Antineoplastic Drugs- Cell Cycle Specific Flashcards
Cell Cycle Specific means
Drugs have specific effect on particular point in the cell cycle
Why are there no true contraindications to antineoplastic drugs?
The benefits outweigh the risks. Might adjust accordingly, or might just pretreat the patient for expected adverse effects.
Mechanism of action of Antimetabolites
Inhibit cell growth by interfering with the synthesis of compounds needed for cell reproduction (folic acid, purines, and pyramidines)
Indications for Antimetabolites
Solid tumors (tumor at some specific location in the body), leukemias, and non-Hodgkin’s lymphoma
Nursing Considerations for Antimetabolites
Educate on potential for Adverse Effects: hair loss, nausea, vomiting, diarrhea, myelosuppression
Antimetabolite Key drugs
Methotrexate
Cytarabine
Indications for methotrexate
Antagonizes folic acid production– cells can no longer grow and reproduce. For treatment of solid tumors such as breast, head and neck, lung cancers, acute lymphocytic leukemia, and non-Hodgkin’s lymphomas
Nursing Considerations for methotrexate
Severe bone marrow suppression with high doses. Will give “rescue” drug leucovorin to prevent myelosuppression.
Indications for cytarabine
Pyradine antagonist. Treats acute myelocytic and lymphocytic leukemia, and non-Hodgkin’s lymphomas.
Nursing Considerations for cytarabine
Can cause Cytarabine syndrome (6-12 hours after infusion): fever, muscle and bone pain, maculopapular rash (on arms), conjunctivitis, and malaise. Can pretreat with corticosteroids to prevent this.
Mechanism of Action of Topoisomerase II Inhibitors
Inhibit enzyme topoisomerase II causing breaks in DNA strands, which leads to cell death.
Indications for Topoisomerase II Inhibitors
Small cell lung cancer and testicular cancer
Adverse Effects of Topoisomerase II Inhibitors
Hair loss, nausea, vomiting
Nursing Considerations of Topoisomerase II Inhibitors
Causes reduced clearance of warfarin and cyclosporine- prolonged AE like increased bleeding tendencies. Watch INR and give lower warfarin dose.
Topoisomerase II Inhibitor Key Drugs
Etoposide- same profile as general class
Nursing Considerations for Etoposide
Treatment of small cell lung cancer and testicular cancer. Interacts with warfarin and cyclosporine.
Mechanism of Action for Mitotic Inhibitors
Works before or during cell mitosis to inhibit cell division
Indications for Mitotic Inhibitors
Variety of solid tumors and some hematologic malignancies (leukemias)
Adverse Effects of Mitotic Inhibitors
Hair loss, nausea, vomiting, myelosuppression
Nursing Considerations for Mitotic Inhibitors
Can pretreat with antiemetic to avoid nausea and vomiting
Mitotic Inhibitors Key Drug
paclitaxel
vincristine
Indications for paclitaxel
Treatment of ovarian cancer, breast cancer, non-small cell lung cancer, and kaposi’s sarcoma
Nursing Considerations for paclitaxel
Can produce hypersensitivity during infusion. Pretreat with steroid (dexomethasone), H1 receptor antagonist (diphenhydramine), or H2 receptor agonist (renididine) to prevent reaction
Indications for vincristine
Treatment of acute lymphocytic leukemia and other cancers (used in conjunction with other neoplastic drugs)
Nursing considerations for vincristine
Do NOT give via intrathecal route, very safe IV
Mechanism of Action for Antineoplastic Enzymes
Enzyme that catalyzes conversion of aspargine (amino acid needed for DNA synthesis) to aspartic acid and ammonia. It INHIBITS DNA synthesis.
Indicatiosn for Antineoplastic Enzymes
ONLY aproved for acute lymphocytic leukemia
Adverse Effects for Antineoplastic Enzymes
hair loss, nausea, vomiting, impaired pancreatic function, specifically in beta cells (causes hyperglycemia). Can also cause pancreatitis.
Nursing Considerations for Antineoplastic Enzymes
Monitor blood sugars!
Antineoplastic Enzymes Key Drugs
Asparaginase
Nursing Considerations for Asparaginase
Treatment of acute lymphocytic leukemia, derived from E. coli bacterium. Common for patients to develop allergic reaction- monitor reaction… if it is severe enough, might use similar drug that is even more toxic, but less risk of hypersensitivity.
