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54/64 Unit 3 > Cancer Pharm And Prevention > Flashcards

Cancer Pharm And Prevention Flashcards

1
Q

What are the goals of cancer treatment?

A

Cure, control, palliation

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2
Q

What stage of cancer will always be palliative?

A

Stage IV

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3
Q

Cancer drugs in clinical trials will have _________ names

A

Protocol (ex: imatinib (Gleevec) was named STI-571 in a clinical trial)

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4
Q

Chemotherapy is most effective when used in a _________ dividing or _________ proliferative tumor

A

Rapidly; highly

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5
Q

What kind of cancer drugs work in different parts of the cell cycle?

A

Cell cycle specific agents

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6
Q

What kind of cancer drugs work in all phases of the cell cycle?

A

Cell cycle non-specific agents

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7
Q

For highly differentiated tumors, would you want to administer cell cycle specific or cell cycle non-specific agents?

A

Cell cycle specific

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8
Q

__________ inhibit cell growth by interfering with synthesis of compounds critical to cellular production including folic acid, purines, and pyrimidines.

A

Antimetabolites

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9
Q

Name 3 examples of antimetabolites

A

Capecitabine (Xeloda), fluorouracil (5-FU), methotrexate (MTX)

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10
Q

Side effects of capecitabine (Xeloda)

A

Peripheral neuropathy, N/V

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11
Q

Adverse effects of Methotrexate (MTX) and capecitabine (Xeloda)

A

Neuro, cardio, and pulmonary toxicity

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12
Q

Capecitabine (Xeloda) and methotrexate (MTX) are contraindicated in patients with

A

Renal dysfunction

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13
Q

Capecitabine (Xeloda) interacts with

A

Warfarin

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14
Q

Methotrexate is often used to treat brain cancer and can be administered

A

Orally and intrathecally (intrathecal administration MUST be preservative-free)

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15
Q

List two examples of mitotic inhibitors

A

Paclitaxel (Abraxane) and vincristine

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16
Q

Mitotic inhibitors such as Paclitaxel (Abraxane) and vincristine are

A

Vesicants

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17
Q

What cancer medication should NEVER be administered intrathecally?

A

Vincristine (black box warning: death)

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18
Q

Paclitaxel (Abraxane) nursing consideration

A

Always premedicate patient with Benadryl, dexamethasone (steroids), and famotidine

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19
Q

T or F: two nurses must verify when hanging chemotherapy

A

True

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20
Q

Irinoteacan (Camptosar) can cause severe diarrhea. What medication can be administered to stop diarrhea?

A

Atropine

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21
Q

Name an example of a topoisomerase I inhibitor

A

Irinoteacan (Camptosar)

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22
Q

Capecitabine (Xeloda), fluorouracil (5-FU), methotrexate (MTX), Paclitaxel (Abraxane), vincristine, and Irinoteacan (Camptosar) are all examples of what kind of cancer agents?

A

Cell cycle phase-specific

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23
Q

Bevacizumab (Avastin) is a form of target drug therapy used to treat lung cancer through antiangiogenic properties meaning it works by

A

Cutting off vasculature (blood supply) of tumors

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24
Q

What kind of cancer does Imatimib (Gleevec) treat and how does it work?

