Ch 42 Chemotherapy Flashcards
What are cytotoxic chemotherapy agents
Cytotoxic chemotherapy agents are toxic to cancer cells.
They kill fast growing cancer cells as well as healthy cells including skin, hair, intestinal mucosa, and hematopoietic cells
What are most of the adverse effects of chemotherapeutic agents
Many of the adverse effects are related to the unintentional harm done to normal rapid proliferating cells, such as those of the GI tract, hair follicles, and bone marrow.
Common adverse effects are nausea, vomiting, myelosupresssion, and alopecia
Name 6 cytotoxic chemotherapy drug classes
ANTIMETABOLITES-kill cancer cells by interrupting a specific phase of cell reproduction
ANTI TUMOR ANTIBIOTICS-kill cancer cells by stopping the synthesis of RNA, DNA or proteins.
ANTIMITOTICS- kill cancer cells by inhibiting mitosis and preventing cell division.
ALKYLATING AGENTS- kills fast growing cancer cells by altering DNA structure and preventing cell reproduction.
TOPOISOMERASE- kills cancer cells by interrupting DNA synthesis
OTHER- kills cancer cells by various mechanisms including interrupting DNA and RNA synthesis in leukemia cells.
What are medications of the class of drugs folic acid analogs? (ANTIMETABOLICS)
Methotextrate ( rheumaterex, trexall)
Pemetrexed ( Alimta)
What is the expected pharmalogical and therapeutic actions of folic acid analogs
Pharmalogical:Stops cell production by inhibiting folic acid conversion
S-phase specific
Therapeutic: choriocarcinoma, solid rumors, such as breast and lung, head and neck sarcomas, acute lymphocytic leukemia, and non Hodgkin lymphoma.
What are adverse effects of all antimetabolic agents
Bone marrow supression ( low WBC a count or neutropenia, bleeding caused by thrombocytopenia or low platelet count, and anemia or low RBCs [ monitor WBC, absolute neutrophil count, platelet count, hgb, and HCT. Assess for bruising, and bleeding gums. Avoid crowds and infectious individuals GI discomfort ( nausea and vomiting) [ administer antiemetic such as ondansetron in combo with dexamethasone, granisetron or metoclopramide before beginning chemotherapy]
What is the route of administration for folic acid analogs such as methotextrate ( Rheumaterex, trexall) and pemtrexed ( Alimta)
Oral
IV
IM
INTRATHECAL
Adverse effects of methotextrate
Mucosa toss ( GI tract), gastric ulcers,perforation
Reproductive toxicity
Renal damage due to hyperuricemia or elevated levels of URIC acid/ administer allopurinol if URIC acid is elevated.
Adverse effects of cytarbine
Liver disease
Pulmonary edema
Arachnoiditis/ indications include nausea, headache and fever/ manifestations may be treated with dexamethasone ( decadron)
What are adverse effects of mercaptopurine
Liver toxicity
Mucositis ( GI tract), gastric ulcers, perforation
Reproductive toxicity such as congenital abnormalities
What meds may cause methotextrate toxicity
Salicylates and other NSAIDs, sulfonamides, penicillin, tetracyclines
Folic acid changes the body’s response to methotextrate decreasing its effect.
What are med interactions of cytarbine
Cytarbine may reduce digoxin levels
Cytarbine may reduce gentamicin response to klebsiella pneumonia
What are med interactions of mercaptopurine
Allopurinol ( Zyloprim) may reduce breakdown of mercaptopurine
Mercaptopurine may either increase or decrease the effects of warfarin.
What should be administered in conjunction to methotextrate
Leukovorkin rescue to reduce toxicity to healthy cells. Leukovorkin is a folic acid derivative . It enters healthy cells and blocks methotextrate from damaging normal cells.
What is chemotherapy
Chemotherapy is used to treat some cancers, it augments the treatment of other cancers, and attempts to increase a clients survival rate and time
It can be given PO,PARENTERALLY, IV, INTRACAVITARY, OR INTRATHECAL.
