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1 Pharmacology > Chemotherapy Agents > Flashcards

Chemotherapy Agents Flashcards

1
Q

chemotherapy agents A.K.A.

A

antineoplastic agents

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2
Q

chemotherapy/antineoplastic agents

A
  • used to cure some CA, augment TX of other, or increase survival rate
  • works by killing fast-growing cells
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3
Q

combo therapy

A
  • uses more than 1 agent
  • more effective than monotherapy
  • reduce medication resistance, increase effectiveness, + reduce toxic effects
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4
Q

examples of fast-growing cells

A

skin, hair, intestinal mucosa, hematopoietic cells

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5
Q

common A/E of chemotherapy/antineoplastic agents

A
  • NVD
  • alopecia
  • mylosuppression
  • infection
  • tumor lysis syndrome
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6
Q

alopecia

A
  • hair loss occur 7-10 days after start

- will last a max of 2 mo after last admin

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7
Q

myelosuppression/infection risk

A

7-10 days after each chemo dose

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8
Q

tumor lysis syndrome

A
  • as cells due, contents spill into bloodstream + cause negative effects
  • hyperuricemia, hyper-K, hyper-PO4, hyper-Ca
  • AKI
  • onset begin 12-24 hr after first IV infusion
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9
Q

types of antineoplastic agents

A 
1 antimetabolite
2 hormonal agents
3 biological response modifiers
4 monoclonal antibody [MAB]
5 growth factors
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10
Q

antimetabolite

drug names

A

methotrexate
fluorouracil
cytarabine
hydroxyurea

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11
Q

methotrexate, cytarabine, fluorouracil (antimetabolite)

route

A

MTX: PO, IV, IM, Intrathecal

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12
Q

methotrexate IV requires…

A

a dedicated IV line

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13
Q

methotrexate [MTX]

MOA

A

stops cell reproduction needed for synth of DNA by inhibiting folic-acid conversion

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14
Q

methotrexate [MTX]

Tx

A
  • breast tumor
  • lung tumor
  • sarcoma
  • Non-Hodgkin Lymphoma
  • ALL
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15
Q

methotrexate [MTX]

AE

A
  • category X
  • mucositis
  • gastric ulcers
  • perforations
  • liver damage
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16
Q

methotrexate, cytarabine, fluorouracil (antimetabolite)

RN/teaching

A
  • if uric acid levels rise, then anticipate PRN Allopurinol
  • increase fluid intake 2-3L/day
  • take med on empty stomach
  • monitor for GI bleed (coffee ground emesis or tarry black stools), mouth sores
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17
Q

methotrexate [MTX] (antimetabolite)

RN/teaching

A

admin w leucovorin to reduce toxicity to healthy cells

–it enters healthy cells + blocks MTX

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18
Q

hydroxyurea

route

A

common PO antimetabolites

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19
Q

hydroxyurea

MOA

A

interrupts DNA synthesis + is cell “S” phase-specific

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20
Q

hydroxyurea

Tx

A
  • sickle cell anemia
  • can cross BBB
  • CML
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21
Q

hydroxyurea

AE

A
  • NVD
  • bone marrow suppression
  • rapid drop in WBC - neutropenic (risk of infectn)
  • thrombocytopenia (risk of bleed)
  • anemia
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22
Q

hydroxyurea

CI

A

caution w antivirals

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23
Q

hydroxyurea

RN/teaching

A
  • withhold if WBC<2.5K
  • withhold if platelets<100k
  • BMS can occur 4-6wk after admin
  • avoid crowds, sick ppl, kids
24
Q

hormonal agents

drug names

A

tamoxifen, raloxifene, anastrazole

25
Q

tamoxifen, raloxifene, anastrazole (hrmnl agent)

MOA

A

ERB: stops growth of breast CA cells which are estrogen dependant

aromatase inhibitors: blocks estrogen production

26
Q

tamoxifen, raloxifene, anastrazole (hrmnl agent)

Tx

A
  • breast CA
  • prevention of breast CA
  • post chemo to prevent breast CA fr returning
27
Q

tamoxifen (hrmnl agent)

AE

A
  • DVT/PE
  • hot flashes
  • endometrial CA
  • hyper-Ca
  • bone pain
  • vaginal DC bleeding
28
Q

anastrazole (hrmnl agent)