A

Treats leukemia by inhibiting enzymes thought to produce leukemia

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25
Side effects of imatimib (Gleevec)
Fatigue, headaches, rash
26
Adverse effects of Femara
Osteoporosis, osteonecrosis of jaw, behavioral problems
27
Alkylating agents cause significant
Bone marrow suppression
28
Alkylating agents nursing consideration
Assess for anemia
29
Avastin and Gleevec are examples of
Target drug therapy
30
Adverse effects of Cisplatin (Platinol)
Nephrotoxicity, ototoxicity, peripheral neuropathy
31
What cancer drug requires a lifetime dose and holds a blackbox warning for cardiotoxicity
Doxirubicin (Adriamycin)
32
Doxirubicin (Adriamycin) nursing consideration
If EF is decreasing, reduce or stop the dose because it can lead to heart failure
33
Doxirubicin (Adriamycin) is a
Vesicant
34
A form of doxirubicin (Adriamycin) that is encapsulated in a liposomal covering to decrease the side effects of the drug
Liposomal doxirubicin (Doxil)
35
Cisplatin (Platinol), doxorubicin (Adriamycin), liposomal doxorubicin (Doxil), bevacizumab (Avastin), and imatinib (Gleevec) are all examples of what kind of cancer agents?
Cell cycle phase-nonspecific
36
Name an example of an alkylating agent
Cisplatin (Platinol)
37
List two examples of cytotoxic antibiotics
Doxorubicin (Adriamycin) and liposomal doxorubicin (Doxil)
38
Cytotoxic antibiotics MOA
Interact with DNA and block DNA synthesis
39
Cytotoxic antibiotics nursing consideration
Toxicity increases when used with other drugs
40
_________ promote synthesis of different types of blood components
Hematopoietic
41
Examples of hematopoietic drugs
Epoetin Alfa (Procrit), Filgastrim (Neupogen), and Pegfilgastrim (Neulasta)
42
Filgastrim and Pegfilgastrim contraindication
Blast cells 10% or higher
43
Side effects of Filgastrim and Pegfilgastrim
Bone pain, muscle aches, neutropenia
44
Patients who take Filgastrim of Pegfilgastrim can develop neutropenia ___hr to ___ days after chemo known as the Nater Period
24hr to 7 days
45
_________ prevent cancer cells from dividing and replicating and increase cytotoxic activity of the natural killer cells
Interferons
46
Side effects of interferons
Flu-like symptoms, increased BUN/Creatinine, orthostatic hypotension
47
What is the only contraindication for immunotherapy?
If the patient has an active infection (therapy will target the infection rather than cancer)
48
Filgastrim dosing
5mcg/kg/day
49
What are the most critical sites for infection in cancer patients?
Venous access devices such as CVC, IJ, PICC, etc.
50
What are the 5 steps for bone marrow transplantation?
Stem cell obtained, conditioning, transplantation, engraftment, transplant recovery
51
How are transplant conditioning days counted?
Reverse; T-10 days counting down
52
How are post-transplant days counted?
In order; T-0 days counting up
53
Late side effects of transplant conditioning
Veno-occlusive disease and secondary cancers
54
Transplant side effects
Infection, DIC, flu-like symptoms, hypertension, fever
55
What cancer drugs can cause hyperuricemia?
Alkylating agents such as vincristine
56
Stomatitis is adverse reaction to chemo/cancer therapies. What education should the nurse provide the client?
Examine mouth daily for white plaque on tongue and cheeks, bleeding, ulcerations, and painful areas
57
What cancer drug can cause hemorrhagic cystitis?
Mitomycin C
58
Patient education related to adverse effect of chemo-brain
Remind the patient that this is a normal, temporary response to therapy
59
What cancer medication can cause pneumonitis?
Bleomycin
60
Pneumonitis patient education
Call provider immediately if experiencing a change in coughing, wheezing, or SOB
61
The size of the tumor will decrease with this type of surgery and chemo effects will improve
Debulking surgery
62
When is neoadjuvent chemotherapy given?
Before primary treatments such as surgery
63
This chemo can cause severe enlargement of the heat which can be life-threatening
Doxorubicin (Adriamycin)
64
Carcinogens are introduced during the _________ phase of Carcinogenesis
Promotion
65
This cancer med is NEVER to be given intrathecally as it is fatal
Vincristine
66
The size of the tumor, the lymphatic spread, and metastatic spread describes what?
TNM staging of cancer
67
Cisplatin, used to treat bladder cancer, can cause which adverse effect?
Nephrotoxicity
68
T or F: TNM is used to stage leukemia lymphomas
False
69
Colony stimulating factors are administered in what time frame following chemotherapy?
24 hours
70
Signs of an enlarged prostate
Dysuria, hematuria, urinary frequency
71
