Antineoplastic/ Chemotherapy Agents Part 1: General Class Wide Effects Flashcards
Rescue agent: Mesna
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
d. Cyclophosphamide
Rescue Agent: Leucovorin
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
e. Methotrexate
- Anti-HER2
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
f. Trastuzumab
Platinum Compound
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
a. Cisplatin
Vinca Alkaloids-
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
b. Vincristine
Anthracyclines
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
c. Doxorubicin
Nitrogen Mustard
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
d. Cyclophosphamide
Antimetabolites
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
e. Methotrexate
Monoclonal Antibody-
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
f. Trastuzumab
BADGOATS 1
-BONE MARROW SUPPRESSION
ADMINISTRATION CONCERNS
which is the above
- Neutropenia- Infection Risk/Safety
- Anemia- S/S and Management
- Thrombocytopenia- S/S and Management
- Infiltration/Extravasation- S/S and Management
- Disposal and PPE
- BONE MARROW SUPPRESSION
1. Neutropenia- Infection Risk/Safety
2. Anemia- S/S and Management
3. Thrombocytopenia- S/S and Management
ADMINISTRATION CONCERNS
- Infiltration/Extravasation- S/S and Management
- Disposal and PPE
BADGOATS 2
GI TRACT CONCERNS
OTHER PATIENT SAFETY CONCERNS
which is the above
- Nausea/Vomiting
- Oral Care, GI irritation/ulceration
- Alopecia
- Tumor Lysis Syndrome
- Sexual/Reproductive
GI TRACT CONCERNS 1. Nausea/Vomiting 2. Oral Care, GI irritation/ulceration OTHER PATIENT SAFETY CONCERNS 3. Alopecia 4. Tumor Lysis Syndrome 5. Sexual/Reproductive
Neutropenia
Low point called ?
“Nadir”
NEUTROPENIA PATIENT SAFETY PRECAUTIONS which is true ? Limit unnecessary procedures Live vaccines NOT recommended LIMIT visitors Do NOT allow sick/ill visitors risk for infection Do NOT allow flowers/potted plants Micro-organisms COOK and CLEAN fruits and vegetables No RAW fruits/veggies – risk of infection
all
“I will avoid crowds to keep from infecting others.“- WHAT IS WRONG WITH THIS
STATEMENT?
Large crowds can infect the immune compromised.
Which true about Reducing Bleeding Risk
Bleeding Gums- soft bristle tooth brush
Electric Razor
Limit activities that could cause a bleed (no rugby)
Rugby is safe
Bleeding Gums- soft bristle tooth brush
Electric Razor
Limit activities that could cause a bleed (no rugby)
Thrombocytopenia
Infiltration put in order.
3) STOP THE INFUSION AND REMOVE THE CATHETER
1) Warm or cold compress- DEPENDS ON WHAT INFILTRATED
4) Elevate Extremity and encourage range of motion
2) Check with provider- how much drug did patient get? Need new
dose?
3) STOP THE INFUSION AND REMOVE THE CATHETER
4) Elevate Extremity and encourage range of motion
1) Warm or cold compress- DEPENDS ON WHAT INFILTRATED
2) Check with provider- how much drug did patient get? Need new
dose?
PREVENTION:
Careful site selection, monitoring and securing of catheter
Extravasation or INFILTRATION
INFILTRATION
PREVENTION:
Use a central line
Chemotherapy certified nurses only give chemotherapy
Use infusion pump, monitor IV site
Extravasation or INFILTRATION
Extravasation
Thrombocytopenia
Extravasation put in order.
1) Try to withdraw any solution from the IV access
3) STOP THE INFUSION!
2) Keep catheter in place- you may need to infuse an antidote
4) Elevate Extremity and follow hospital protocol
3) STOP THE INFUSION!
1) Try to withdraw any solution from the IV access
2) Keep catheter in place- you may need to infuse an antidote
4) Elevate Extremity and follow hospital protocol
? Spill- Contact Occupational Safety and Health Administration (OSHA)
Large or Small Spill
Large
? Spill- Chemotherapy Spill Kits
Large or Small Spill
Small Spill
Goggles, mask, protective clothing, shoe covers, absorbent pads, detergent cleansers,
chemotherapy waste disposal bags
Large or Small Spill
Small Spill
Which is true about
CHEMOTHERAPY INDUCED NAUSEA/VOMITING –
Don’t eat if nauseated
Limit fluids prior to chemotherapy (reduce nausea)
Eat foods at ROOM temperature (Hot Foods Increase Nausea)
Do NOT drink extra fluids (can cause over-distention)
Do NOT eat extra unsaturated fats (don’t break down as well)
Patients will typically experience weight loss
all
Oral Hygiene is Essential
Flossing once daily (ATI has wrong answer of 4 times daily)
AVOID Alcohol based mouthwash ( No alcohol!)
Run toothbrush in dishwasher weekly (not monthly- ATI distractor)
Use soft bristle tooth brush
Magic Mouthwash- antifungal, lidocaine, antihistamine
BLAND DIET- No hot (temperature), Avoid spicy foods, etc.