AE

A
  • muscle pain
  • hot flashes
  • vaginal bleed
29
Q

tamoxifen, raloxifene, anastrazole (hrmnl agent)

CI

A
  • Hx of blood clots

- category D/X

30
Q

tamoxifen, raloxifene, anastrazole (hrmnl agent)

RN/teaching

A
  • increase fluids

- discuss travel/surgeries

31
Q

biological response modifiers [BRM]

drug names

A

interferon: alfa-2A or 2B

- –anti neoplasm

32
Q

chemotherapy is always give via

A

central venous catheter

bc chemo is v irritating

33
Q

interferon: alfa-2A or 2B

MOA

A

INCREASES immune response

decreases production of CA cells

34
Q

interferon: alfa-2A or 2B

Tx

A
  • treat/prevent leukemia
  • CML
  • lymphoma
  • kaposi’s sarcoma

other use: anti viral

35
Q

interferon: alfa-2A or 2B

AE

A

**depression
-flu like s/s
-BMS
alopecia
-thyroid dysfunction
-neurotoxicity

36
Q

interferon: alfa-2A or 2B

CI

A

pancreatitis

37
Q

interferon: alfa-2A or 2B should be administered at _____ temp

A

room temp

-but store in fridge

38
Q

interferon: alfa-2A or 2B

RN/teaching

A
  • *monitor for suicidal ideation
  • ordered in MU (million units)
  • pre-med w APAP
39
Q

4 MOA of interferon A (alfa-2B)

A

1 ANTIVIRAL: stim body cells to prevent viral entry
2 IMMUNOMODULATORY: incr immune response
3 ANTIPROLIFERATIVE: prevent virus fr replicating inside cells
4 ANTINEOPLASTIC: fights cancer cells

40
Q

Monoclonal Antibodies [MAB]

drug names

A
  • rituximab
  • blinatumomab
  • trastuzumab

ends in mab

41
Q

rituxi, blinatumo, trastuzu [-MAB]

RN/teaching

A
  • have emergency resuscitative equipment readily available
  • stay w patient for first 15 mins of infusion
  • client should be tested for TB prior to MAB infusion
42
Q

rituxi, blinatumo, trastuzu [-MAB]

AE

A
  • can cause instant anaphylaxic or other life threatening rxn
  • —often w first dose
43
Q

rituxi, blinatumo, trastuzu [-MAB]

route

A

SQ or IV infusion

44
Q

growth factor [GF]

drug names

A
  • epoiten alfa
  • filgastim
  • pegfilgastim
  • sargramostin
  • oprevelkin
45
Q

epoiten alfa [GF]

MOA

A

acts on bone marrow to increase production of RBC

46
Q

epoiten alfa [GF]

Tx

A
  • CKD patients
  • anemia 2n2 chemo therapy
  • HIV/AIDS
47
Q

epoiten alfa [GF]

RN/teaching

A
  • hold if Hgb>11
  • each vial is for single dose (no reinsterting needle)
  • dose is often MWF
48
Q

filgastim, pegfilgastim [GF]

MOA

A

acts on bone marrow to incease NEUTROPHILS

  • **drugs that increase neutroPHIL have -FIL in the name
  • **all neutroPHILS can get FILtered in the spleen to cause splenomegaly
49
Q

filgastim, pegfilgastim [GF]

Tx

A
  • CA w neutropenia, agranulocytosis

- prior to harvest of stem cells

50
Q

if your spleen ruptures, you can feel pain in

A

left quadrant pain that may be referred to left shoulder

aka Kehr’s sign

51
Q

filgastim, pegfilgastim [GF]

AE

A
  • splenomegaly
  • incr uric acid
  • LDH
  • alk phos
  • bone pain
  • leukocytosis
52
Q

filgastim, pegfilgastim [GF]

CI

A

sickle cell disease

53
Q

filgastim, pegfilgastim [GF]

RN teaching

A
  • monitor pain in LUQ or left shoulder [kehr’s sign=spleen rupture]
  • admin SQ 24hr after each round of therapy
  • —-wait 14 days for next round of chemo
54
Q

sagramostin [GF]

MOA

A

stimulates bone marrow to make WBC

55
Q

sagramostin [GF]

Tx

A

hastens bone marrow function after bone marrow transplant

56
Q

oprelvekin

MOA

A

increase production of PLATELETS

1 Pharmacology (33 decks)

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