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Pharmacology Test #3 > Chemotherapy Agents > Flashcards

Chemotherapy Agents Flashcards

1
Q

What is another name for chemotherapy agents?

A

antineoplastics

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2
Q

What is the therapeutic action of antineoplastics, and what is there purpose?

A

kill cancer cells or boost the immune system of the host; either way the ultimate goal is to shrink the size of the tumor so the immune system can deal with it.

cure, palliation, prophylactic (to prevent recurrence)

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3
Q

Can any nurse administer antineoplastics?

A

No, they require someone with special training and certification.

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4
Q

What happens if an antineoplastic spills?

A

This requires special precautions that will be included in institutional policy, at the very least a spill kit will be needed (full gown, goggles, mask, shoe covers, hat, special bags)

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5
Q

What type of cells are antineoplastics most effective against?

A

cells that replicate faster (high growth fraction)

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6
Q

What two types of cancer are less responsive to antineoplastics?

A

breast and lung cancers

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7
Q

What cells in our body (non-cancerous) are more susceptible to side effects of antineoplastics?

A

hair, GI, and bone marrow (high growth fraction)

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8
Q

Why are multiple drugs given during chemotherapy treatment?

A

different drugs act at different replication stages (increases effectiveness)

lower doses cause less toxicity and less resistance of cells (mutation)

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9
Q

Why are antineoplastics sometimes given as a series?

A

this gives normal cells time to recover

target new replicating cells

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10
Q

What is the therapeutic action of antimetabolites (cytotoxic chemotherapy agent)?

A

causes cell death by interrupting cell reproduction (inhibits folic acid conversion that is part of the replication process)

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11
Q

What pregnancy category is methotrexate?

A

category X

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12
Q

What may the nurse administer to reduce the toxicity of antimetabolites to healthy cells?

A

leucovorin (folic acid derivative)

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13
Q

What are some adverse effects of antimetabolites and nursing considerations for them?

A

bone marrow suppression - monitor for bleeding, bruising, and infection, monitor CBC, WBC, and platelets

mucositis, gastric ulcer, perforation - maintain good oral hygiene, avoid mouthwash with alcohol (irritates oral mucosa)

Renal dysfunction - monitor and encourage 2-3L of fluid daily

N/V - give antiemetic, avoid mouthwash with alcohol, and maintain good oral hygiene (usually antiemetic is given before treatment to avoid n/v)

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14
Q

What is the difference between methotrexate being used as a DMARD and methotrexate being used as a cyotoxic chemotherapy agent?

A

when it is used as a DMARD it is given at a lower dose

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15
Q

What is the therapeutic action of antitumor (cytotoxic chemotherapy agent) drugs?

A

causes cell death by stopping RNA and DNA synthesis.

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16
Q

What are some adverse effects of antitumor drugs and some nursing considerations for them?

A

bone marrow suppression - monitor for bleeding, signs of infections, bruising, monitor CBC, WBC, platelets

n/v, stomatitis - good oral hygiene, avoid mouthwash with alcohol, give antiemetic

cardiotoxic (can induce CHF) - monitor ECG, symptoms of CHF

alopecia (hair loss) will occur after 7-10 days and last 2 months after therapy has stopped - pick out wig before hair loss begins, avoid vigorous brushing

extravasation (tissue damage around administration site) - use central line for infusions (usually use portacaths now), MONITOR IV SITE FOR LEAKS

discoloration of urine and sweat (red) - harmless, make sure patient knows

17
Q

When does hair loss begin to occur when on chemotherapy and how long does it last after therapy has stopped?

A

starts after 7-10 days and will last 2 months after therapy has stopped

18
Q

What pregnancy category is adriamycin?

A

cat D

19
Q

What is the therapeutic action of antimitotics (cytotoxic chemotherapy agent)?

A

causes cell death by inhibiting mitosis and preventing cell division

20
Q

What are some adverse effects of antimitotics and some nursing considerations for them?

