Cancer Medications Flashcards

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1
Q

What blood tests are important to monitor in Pt taking antineoplastic medications ?

A
  • CBC ( complete blood count )
  • WBC ( white blood count )
  • Platelet count
  • Uric acid level
  • Electrolytes
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2
Q

What do you monitor in platelet count ? * think about low levels and bleeding*

A
  • <50,000 cells/mm^3 leads to prolonged bleeding in minor trauma
  • < 20,000 cells/mm^3 leads to spontaneous and uncontrolled bleeding
  • Bleeding precautions are initiated
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3
Q

What can decreased platelets cause ?

A
  • Bleeding gums
  • Nose bleeds
  • Ecchymosis ( bruising )
  • Petechiae ( small purple spots under the skin )
  • Increased bleeding
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4
Q

What are avoided in Pts with low platelet count * think of bleeding precautions*

A
  • Intra musc Inj

- Venipunctures

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5
Q

What precautions are initiated for low WBCs and what do you monitor for ?

A
  • Neutropenic
  • Bleeding precautions
  • Monitor fever and sore (these are s/sx of infection)
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6
Q

Are there any changes in appetite in taste in Pts receiving antineoplastic medications ?

A

Yes, loss of appetite and food will taste bitter

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7
Q

What other symptoms should you monitor for a Pt receiving antineoplastic meds ? What kind of diet should you provide/ medications ?

A
  • Nausea
  • Vomiting
    Diet :
    Should be high in calories and taken with protein supplements
    Meds:
    Antiemetics
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8
Q

When are Antiemetics given when receiving chemo ? * is it before or after*

A
  • Antiemetics are given several hours before chemo (12-48 hours after ) because antineoplastic meds stimulate vomiting center in the brain
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9
Q

What do you encourage the Pt to take while on chemo *what helps keep you _____ during exercise ?

A
  • IV hydrations ( administered before and after therapy )

- Encourage fluids to also help with kidney function

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10
Q

Why do Pts receiving antineoplastic meds have to take contraceptives ?

A
  • Contraceptives must be used because antineoplastic meds have a teratogenic effect ( can cause abnormalities )
  • Infertility is discussed ( can be irreversible )
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11
Q

What are side/adverse effects of chemotherapy ?

A
  • Mucositis
  • Alopecia
  • Anorexia/nausea/vomiting
  • Diarrhea
  • Anemia
  • Low WBCs ( neutropenia)
  • Thrombocytopenia ( increased bleeding )
  • Infertility, sexual alterations (remember need for contraceptives )
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12
Q

Can Pt on chemo receive live vaccines ?

A

no

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13
Q

What are antimetabolite medications ( what do they do ?)

A
  • Stop synthesis of cell protein and cell division
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14
Q

List some of the antimetabolite medications & what are some side/adverse effects ?

A
  • Cytara-bine (Ara- C)
  • Gemcita-bine ( Gemzar )
  • Capecita-bine ( Xeloda )
  • Methotrexate ( Rhematrex ,Trexall )
  • Fluorouracil ( Adrucil )

Side/Adverse Effects:

  • Diarrhea
  • Alopecia
  • Stomatitis
  • Depression of bone marrow
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15
Q

What are common side effects in Antimetabolite medications ?

A
  • Stomatitis ( Cytarabine, Fluorouracil, methotrexate, )
  • Hyperuricemia * excess uric acid* ( cytarabine, methotrexate, )
  • Hepatotoxicity ( Cytarabine ,Methotrexate )
  • Alopecia ( Cytarabine, Fluorouracil, Methotrexate )
  • Phototoxicity (Cytarabine, Fluorouracil, methotrexate)
  • Hematological/GI/Skin toxicity ( Methotrexate, )
  • Diarrhea (Fluorouracil)
  • Cerebellar dysfunction (Fluorouracil,)
  • GI ( Methotrexate)
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16
Q

What is important to monitor with a cancer Pt. taking fluorouracil ?

A
  • Cerebellar dysfunction

- Photosensitivity

17
Q

What is given to a Pt when taking large doses of methotrexate to prevent toxicity ?

A

Leucovorin (rescue)

18
Q

Name some hormonal medications

A
  • Bicalutamide ( Casodex )
  • Flutamide (Eulexin)
  • Nilutamide ( Nilandron )
  • Tamoxifen Citrate ( Nolvadex) used in Pts with breast cancer
19
Q

What are hormonal and enzymes used for in cancer ?

A
  • Suppress the immune system and block normal hormones in hormone sensitive tumors
  • Changes hormonal balance and slow growth rates of certain tumors
20
Q

What are the side/adverse effects of hormonal and enzyme medications ?

A
  • Anorexia/Nausea/Vomiting
  • Leukopenia (reduction in white blood cells)
  • Sex characteristics ( masculinizing effect in women chest and facial hair and stopping of menses
  • Feminine characteristics in men (Gynecomastia)
  • Breast swelling
  • Hot flashes
  • Weight gain
  • Hemorrhagic cystitis, Hypouricemia, Hyperlipidemia, Hypertension
  • Thromboembolic disorders
  • Edema
  • Electrolyte imbalances
21
Q

What are side effects in taking tamoxifen ?

A
  • Edema
  • Hypercalcemia
  • Elevated cholesterol
  • Triglyceride levels
22
Q

What does tamoxifen do in relations to hormones ? ( what is decreasing In women)

A

estrogen

23
Q

What are Immunomodulator agents (what are med names ?)

A
  • Alemtuzumab (Campath)
  • Rituximab (Rituxan )
  • Cetuximab ( Erbitux)
24
Q

What do immunomodulators do ?

A
  • Stimulate immune system to recognize cancer cells and to try and destroy them
25
Q

Other Antineoplastic medications ? think of what they end in

A
  • Carmustine ( BiCNU)
  • Ranimustine ( Cymerin)
  • Iomustine ( CeeNU)
  • Cisplastin (CDDP)
  • Satraplatin (SPERA)
  • Oxoliplatin ( Eloxatin)
  • Etoposide (Eposin)
  • Teniposide ( Vumon)
  • Tepotecan ( Hycamtin )
  • Irinotecan (Campto)
  • Rubitecan (Orathecin)