Drug Therapy for Cancer Flashcards
what are some common endings for cancer drugs?
-ate, -ib, -ine, -one
what are the characteristics of cancer?
- persist
- invade (transformer - disguise themselves)
- metastasize
- immortal (don’t die)
does chemotherapy work better for slow-growing cancer or fast-growing cancer?
fast-growing cancer (chemo doesn’t work well for slow-growing cancers like prostate or thyroid)
what doesn’t chemotherapy work well for?
- solid tumors
- slow-growing cancer
what are the four most common side effects of chemo? what do they have in common?
all rapidly growing cells - chemo kills rapidly dividing cells which are cancer cells and these cells
- decreased immune system (low WBC)
- fatigue (low H&H)
- hair loss
- GI (nausea and vomiting)
why do people typically need more than 1 chemotherapy drug?
because the chemos might work in different parts of the cell cycle
- cell cycle-specific
- cell cycle nonspecific
why would cancer patients be on steroids?
- decrease inflammation so chemo can work better
what is the nurse’s role when counseling a patient about chemotherapy options?
- guide patients to ask questions to their provider
- guide them to professional resources
what is the schedule of cancer treatment like?
- complicated due to tolerance
- demanding of time
- realistic for lifestyle
why would drugs be alternated for cancer or stop for a period of time?
- tolerance
- to allow healthy cells that were damaged like bone marrow cells a chance to recover
- recover platelet, WBC, and bone marrow count
- fatal cells (not cells causing hair loss)
what is the Karnofsky performance scale?
determine who would be a good candidate for chemotherapy
- 100 best score
- less than 40 would not be a good candidate
what are the 3 reasons chemotherapy would be performed?
- cure/complete response (remission)
- control (prevent a tumor from growing, shrink a tumor in preparation for surgery)
- palliation (less aggressive, just enough to keep a patient comfortable)
what needs to be known about palliation chemotherapy?
- less aggressive
- just enough to help with symptoms and keep patient comfortable, can be confusing for patient and family so inform them this is not to cure the patient’s cancer)
what would combination chemo be used?
to use medications with different side effects to limit side effects
what is an ommaya reservoir?
a way to perform direct chemotherapy
- fewer side effects
- more specific
a small, plastic device that is implanted in your brain. It allows your doctor to deliver medicine directly to the fluid around your brain and spinal cord
what precautions are needed when handling antineoplastics (medications used to treat cancer)?
- airflow hood
- low permeability gown
- chemo gloves
- face shield or googles
- chemo waste disposal container
- no food or drink in the area
- DON’T CRUSH CANCER DRUGS
what is needed with patients’ urine after chemotherapy?
it is toxic
- chemotherapy gloves when handling
- flush toilet multiple times
what do you do as a nurse with a neutropenic patient?
very susceptible to infection
- glove, gown, mask yourself to protect patient
- no live plants
- no fresh fruit or vegetables
- limited visitors
how are chemo doses determined?
by body weight and surface area
- different for everyone
what is the action of alkylating agents?
binds to DNA and cause impaired functioning and replication to eventually kill the cell
- kills for within
what part of the cell cycle do alkylating agents work in?
non-specific
what is an example of an alkylating agent?
cyclophosphamide
what are the adverse effects of alkylating agents?
- neutropenia
- severe nausea and vomiting (90%)
- bone marrow suppression
- hair loss (alopecia)
what is the common ending for platinum compounds?
-tin
what is the action of platinum compounds?
binds to DNA and cause impaired functioning and replication to eventually kill the cell
- kills from within
what part of the cell cycle do platinum compounds work in?
non-specific
what are the side effects of platinum compounds?
- neuropathy
- severe nausea and vomiting
- mild to moderate bone marrow impression
- ototoxicity
what is an example of platinum compounds?
cisplatin
what is the action for folic acid analogs?
interrupts the folic acid synthesis
what cell cycle phase do folic acid analogs work in?
s phase
what is an example of folic acid analogs?
methotrexate
what are the adverse effects of folic acid analogs?
- bone marrow suppression
- oral and GI ulcers
- renal impairment
- GI distress
what are examples of dose-limiting toxicities?
means to stop or pause treatment
- myelosuppression
- cardiotoxicity
- pulmonary fibrosis
- neurotoxicity
- hypersensitivity
- renal toxicity
- tumor lysis syndrome
what hematopoietic side effects are seen with chemo?
- anemia (decreased RBC)
- thrombocytopenia (decreased platelets)
- leukopenia/neutropenia (decreased WBC/neutrophils)
what are the treatments for anemia caused by chemo?