A

peripheral neuropathy effects - report weakness, paresthesia, tingling, ataxia

alopecia - will begin 7-10 days after therapy and last 2 months after stopped (pick out wig before hair loss begins, avoid vigorous brushing)

tissue damage from extravasation - use central line(most have portacaths), MONITOR IV SITE FOR LEAKS

n/v - give antiemetics before therapy, maintain good oral hygiene, avoid mouthwash with alcohol

21
Q

What pregnancy category is vincristine (antimitotic)?

A

Cat D

22
Q

Is vincristine (antimitotic) bone marrow toxic?

A

NO NO NO

23
Q

What is the therapeutic action of alkylating (cytotoxic chemotherapy agent) agents?

A

causes cell death by altering DNA and preventing cell reproduction

24
Q

What pregnancy category are alkylating agents in?

A

category C

25
Q

What are some adverse effects of alkylating agents and some nursing considerations for them

A

hemorrhagic cystitis - encourage 3L fluid daily, monitor urine for blood and pain urinating, mesa (mesnex) may be given to reduce hematuria

bone marrow suppression - monitor for bleeding, bruising, signs of infection, monitor CBC, WBC, platelets

n/v - give antiemetic before therapy, maintain good oral hygiene, avoid mouthwash with alcohol

alopecia - will begin 7-10 days after therapy and last 2 months after stopped (pick out wig before hair loss begins, avoid vigorous brushing)

26
Q

What medication can be given to reduce hematuria from hemorrhagic cystitis?

A

mesa (Mesnex)

  • helps break down metabolites from medication that cause the hematuria
27
Q

What is the therapeutic action of topoisomerase inhibitors?

A

causes cell death by interrupting DNA synthesis

28
Q

What pregnancy category are topoisomerase inhibitors?

A

cat C

29
Q

What are some adverse effects of topoisomerase inhibitors and some nursing considerations for them?

A

bone marrow suppression - monitor for bleeding, bruising, signs of infection, monitor CBC, WBC, platelets

n/v - give antiemetic before therapy, maintain good oral hygiene, avoid mouthwash with alcohol

alopecia - will begin 7-10 days after therapy and last 2 months after stopped (pick out wig before hair loss begins, avoid vigorous brushing)

30
Q

What are three things to monitor for in most antineoplastics?

A

bone marrow suppression (except for vincristine (Oncovin) an antimitotic)

alopecia

n/v

31
Q

What two antineoplastic medications can cause extravasation?

A

adriamycin (Doxorubicin)

vincristine (Oncovin)

32
Q

Should we monitor IV sites whether medications can cause extravasation or not?

A

YES YES YES

33
Q

What is the therapeutic action of estrogen receptor blockers (noncytotoxic chemotherapy agent)?

A

antiestrogen/hormonal agents; stops the growth of breast cancer cells which are estrogen-dependent cancer

USED FOR BREAST CANCER ONLY

NONTOXIC TO HEALTHY CELLS

34
Q

What pregnancy category are estrogen receptor blockers?

A

cat D

35
Q

What are some adverse effects for estrogen receptor blockers and some nursing considerations for them?

A

increased risk of stroke/PE - monitor for symptoms

increased risk for endometrial cancer - monitor for abnormal vaginal discharge or bleeding

n/v - give antiemetic (good oral hygiene, avoid mouthwash with alcohol)

hot flashes - educate patient

hypercalcemia (rare) - monitor levels (not sure if its because of the breast cancer or the Tamoxifen)

36
Q

When is nalvadex (Tamoxifen), an estrogen receptor blocker, contraindicated?

A

In patients taking warfarin because it increases the risk for bleeding - MONITOR PT/INR

37
Q

What is the therapeutic action of biologic response modifiers?

A

energizes the immune system: increase immune system response and decreases production of cancer cells

38
Q

What are some adverse effects of interferons (antiviral/anticancer) and interleukins (similar to interferons) and some nursing considerations for them?

A

Bone marrow suppression of RBCs from the increase in demand of WBCs - monitor for anemia

flu-like symptoms (fever, fatigue, HA, chills) - monitor and report

cardiotoxicity - monitor and report symptoms

peripheral neuropathy effects - report weakness, paresthesia, tingling, ataxia

depression/anxiety - educate and report

Pharmacology Test #3 (8 decks)

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