Antineoplastic Drugs: Cell-cycle Nonspecific and Misc Drugs

Question 1

Cell-Cycle nonspecific Drug classes

Answer 1

• Alkylating Drugs = Cisplatin AND Cyclophosphamide AND Mechlorethamine
• Cytotoxic Antibiotics = Doxorubicin

Question 2

Alkylating Drugs

Answer 2

MOA:
Prevent cancer cells from reproducing by altering chemical structure of cell’s DNA

Indications:
Wide spectrum of malignancies

Adverse Effects:
Nephrotoxicity, peripheral neuropathy, ototoxicity, hemorrhagic cystitis

Interactions:
Other nephrotoxic drugs (like AMINO GLYCOSIDES) and bone marrow suppressing drugs

Nursing Considerations:

• watch kidney function
• monitor for hearing loss/tinnitus

Question 3

Alkylating Drugs - Key Drugs

Answer 3

Cisplatin
Treatment of solid tumors such as bladder, lung, testicular, and ovarian tumors
Bifunctional alkylating drug (bi means works on two sites on DNA; poly means it works on more than 2)

Cyclophosphamide (can also be used for transplants and severe rheumatoid disorders)
Treatment of bone and lymph cancers as well as other solid tumors, leukemias and multiple myeloma
Polyfunctional alkylating drug

Mechlorethamine
Treatment of Hodgkin’s and non-Hodgkin’s lymphoma
Bifunctional alkylating drug

Cyclo and Mech have bone marrow suppression effects esp. if used with other BM suppressing drugs and radiation

Question 4

Cytotoxic Antibiotics

Answer 4

MOA:
Block DNA synthesis

Indications:
Variety of solid tumors and some hematologic malignancies

Adverse Effects:
Hair loss, nausea, vomiting, and myelosuppresion

Interactions:
Increased toxicities when used with other chemo drugs or with radiation therapy

Nursing Considerations:
- monitor for toxicities when used with other chemo drugs

Question 5

Cytotoxic Antibiotics - Key Drugs

Answer 5

Doxorubicin:
- Treatment of breast, bone, and ovarian cancer.
Leukemia, neuroblastoma, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma
- Be aware of EXTRAVASATION with IV administration
- Increases serum digoxin levels

Question 6

Treating Extravasation

Answer 6

• Cool site for 24hrs
• Rest and ELEVATE for 24 to 48 hrs
• if not healed, contact physician

Question 7

S/S of Digoxin Toxicity

Answer 7

Confusion
Irregular pulse
Loss of appetite
Nausea, vomiting, diarrhea
Palpitations
Vision changes (unusual), including blind spots, blurred vision, changes in how colors look, or seeing spots)
Other symptoms may include:

Decreased consciousness
Decreased urine output
Difficulty breathing when lying down
Excessive nighttime urination
Overall swelling