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Pharm 2 > drug therapy for the treatment of cancer > Flashcards

drug therapy for the treatment of cancer Flashcards

1
Q

describe the multi step process of the path of cancer

A

starts with on abnormal cell then mutation or tumor initiation

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2
Q

pathophysiology

abnormal cells have increasing capacity for…

A
  • survival
  • proliferation
  • invasive
  • metastasis
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3
Q

where are the most common sites for metastasis

A

liver, lungs, bone, and brain

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4
Q

what are three types of cancer with the higest mortality rates

A

1) lung
2) breast
3) prostate

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5
Q

name some different causes of cancer

A
  • radiation (ex solar UV radiation)
  • chemicals (ex. asbestos, cigarette smoking)
  • viruses (ex. HPV)
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6
Q

do hormones cause cancer?

A

nope but they promote it

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7
Q

describe drug therapy to treat cancer

A
  • interfere with cell replication, nutrient use use or supply, genetic materials
  • most active against rapidly dividing cells (cause of side effects of many drugs, most cells will recover when chemo is stopped)
  • most are dosed by weight
  • teratogenic
  • hard on liver and kidneys (something to watch for)
  • goals is remission
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8
Q

how is chemotherapy given

A
  • oral
  • intravenous
  • injection
  • intrathecal
  • intra-arterial
  • topical
  • intraperitneal
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9
Q

what is the number one goal of nursing interventions for cancer patients

A

education

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10
Q

name some different goals of nursing interventions for cancer patients

A
  • education
  • provide supportive care
  • strenghten host defenses
  • safe chemo admin
  • assess for reduction of tumor size, normal lab values
  • assess for adverse reactions
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11
Q

name some types of different antineoplastic drugs

A
  • alkylating drugs
  • antimetabolites/antifolates
  • antitumor antibiotics/plant alkaloids
  • biologic antineoplastic drugs
  • antineoplastic hormone inhibitors
  • cytoprotectant drugs
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12
Q

alkylating agents work by…

A

preventing cancer cells from replicating

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13
Q

name two alkylating agents

A

cyclophosphamide and cisplatin

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14
Q

alkylating agents

describe cyclophosphamide

A
  • treats many different types of cancers, used at the very beginning of treatment before maintenance chemo
  • oral or IV administration (usually IV)
  • many different dosing regimens
  • bladder toxicity
  • drink 2L fluid/day, overhydrate 1-2 days after being administered the drug
  • administer antiemetics
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15
Q

alkylating agents

describe cisplatin

A
  • treatment of advanced bladder, ovarian, and testicular cancer
  • IV only
  • must verify patient line prior to administration
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16
Q

what do you do for cisplatin extravasation

A

1) stop infusion
2) disconnect tubing (leave cannula/needle in place
3) aspirate
4) initiate sodium thiosulfate antidote
5) elevate extremity

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17
Q

what is the antidote for cisplatin extravasation

A

sodium thiosulfate

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18
Q

antimetabolites work by…

A

mimicking the molecule that cells need to grow

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19
Q

name some antimetabolites

A
  • methotrexate
  • fluorouracil
  • hydroxyurea
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20
Q

antimetabolites

describe methotrexate

A
  • teratogenic, prevents folic acid from being produced
  • oral, IM, intrathecal, or subq

also used for lupus and rheumatoid arthritis, hazardous drug

21
Q

antimetabolites

describe fluorouracil

A
  • topical
  • do not use metal to apply
22
Q

antimetabolites

describe hydroxyurea

A
  • oral only
  • do not crush or break

hazardous drug, also used to treat sickle cell

23
Q

a nurse is caring for a patient receiving cisplatin. the nurse is most concerned about what complication?

