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320 Pharmacology > Antineoplastic Drugs > Flashcards

Antineoplastic Drugs Flashcards

1
Q

Cancer Treatments?

A
  • Chemotherapy
  • Surgery
  • Radiation
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2
Q

Describe Chemotherapy.

A
  • Combination of drugs is usually more effective than single-drug therapy
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3
Q

Antineoplastics primary complications?

A
  • Emetic potential
  • Harmful to all rapidly growing cells
    • Cancer cells
    • Healthy, normal human cells
  • Bone Marrow Suppression
    • No chemo if ANC < 1000; < 500 = severe neutropenia
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4
Q

How to treat Emetic potential?

A
  • ondansetron
  • Aprepitant, fosaprepitant
  • dronabinol
  • ginger (herbal)
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5
Q

Antineoplastics potential complications?

A
  • Extravasation
    - If suspected, STOP the infusion immediately
  • Tumor Lyse Syndrome: Medical Emergency
  • Hemorrhagic Cystitis
  • Cardiotoxicity
  • Constipation
  • Learning or cognitive issues for prepubertal clients
  • Infertility
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6
Q

Describe the electrolyte levels during Tumor Lyse Syndrome.

A
  • ↑ Hyperphosphatemia
  • ↑ Hyperkalemia
  • ↑ Hyperuricemia
  • ↓ Hypocalcemia
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7
Q

What does Folate (Folic Acid) Antagonist - MTX (Methotrexate) treat?

A
  • Monotherapy
    • Non-Hodgkin’s lymphoma
    • Squamous cell carcinoma of the head/neck
    • Mycosis fungoides (cutaneous T-cell lymphoma)
  • In combination w/ other drugs
    • Acute lymphoblastic leukemia
    • Osteosarcoma
    • Breast cancer
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8
Q

What drug needs to be given after Methotrexate (MTX)?

A
  • Leucovorin will always be given after HD MTX
    • Starts 24 hrs after the end of chemotherapy; “rescue”
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9
Q

What does Vincristine treat?

A
  • Hodgkin’s disease
  • Leukemias
  • Neuroblastomas
  • Malignant lymphomas
  • Wilms’ tumor
  • Rhabdomyosarcoma
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10
Q

Vincristine adverse effects?

A

May cause progressive peripheral neuropathy

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11
Q

How is vincristine administered?

A

Intravenous ONLY

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12
Q

Leucovorin indication?

A
  • Helps prevent severe myelosuppression
    - Treats anemia caused by the lack of folic acid
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13
Q

How do Alkylating Drugs work?

A

Prevents cancer cells from reproducing by altering structure of the DNA

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14
Q

cisplatin indications?

A
  • Metastatic testicular and ovarian carcinoma
  • H & N cancer
  • Cervical cancer
  • Lung cancer
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15
Q

When should you seek caution for cisplatin?

A

Hearing loss

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16
Q

cisplatin adverse effect?

A

EENT: ototoxicity, tinnitus

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17
Q

cyclophosphamide indications?

A
  • Hodgkin’s disease
  • Leukemias
  • Neuroblastoma
  • Malignant lymphomas
  • Mycosis fungoides
  • Multiple myeloma
  • Ovarian carcinoma
  • Breast carcinoma
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18
Q

cyclophosphamide management?

A
  • Prevention of hemorrhagic cystitis
    • mesna
    • Increase fluids to 2000-3000 mL/day
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19
Q

How do Antineoplastic Antibiotics work?

A

Block DNA synthesis through a process called intercalation

20
Q

Doxorubicin indications?

A
  • Alone or w/ others in the treatment of various solid tumors including:
    • Breast
    • Ovarian
    • Bladder
  • Also, malignant lymphomas and leukemias
21
Q

Doxorubicin adverse effects?

A
  • GU: red urine (normal finding)
  • Cardiotoxicity
    • Acute left ventricular HF
    • Administer dexrazoxane (cardioprotective)
    • Routine monitoring of cardiac ejection fraction
22
Q

Bleomycin indications?