Does the staging system determine the response to chemo?
NO
72
5-FU can cause what side effect?
Stomatitis
73
Methotrexate requires addition of what supplement?
Folic acid
74
Replication inhibition, gene alteration, and migration describe what type of cancer cell?
Malignant
75
What infection plays a role in the development of cervical cancer?
HPV
76
Bevacicimab (Avastin) works through
Antiangiogenesis
77
How big does a tumor need to be before it requires nutrition and oxygen?
0.6 sonometers
78
Does liposomal doxorubicin have a lifetime dose?
No
79
How long do you hold pressure for a thrombocytopenic patient?
5 min
80
In bone marrow suppression, what is the main component of blood cells that decrease first?
Hemoglobin (which causes anemia)
81
List an example of a nitrogen mustard chemotherapy
Cyclophosphamide (Cytoxan)
82
What is the single, most preventable cancer cause?
Chemical carcinogens such as tobacco
83
Examples of physical carcinogens
UV, scans/X-rays, tanning beds, germicidal lamps
84
Dietary risk factors for cancer
Low fiber, high red meat and animal fats, preservatives, additives, artificial sweeteners
85
Immunity risk factors for cancer
Immunosuppressive agents, transplantation, stage III HIV
86
What is the single most important and unpreventable risk factor for cancer?
Advancing age (median age for diagnosis is 66)
87
CAUTION cancer symptoms
Change in bowel/bladder habits, A sore throat that does not heal, Unusual bleeding or discharge, Thickening or lumps in breast, Indigestion or difficulty swallowing, Obvious changes in wart or mole, Nagging cough or hoarseness
88
Inherited cancers include
Colon, prostate, breast
89
Strategies to prevent the occurrence of cancer
Primary prevention
90
Use of screening strategies to detect cancer early, at a time when cure of control is more likely
Secondary prevention
91
Modifiable factors to prevent cancer
Decrease alcohol intake (1 oz/day), increase fiber, decrease fat, limit sexual partners, smoking cessation
92
T or F: smoking cessation decreases risk for cancer
True, BUT still at higher risk than non-smokers
93
Medication that can be given to premenopausal women to reduce risk for breast cancer if BRCA gene is present
Tamoxifen
94
Soft foods for cancer patients
Scrambled eggs, cheese/cottage cheese, nut butters, cold protein shakes
95
Normal prealbumin levels
15-36 mg/dL
96
Normal cholesterol levels
160-200 mg/dL
97
Number one lab to assess when patient is Cachexic or malnourished
Prealbumin
98
S/S of undernutrition/malnutrition
Thin, brittle hair and nails, decreased HR, BP, and RR, muscle wasting, increased susceptibility to infections
99
To increase nutritional intake, what can the nurse expect to be ordered?
Carnation instant breakfast, ensure, Greek yogurt
100
_________ feedings are given if patient is unable to maintain adequate nutrition orally
Enteral
101
What should the nurse assess prior to instituting enteral feedings?
Advanced directives
102
Enteral feeding given through port or triple lumen catheter with infusion pump for long-term use
TPN
103
T or F: TPN is associated with more complications and is more conducive to infection d/t sugar-based feedings
True
104
Nasally inserted tubes and PEG tubes should be verified for placement with an
X-Ray
105
Enteral feeding that is endoscopically and percutaneously placed in the stomach
PEG tube
106
Enteral feeding that bypasses the stomach and goes into jejunum indicated for patients with stomach cancer
Jejunostomy tube
107
What is the most common complication of TPN?
Tube obstruction
108
Interventions for TPN tube obstruction
Verify correct placement, then push 30mL of water through tube for dislodgement
109
How often should residuals be checked in patients with TPN?
Every 6 hrs
110
If the pharmacy does not deliver TPN in time for next feeding, what can the nurse hang until TPN is ready?
D10
111
Cancer patient education
Keep food diary, report fever >100.4, call if increased or uncontrolled vomiting, report new onset of bleeding, changes in bowel habits, inability to eat and drink, and desire to end life
112
Survivorship plan includes
Detailed description of treatment plan, when to call provider, follow-up appointment dates
113
Lymphedema is treated through
Physical therapy
114
What are the 6 ethical principles?
1) autonomy (self-determination), 2) beneficence (positive action to help others), 3) nonmaleficence (preventing harm), 4) fidelity (keeping promises), 5) veracity (truth-telling), 6) social justice (equality and fairness to all patients regardless of age, race, gender, ethnicity, etc.)

54/64 Unit 3 (8 decks)

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