A

extravasation

cisplatin can cause extravasation if IV is not patent

24
Q

what does the nurse incldue in pt teachig fro cyclophosphamide

A

it is important to drink at least 2L of water per day for 1-2 days after your dose

this med can cause bladder toxicity

25
Q

how do biologic antineoplastics work

A

use your own body to fight cancer

stimulate body to detect cancer cells and attack

26
Q

biologic antineoplastics

whats the QSEN safety alert for growth factor and tyrosine kinase inhibitors

A

swallow whole or completely dissolve in water

27
Q

name two antineoplastic hormone inhibitors

A
  • tamoxifen
  • anastrozole
28
Q

antineoplastic hormone inhibitors

describe tamoxifen

A
  • treats and reduces risk of breast cancer
  • oral
  • double glove if splitting the pill
29
Q

what is important to remember about antineoplastic hormone inhibitors

A

need baseline and periodic bone mineral density testing for both meds

this is bc estrogen is important for bones

30
Q

what are cytoprotectants used for

A

used to reverse the adverse effects of cancer drugs

31
Q

name some different cytoprotectants

A
  • epoetin alfa
  • filgrastim
  • leucovorin
  • recombinant human interleukin-11 (oprelvekin)
  • colony stimulating factor (sargramostim)
32
Q

cytoprotectants

describe epoetin alfa

A
  • human erythropoietin
  • stimulates RBC production alongside chemotherapy
  • used for anemia
33
Q

cytoprotectants

describe filgrastim

A

helps with WBC production

34
Q

cytoprotectants

describe leucovorin

A
  • acts as folic acid in body
  • used for high doses of methotrexate since methotrexate decreases folic acid
35
Q

cytoprotectants

describe recombinant human interleukin-11 (oprelvekin)

A
  • helps with thrombocytopenia
  • helps get platelets up and prveent bleeding
36
Q

cytoprotectants

describe colony stimulating factor (sargramostim)

A
  • immune booster
  • helps with WBC production
37
Q

common complications of anticancer drug therapy

how do you treat nausea and vomiting

A
  • treat with serotinin receptor antagonist and corticosteroid
  • palonostron
  • benzodiazepines may also be effective bc the nausea and vomiting is CNS related
38
Q

common complications of anticancer drug therapy

describe the treatment of anorexia

A

supplements may be helpful

39
Q

common complications of anticancer drug therapy

describe the treatment of fatigue

A
  • alternate periods of activity and rest
  • cluster care
40
Q

common complications of anticancer drug therapy

describe the treatment of alopecia

A

counsel patients - temporary, hair will grow back

41
Q

common complications of anticancer drug therapy

describe treatment musocitis

oral ulcers that may extend down GI tract

A
  • condition is temporary: lasts 7 -10 days
  • use measures to decrease ulcerations: chewing ice before chemotherapy has been shown to help
42
Q

common complications of anticancer drug therapy

describe treatment of infection

A
  • infection control patient teaching
  • filgrastim or colony stimulating factors (sargramostim) administration
43
Q

common complications of anticancer drug therapy

describe bleeding prevention

A
  • bleeding preacutions
  • thrombopoietin or recombinant human interleukin-11 (oprelvekin) administration
  • platelet administration
44
Q

common complications of anticancer drug therapy

describe treatment of hyperuricemia

A
  • encourage high fluid intake
  • allopurinol adminstration
45
Q

common complications of anticancer drug therapy

describe treatment of hand-foot syndrome

A
  • decrease heat and friction
  • ice and acetaminophen
46
Q

your patient is receiving rituximab and is complaining of bleeding gums and easy bruising. you receive labs on the patient, and the platelet count has decreased to 50,000. the nurse should anticipate starting which med?

A

recombinant human interleukin-11 (oprelvekin)

to stimulate platelet production

47
Q

what are some symptoms of tumor lysis syndrome and why does it happen

A
  • hyperkalemia
  • hyperphosphatemia
  • hyperuricemia
  • hypomagnesia
  • hypocalcemia
  • acidosis

cells die and stuff inside is released into the bloodstream

48
Q

how do you treat and prevent tumor lysis syndrome

A

treat each lab value individually

  • aggressive hydration
  • sodium bicarbonate (for acidosis)
  • allopurinol (hyperuricemia)
  • insulin (for hyperkalemia)
  • kayexalate (hyperphosphatemia)

Pharm 2 (34 decks)

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