling in hands and feet, paralytic ileus), myelosuppression, nausea, and vomiting, ALOPECIA (common to vinca alkaloid),
- Hypersensitivity reactions- premeditate with steroids, antihistamine, h2 blocker,

17
Q

Topoisomerase – 1 inhibitors –

A

Cell cycle specific, kills during S PHASE

inhibits cell replication by inhibiting enzyme

18
Q

Topoisomerase – 1 inhibitors – Cell cycle specific, kills during S PHASE; inhibits cell replication by inhibiting enzyme.

  • Side effects:
    o ________ (severe _____, administer______)
    o Troptocan (severe diarrhea)
    o Etoposide (hypotension, bronchospasm, monitor BP)
A
  • Side effects:
    o Irinotecan (severe diarrhea, administer strophine)
    o Troptocan (severe diarrhea)
    o Etoposide (hypotension, bronchospasm, monitor BP)
19
Q

Alkylating agent –

A

Cell cycle NON-SPECIFIC, interfere with DNA structures

20
Q

Types of alkylating agents

A
  • Cyclophosphamide
  • Cisplatin
21
Q

Alkylating agent – Cell cycle NON-SPECIFIC, interfere with DNA structures

Cyclophosphamide (PO,IV)
o Treats Cancer: ______, _______, _____, HD & NH ____________, multiple ______
o Side effects: ______ _______(administer ____ hydrate, assess urine for _____, void frequently before bed time),______________________________________________________

A

Cyclophosphamide (PO,IV)
o Treats Cancer: Leukemia, ovarian, breast, HD & NH lymphomas, multiple myeloma
o Side effects: Hemorrhage cytisis (administer early, hydrate, assess urine for blood, void frequently before bed time), sterility, nausea, vomiting, myelosuppression, cardiotoxic.

22
Q

Alkylating agent

  • Cisplatin (IV)
    o _______________ (monitor I&O, hydrate, creatinine & BUN, mannitol)
    o _______ _______
    o ________ ______(watch K and Mg w/ electrolytes)
    o ___________
    o ______________
A

o Nephrotoxicity (monitor I&O, hydrate, creatinine & BUN, mannitol)
o Peripheral neuropathy
o Electrolyte imbalance (watch K and Mg w/ electrolytes)
o Ototoxicity
o Emetogenic

23
Q

Antitumor antibiotic –

A

Cell cycle NON-SPECIFIC (block DNA synthesis)

24
Q

Types of antitumor antibiotic

A
  • Doxorubicin – (Vesicant Agent)
  • Bleomycin (NOT VESICANT Agent)
25
Q

Antitumor antibiotic –

  • Doxorubicin – (Vesicant Agent)
    o ____ in color
    o Side effects: ___ ______,________
    o Max accumulative dose ___________
A

o Red in color
o Side effects:hair loss, cardio-toxic
o Max accumulative dose 550 mg/m2, Zina Card

26
Q

Anti tumor agent
- Bleomycin (NOT VESICANT Agent)

o ______ toxicity
o Test dose with ____ administration

____________

o Baseline BFT
o Not for people over the age of __ years old

A

Bleomycin (NOT VESICANT Agent)

o Pulmonary toxicity
o Test dose with Pirst administration

Hypersensitivity/anaphylaxis

o Baseline BFT
o Not for people over the age of 70 years old

27
Q

Know what it means when a chemotherapeutic agent is classified as a “vesicant” agent:

A

Causes extravasation, leakage from blood vessel into tissue

28
Q

Hormonal agents- Antiestrogen

  • Aromatase Inhibitors
    o Blocks enzyme from converting _______ to _______
    o Used in ER-positive _____ _______ women with breast cancer
    o Side effects: _______
A
  • Aromatase Inhibitors
    o Blocks enzyme from converting androgen –> estrogen
    o Used in ER-positive POST MENOPAUSAL women with breast cancer
    o Side effects: osteoporosis
29
Q

Hormonal agents- Antiestrogen

  • Tamoxifen, Raloxifene, Fulvestrant
    o Used in estrogen receptor positive (ER+) women w/breast cancer
    o Side effects: Hot Plashes, RISK OF _____ _____ ______, headaches
A
  • Tamoxifen, Raloxifene, Fulvestrant
    o Used in estrogen receptor positive (ER+) women w/breast cancer
    o Side effects: Hot Plashes, RISK OF DEEP VEIN THROMBOSIS, headaches
30
Q

Hormonal agents- Antiestrogen

  • Progestins
    o Used for….
A

women with endometrial cancer

31
Q

Hormonal agents- Antiestrogen- Trastuzumab

Used in..

Side effects?

A

o Monoclonal antibody used in metastatic breast cancer treatment.
o Side effects: cardio-toxic, ventricular dysfunction, and C- heart failure

32
Q

Biological Response Modifiers
- Interferon: enhance immune system & stops division
o Treats:
o Treats Cancer:
o Side Effects: fever like, diarrhea, anorexia, paranoid, dizziness, confusion, tachycardia, neutropenia, thrombocytopenia
o Renal: BUN & creatinine
o Psych: Depression and suicide.

A

o Treats: papilovirus, Hep C, multiple sclerosis
o Treats Cancer: Kaposi, myeloma, renal, bladder
o Side Effects: fever like, diarrhea, anorexia, paranoid, dizziness, confusion, tachycardia, neutropenia, thrombocytopenia
o Renal: BUN & creatinine
o Psych: Depression and suicide.

33
Q
  1. Biological Response ModiPiers
    - Interferon alpha
A

o Flu-like symptoms, nero changes, monitor CBC

34
Q

Side effects of chemotherapy:

A

Myelosuppression
Mucositis
Alopecia
Reproductive organs
GI mucosa

35
Q
  • Myelosuppression: leukopenia, neutropenia, thrombocytopenia, anemia
    o Neutropenia: low immune system, high-risk of infection. Hand washing, make sure vaccines are up to date.
    o Thrombocytopenia: high risk of bleeding. Prevent bleeding, no razors, shaving.
    o Anemia: rest, monitor oxygenation, erythropoietin, blood transfusions.
A
  • Myelosuppression: leukopenia, neutropenia, thrombocytopenia, anemia
    o Neutropenia: low immune system, high-risk of infection. Hand washing, make sure vaccines are up to date.
    o Thrombocytopenia: high risk of bleeding. Prevent bleeding, no razors, shaving.
    o Anemia: rest, monitor oxygenation, erythropoietin, blood transfusions.
36
Q
  • Mucositis: mouth blisters. Assess, pain control, dietary, oral hygiene.
  • Alopecia: hair loss. It will grow back .
  • Reproductive organs
  • GI mucosa
A
  • Mucositis: mouth blisters. Assess, pain control, dietary, oral hygiene.
  • Alopecia: hair loss. It will grow back .
  • Reproductive organs
  • GI mucosa

Pharm (9 decks)

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