- epoetin
- darbepoetin
- blood transfusion
what are the treatments for thrombocytopenia caused by chemo?
- oprelvekin (Neumega)
- platelet transfusion
what are the treatments for leukopenia/neutropenia caused by chemo?
filgrastim (Neupogen)
what are the gastrointestinal side effects of chemo?
- anorexia
- nausea
- vomiting
- mucositis (mouth sores)
- stomatitis
- constipation
- diarrhea
- pancreatitis
- hepatic toxicity
what kind of diet should cancer patients be on?
high-calorie diet (eating is really important)
what are the genitourinary side effects of chemo?
- cystitis (inflammation of the bladder)
- hemorrhagic cystitis
- acute renal failure
- chronic renal insufficiency
what are the integumentary side effects of chemo?
- alopecia (emotional issues)
- dermatitis
- nail changes
- hand-foot syndrome (impaired immune system)
- hyperpigmentation
- radiation recall
- rash
- extravasation
what is extravasation?
- leakage of blood, lymph, or other fluid, such as an anticancer drug, from a blood vessel or tube into the tissue around
- why chemo needs to be given through a port
- pain and inflammation in the SQ tissue
- cellular/tissue damage if leakage into SQ tissue
what are the cardiovascular side effects of chemo?
- cardiac toxicity
- extravasation
- phlebitis (inflammation of a vein)
- venous fibrosis (blood clots)
what are the pulmonary side effects of chemo?
- fibrosis
- pneumonitis (inflammation of lung tissues)
- edema
what are the neurological side effects of chemo?
- central neurotoxicity
- ototoxicity
- metabolic encephalopathy
- peripheral neuropathy
what are the mood alteration side effects of chemo?
- anxiety
- depression
- euphoria
what are the reproductive side effects of chemo?
- infertility
- changes in libido
- erectile dysfunction
- amenorrhea
what are the metabolic side effects of chemo?
- hyp/hypercalcemia
- hypo/hyperglycemia
- hyperphosphatemia
- hyperuricemia
- hypo/hyperkalemia
- hypomagnesemia
- tumor lysis syndrome
what is tumor lysis syndrome?
no many cancer cells are killed at once and they release toxic chemicals
- hyperkalemia, hyperphosphatemia, hyperuricemia, hypomagnesemia, hypocalcemia, and acidosis
how is a patient with tumor lysis syndrome treated?
- rehydration
- fix electrolyte imbalances
- if pt is acidotic give sodium bicarb
- treat/prevent gout (allopurinol)
what are the latent effects of chemotherapy?
- cognitive dysfunction
- learning disabilities
- changes in memory
- secondary malignancies
what are the two types of hormonal inhibitors typically given after cancer?
- antiestrogen
- aromatase inhibitors
what is the name of the antiestrogen hormonal inhibitor?
tamoxifen (nolvadex)
what is the action of an antiestrogen hormonal inhibitor?
blocks estrogen receptors of breast cancer cells
what is the use of an antiestrogen hormonal inhibitor?
used after breast cancer
what are the adverse effects of an antiestrogen hormonal inhibitor?
similar to menopause
- hot flashes
- nausea and vomiting
- fluid retention
- blood clots
what is the administration like for antiestrogen hormonal inhibitors?
20mg PO daily for 2-5 years
what is the name of the aromatase hormonal inhibitors?
letrozole (Femara)
what is the action of aromatase hormonal inhibitors?
inhibits aromatase which reduces estrogen levels
what is the use of aromatase hormonal inhibitors?
after breast cancer or other estrogen-related cancers like ovarian cancer
what are the adverse effects of aromatase hormonal inhibitors?
- musculoskeletal pain
- fatigue
what is the use like for aromatase hormonal inhibitors?
should be taken after 2-3 years of tamoxifen
what is the common ending for biologic antineoplastic drugs?
- mab
- nib
- mib
what is biotherapy?
treatment with agents from biologic sources and or agents able to affect biologic response
what are biologic response modifiers?
change the relationship between tumor and host by modifying biologic response of the host
- body will kill cancer cells itself
- less serious side effects
what are the benefits of biotherapy?
- an intact immune system will recognize abnormal cells and destroy them
- cancer cells are constantly formed and destroyed by the immune system
what is the role of biotherapy?
- cure/complete response
- control
- maintenance
- supportive therapy
what are the side effects of biotherapy?
- fatigue
- flu-like symptoms
- hypersensativity
- infusion-related reaction
- rashes
- capillary leak syndrome
