Cancer Medications Flashcards
What blood tests are important to monitor in Pt taking antineoplastic medications ?
- CBC ( complete blood count )
- WBC ( white blood count )
- Platelet count
- Uric acid level
- Electrolytes
What do you monitor in platelet count ? * think about low levels and bleeding*
- <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
What can decreased platelets cause ?
- Bleeding gums
- Nose bleeds
- Ecchymosis ( bruising )
- Petechiae ( small purple spots under the skin )
- Increased bleeding
What are avoided in Pts with low platelet count * think of bleeding precautions*
- Intra musc Inj
- Venipunctures
What precautions are initiated for low WBCs and what do you monitor for ?
- Neutropenic
- Bleeding precautions
- Monitor fever and sore (these are s/sx of infection)
Are there any changes in appetite in taste in Pts receiving antineoplastic medications ?
Yes, loss of appetite and food will taste bitter
What other symptoms should you monitor for a Pt receiving antineoplastic meds ? What kind of diet should you provide/ medications ?
- Nausea
- Vomiting
Diet :
Should be high in calories and taken with protein supplements
Meds:
Antiemetics
When are Antiemetics given when receiving chemo ? * is it before or after*
- Antiemetics are given several hours before chemo (12-48 hours after ) because antineoplastic meds stimulate vomiting center in the brain
What do you encourage the Pt to take while on chemo *what helps keep you _____ during exercise ?
- IV hydrations ( administered before and after therapy )
- Encourage fluids to also help with kidney function
Why do Pts receiving antineoplastic meds have to take contraceptives ?
- Contraceptives must be used because antineoplastic meds have a teratogenic effect ( can cause abnormalities )
- Infertility is discussed ( can be irreversible )
What are side/adverse effects of chemotherapy ?
- Mucositis
- Alopecia
- Anorexia/nausea/vomiting
- Diarrhea
- Anemia
- Low WBCs ( neutropenia)
- Thrombocytopenia ( increased bleeding )
- Infertility, sexual alterations (remember need for contraceptives )
Can Pt on chemo receive live vaccines ?
no
What are antimetabolite medications ( what do they do ?)
- Stop synthesis of cell protein and cell division
List some of the antimetabolite medications & what are some side/adverse effects ?
- 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
What are common side effects in Antimetabolite medications ?
- 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)
What is important to monitor with a cancer Pt. taking fluorouracil ?
- Cerebellar dysfunction
- Photosensitivity
What is given to a Pt when taking large doses of methotrexate to prevent toxicity ?
Leucovorin (rescue)
Name some hormonal medications
- Bicalutamide ( Casodex )
- Flutamide (Eulexin)
- Nilutamide ( Nilandron )
- Tamoxifen Citrate ( Nolvadex) used in Pts with breast cancer
What are hormonal and enzymes used for in cancer ?
- Suppress the immune system and block normal hormones in hormone sensitive tumors
- Changes hormonal balance and slow growth rates of certain tumors
What are the side/adverse effects of hormonal and enzyme medications ?
- 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
What are side effects in taking tamoxifen ?
- Edema
- Hypercalcemia
- Elevated cholesterol
- Triglyceride levels
What does tamoxifen do in relations to hormones ? ( what is decreasing In women)
estrogen
What are Immunomodulator agents (what are med names ?)
- Alemtuzumab (Campath)
- Rituximab (Rituxan )
- Cetuximab ( Erbitux)
What do immunomodulators do ?
- Stimulate immune system to recognize cancer cells and to try and destroy them
Other Antineoplastic medications ? think of what they end in
- Carmustine ( BiCNU)
- Ranimustine ( Cymerin)
- Iomustine ( CeeNU)
- Cisplastin (CDDP)
- Satraplatin (SPERA)
- Oxoliplatin ( Eloxatin)
- Etoposide (Eposin)
- Teniposide ( Vumon)
- Tepotecan ( Hycamtin )
- Irinotecan (Campto)
- Rubitecan (Orathecin)
