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NURS 305 - All Content > Antineoplastic Drugs > Flashcards

Antineoplastic Drugs Flashcards

1
Q

What is a neoplasm?

A

A mass of new cells / tumor

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2
Q

______ refer to a various group of symptoms that cannot be directly attributed to the spread of a cancerous tumor

A

Paraneoplastic syndromes

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3
Q

What are the early signs of malignancy associated with paraneoplastic syndromes?

A
  • Cachexia (most common)
  • Fatigue / fever
  • Hypercalcemia
  • Neuropathies
  • SIADH
  • Cushing’s syndrome
  • Addison’s syndrome
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4
Q

Chemotherapy is divided into what 2 groups based on their effects on the cell cycle?

A
  • Cell cycle–nonspecific (CCNS)
  • Cell cycle–specific (CCS)
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5
Q

Describe cell cycle–specific (CCS) antineoplastic drugs

A
  • Cytotoxic during a specific cell-cycle phase
  • Used to treat a variety of solid or circulating tumors
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6
Q

Describe cell cycle–nonspecific (CCNS) antineoplastic drugs

A

Cytotoxic during any cell-cycle stage

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7
Q

Chemotherapy drugs have a ______

A

Narrow therapeutic index

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8
Q

Adverse effects of chemotherapy are ______

A

Dose-limiting

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9
Q

To maximize cell death, CCS and CCNS are usually combined to increase ______

A

Synergistic effects

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10
Q

Chemotherapy is harmful to ______

A

All rapidly growing cells - chemo cannot distinguish between healthy cells / cancer cells

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11
Q

What types of healthy human cells are affected by chemotherapy?

A
  • Hair follicles - hair loss
  • GI tract - nausea, vomiting, diarrhea
  • Bone marrow cells - decreased RBCs, WBCs, platelets
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12
Q

What are the adverse effects of chemotherapy?

A
  • Alopecia
  • Emetic potential
  • Myelosuppression -significant decrease in bone marrow activity
  • Nadir - time of lowest blood counts (usually 7-10 days after tx)
  • Extravasation - use metaport / implanted device
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13
Q

Describe the targeted drug therapy associated with chemotherapy

A
  • Specific
  • Deliberate
  • Cytostatic - precision chemo
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14
Q

What is the primary antimetabolite associated with chemotherapy

A

methotrexate

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15
Q

Describe the MOA of antimetabolites

A

Block DNA synthesis at the S phase

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16
Q

Describe the use of antimetabolites

A

Used in combination with other drugs

17
Q

What are the adverse effects of antimetabolites?

A
  • Tumor lysis syndrome
  • Palmar-plantar dysesthesia (also called hand-foot syndrome),
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
18
Q

Describe tumor lysis syndrome

A

Common complication of chemotherapy characterized by excessive cellular waste products and electrolytes (increased uric acid, phosphates, & potassium; hypocalcemia)

19
Q

Describe the treatment of tumor lysis syndrome

A
  • Avoid foods high in potassium
  • IV regular insulin with dextrose
  • Loop dimetric - lasix
20
Q

Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome?

A

Hyperuricemia - Manifestations of tumor lysis syndrome include hyperphosphatemia, hyperkalemia, and hypocalcemia. These electrolyte abnormalities are often treated with diuretics such as mannitol, intravenous calcium supplementation, oral or rectal potassium exchange resin, and oral aluminum hydroxide. Hyperuricemia can lead to nephropathy, and hemodialysis may be required in severe cases of tumor lysis syndrome

21
Q

Describe mitotic inhibitors / plant alkaloids

A
  • Taxanes: paclitaxel, docetaxel, cabazitaxel (Jevtana), and eribulin (Halaven)
  • Antimicrotubule compounds that cause disruption and interference with vital cell function when cells are dividing (mitosis) - apoptosis
22
Q

Describe the MOA of mitotic inhibitors / plant alkaloids

A
  • Can work in various phases of the cell cycle (late S phase, throughout G2 phase, and M phase)
  • All work shortly before or during mitosis and thus inhibit cell division
  • Each different subclass inhibits mitosis in a unique way
23
Q

What are the indications of mitotic inhibitors?

A
  • Often used in combination therapies
  • Used to treat a variety of solid tumors and some hematologic malignancies
  • Testicular, small cell lung, breast, ovarian, non–small cell lung cancers
  • Kaposi’s sarcoma
  • Acute leukemia
24
Q

What are the side effects of mitotic inhibitors?

A
  • Hair loss, nausea and vomiting, myelosuppression
  • Liver, kidney, lung toxicities
  • Damage to peripheral nerves- reversible or irreversible-s/s decrease in muscular strength and numbness and tingling of fingers and toes
25
Q

Describe the nursing interventions associated with mitotic inhibitors

A
  • Assess baseline blood counts before administering antineoplastic drugs
  • Follow specific administration guidelines for each antineoplastic drug
  • Remember that all rapidly dividing cells (both normal and cancer cells) are affected
  • Implement measures to monitor for and prevent infection in patients with neutropenia or leukopenia
  • Anticipate nausea and vomiting and implement measures to reduce these effects
  • Antiemetics often work better if given 30 to 60 minutes before chemotherapy is started
26
Q

The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient’s white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately?

A

Fever - principal early sign of infection, especially in those with decreases WBCs

27
Q

When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection?

A

Perform hand hygiene - risk of infection from leukopenia / neutropenia / immunosuppression is one of the more significant adverse effects that requires close attention

28
Q

Describe the MOA of topoisomerase Inhibitors (Camptothecins)

A

Induce breaks in the DNA strand and interferes with reproduction

29
Q

What are the indications of topoisomerase Inhibitors (Camptothecins)?

A
  • Ovarian cancer
  • Colorectal cancer
  • Small cell lung cancer
30
Q

What are the side effects of topoisomerase Inhibitors (Camptothecins)?

A
  • Dose-limiting effects
    (nausea / vomiting, myelosuppression)
  • Nephrotoxicity, peripheral neuropathy, ototoxicity (hydration can prevent nephrotoxicity)
  • Extravasation causes tissue damage and necrosis
31
Q
  • Finish lecture notes
A

NURS 305 - All Content (20 decks)

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