Report Ulcers, blood in stool, etc.
all
Treatment? ALLOPURINOL
Alopecia
Tumor Lysis Syndrome
Sexual Health-
Tumor Lysis Syndrome
USED TO TREAT- Wide array of cancers a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
c. Doxorubicin
ADVERSE EFFECTS: BAD GOATS a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
c. Doxorubicin
c. Doxorubicin
Alopecia
Starts ? days when beginning treatment
Can last ? months after end of treatment
Alopecia
Starts 7-10 days when beginning treatment
Can last 2 months after end of treatment
ADVERSE EFFECTS Cardiac Toxicity Ruby red a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
c. Doxorubicin
c. Doxorubicin
Harmless red discoloration of bodily fluids?
Cardiac Toxicity
Ruby red
Ruby Red
c. Doxorubicin
LIFE TIME LIMIT!
Cardiac Toxicity
Ruby red
Cardiac Toxicity
Monitor EKG and Echocardiogram
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
c. Doxorubicin
USED TO TREAT- Wide array of cancers Derived from vinca rosea plant (periwinkle plant) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
b. Vincristine
MECHANISM: Mitotic Inhibitor a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
b. Vincristine
MECHANISM: Believed to inhibit Topoisomerase II, which inhibits production of DNA and RNA a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
c. Doxorubicin
ADVERSE EFFECTS: BAD GOATS Peripheral Neuropathy a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
b. Vincristine
Nearly ALL patients will have Decreased reflexes Weakness Sensory Loss Paresthesias (numbness/tingling) 30-50% of patients have autonomic nerve damage Constipation Urinary hesitancy/retention
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
b. Vincristine
USED TO TREAT- Wide array of cancers Includes acute lymphomas; solid tumors (head, neck, ovary and breast cancers); Hodgkin’s and non-Hodgkin’s lymphomas; and multiple myeloma a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
d. Cyclophosphamide
MECHANISM: Kills rapid growing cells by alkylation of DNA and RNA synthesis a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
d. Cyclophosphamide
ADVERSE EFFECTS: BAD GOATS Acute Hemorrhagic Cystitis a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
d. Cyclophosphamide
Increase fluids to 3 Liters/Day Monitor for blood in urine a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
d. Cyclophosphamide
Watch out for electrolyte abnormalities hyperkalemia a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
d. Cyclophosphamide
Commonly given with Mesna (uro-protectant)
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
d. Cyclophosphamide
USED TO TREAT- Wide array of cancers Includes bladder, testicular, and ovarian cancers a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
a. Cisplatin
MECHANISM: Kills rapid growing cells by alkylation of DNA and RNA synthesis a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
a. Cisplatin
ADVERSE EFFECTS: BAD GOATS Highly Emetogenic Renal Toxicity Hearing Loss Paresthesia's a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
a. Cisplatin
USED TO TREAT- Solid Tumors (breast/lung) Lymphomas/Leukemia Rheumatoid Arthritis Ectopic Pregnancy a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
e. Methotrexate
MECHANISM: Rheumatoid Arthritis (?): Mechanism isn’t 100% understood, but it does function as anti-inflammatory and immunomodulator a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
e. Methotrexate
LOW DOSE
MECHANISM: CANCER (?): inhibits dihydrofolate
reductase, stops cells from utilizing folic acid for
DNA synthesis (this means fast acting cells….like
cancer!!!)
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
e. Methotrexate
(HIGH DOSE
MECHANISM: Suppresses S-phase specific cell reproduction a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
e. Methotrexate
The Good: Kills Cancer or stops overactive immune system a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
e. Methotrexate
The Bad (high dose therapy): BAD GOATS!
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
e. Methotrexate
CANCER: When destroying tumors, they release DNA byproduct. Result=hyperuricemia a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
Patients can have extreme turnover of DNA byproduct: Tumor Lysis Syndrome This can cause nephrotoxicity! a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
Result=hyperuricemia
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
This medication is Pregnancy Category X
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
This medication is associated with SCAR (SJS/TEN)
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
This medication can cause photosensitivity
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
This medication can cause liver toxicity
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
PROTECT FROM SUNLIGHT
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
NOTABLE DRUG-DRUG CONCERNS: INCREASED EFFECTS: NSAIDS (including aspirin) Antibiotics like penicillin and sulfamethoxazole can increase ? toxicity a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
Leucovorin Rescue (sort of an antidote) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
In the hospital we can check ? levels (we then dose the leucovorin based on the levels) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
Oral versions are given ONCE WEEKLY, if you see
ONCE DAILY, BE CAREFUL!!! You could kill someone
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
e. Methotrexate
USED TO TREAT- HER2+ Breast Cancer a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
f. Trastuzumab
? is a monoclonal antibody which binds to the extracellular
domain of the human epidermal growth factor receptor 2 protein (HER-2); it
mediates antibody-dependent cellular cytotoxicity by inhibiting proliferation
of cells which overexpress HER-2 protein.
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
f. Trastuzumab
ADVERSE EFFECTS: TWO BOXED WARNINGS: CARDIOMYOPATHY INFUSION REACTIONS AND PULMONARY TOXICITY a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
f. Trastuzumab
Stop immediately if dyspnea or significant hypotension a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
f. Trastuzumab
Highly Emetogenic
a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab
a. Cisplatin