A
  • Lymphomas
  • Squamous cell carcinoma
  • Testicular embryonal carcinoma
23
Q

Bleomycin adverse effects?

A
  • Pulmonary fibrosis
  • Pneumonitis
24
Q

tamoxifen indications?

A
  • Estrogen-receptor positive (ER+) metastatic breast cancer
  • Adjuvant treatment of early-stage ER+ breast cancer
  • Prevention of breast cancer in high-risk patients
25
Q

Leuprolide indications?

A
  • Advanced prostate cancer in patients who are unable to tolerate orchiectomy (surgical removal of the testes) or estrogen therapy
26
Q

Rituximab indications?

A
  • Relapse of refractory, low-grade or follicular B-cell non-Hodgkin’s lymphoma
  • Chronic lymphocytic leukemia
27
Q

Rituximab Adverse Effects?

A
  • hypersensitivity reactions (including anaphylaxis & angioedema)
  • infusion reactions
  • flu like symptoms
28
Q

Rituximab Special Considerations?

A

pre-medicate w/ acetaminophen & diphenhydramine

29
Q

Antineoplastics nursing considerations (drug adverse)?

A

Doxorubicin and daunorubicin may turn the urine a reddish color

30
Q

Antineoplastics nursing intervention?

A

notify prescriber immediately if client starts coughing, SOB, or abnormal breath sounds

31
Q

Antineoplastics Patient Education?

A
  • increase fluids
  • avoid aspirin and ibuprofen
  • avoid foods that may irritate GI tract
  • diarrhea or constipation may occur
32
Q

What do Hematopoietic Drugs-Colony Stimulating Factors (CSFs) do?

A

Reduce the duration of low neutrophil counts

33
Q

Types of CSFs?

A
  • Filgrastim (Neupogen)
  • Pegfilgrastim (Neulasta)
34
Q

CSFs adverse effects?

A

bone pain

35
Q

When should filgrastim be given?

A

Must be given BEFORE a client develops an infection; given after 24 hours after myelosuppressive chemotherapy

36
Q

Hematopoietic Drugs Implementation?

A
  • Assess pain level
  • Administer scheduled PRN pain meds
  • Offer non-pharmacologic methods of pain reduction
37
Q

Types of Modifying Drugs?

A
  • Monoclonal Antibodies
    • adalimumab
    • infliximab
  • Disease-modifying antirheumatic drugs (DMARDs)
    • MTX
    • leflunomide
    • etanercept
38
Q

adalimumab indications?

A
  • Crohn’s disease
  • UC
  • plaque psoriasis
  • psoriatic arthritis
39
Q

adalimumab contraindication?

A

Active infection

40
Q

infliximab indications?

A
  • Ankylosing spondylitis
  • Crohn’s Disease
  • UC
  • plaque psoriasis
  • RA
41
Q

Infliximab special considerations?

A
  • Contraindication in severe heart failure; it will worsen this condition
  • FDA black box warning reporting cases of TB and fungal infections
42
Q

Examples of DMARDs?

A

Nonbiologic:

  • Methotrexate
  • Leflunomide

Biologic:

  • Etanercept
43
Q

DMARDs are NOT used in patients with?

A
  • active bacterial infection
  • active herpes zoster
  • active or latent TB
  • acute or chronic hepatitis B or C
44
Q

Leflunomide contraindication?

A

Contraindicated in clients who are or may become pregnant (Category X)

45
Q

Methotrexate (MTX) drug profile?

A
  • Commonly used to treat RA in much lower doses
  • Weekly dosing (NOT DAILY!!!!)
  • Advise to take folic acid supplement to lessen likelihood of adverse effects
46
Q

What does Etanercept treat?

A
  • RA (including juvenile RA)
  • psoriasis

320 Pharmacology (36 decks)

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