drug therapy for the treatment of cancer Flashcards
describe the multi step process of the path of cancer
starts with on abnormal cell then mutation or tumor initiation
pathophysiology
abnormal cells have increasing capacity for…
- survival
- proliferation
- invasive
- metastasis
where are the most common sites for metastasis
liver, lungs, bone, and brain
what are three types of cancer with the higest mortality rates
1) lung
2) breast
3) prostate
name some different causes of cancer
- radiation (ex solar UV radiation)
- chemicals (ex. asbestos, cigarette smoking)
- viruses (ex. HPV)
do hormones cause cancer?
nope but they promote it
describe drug therapy to treat cancer
- 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
how is chemotherapy given
- oral
- intravenous
- injection
- intrathecal
- intra-arterial
- topical
- intraperitneal
what is the number one goal of nursing interventions for cancer patients
education
name some different goals of nursing interventions for cancer patients
- education
- provide supportive care
- strenghten host defenses
- safe chemo admin
- assess for reduction of tumor size, normal lab values
- assess for adverse reactions
name some types of different antineoplastic drugs
- alkylating drugs
- antimetabolites/antifolates
- antitumor antibiotics/plant alkaloids
- biologic antineoplastic drugs
- antineoplastic hormone inhibitors
- cytoprotectant drugs
alkylating agents work by…
preventing cancer cells from replicating
name two alkylating agents
cyclophosphamide and cisplatin
alkylating agents
describe cyclophosphamide
- 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
alkylating agents
describe cisplatin
- treatment of advanced bladder, ovarian, and testicular cancer
- IV only
- must verify patient line prior to administration
what do you do for cisplatin extravasation
1) stop infusion
2) disconnect tubing (leave cannula/needle in place
3) aspirate
4) initiate sodium thiosulfate antidote
5) elevate extremity
what is the antidote for cisplatin extravasation
sodium thiosulfate
antimetabolites work by…
mimicking the molecule that cells need to grow
name some antimetabolites
- methotrexate
- fluorouracil
- hydroxyurea
antimetabolites
describe methotrexate
- teratogenic, prevents folic acid from being produced
- oral, IM, intrathecal, or subq
also used for lupus and rheumatoid arthritis, hazardous drug
antimetabolites
describe fluorouracil
- topical
- do not use metal to apply
antimetabolites
describe hydroxyurea
- oral only
- do not crush or break
hazardous drug, also used to treat sickle cell
a nurse is caring for a patient receiving cisplatin. the nurse is most concerned about what complication?
extravasation
cisplatin can cause extravasation if IV is not patent
what does the nurse incldue in pt teachig fro cyclophosphamide
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
how do biologic antineoplastics work
use your own body to fight cancer
stimulate body to detect cancer cells and attack
biologic antineoplastics
whats the QSEN safety alert for growth factor and tyrosine kinase inhibitors
swallow whole or completely dissolve in water
name two antineoplastic hormone inhibitors
- tamoxifen
- anastrozole
antineoplastic hormone inhibitors
describe tamoxifen
- treats and reduces risk of breast cancer
- oral
- double glove if splitting the pill
what is important to remember about antineoplastic hormone inhibitors
need baseline and periodic bone mineral density testing for both meds
this is bc estrogen is important for bones
what are cytoprotectants used for
used to reverse the adverse effects of cancer drugs
name some different cytoprotectants
- epoetin alfa
- filgrastim
- leucovorin
- recombinant human interleukin-11 (oprelvekin)
- colony stimulating factor (sargramostim)
cytoprotectants
describe epoetin alfa
- human erythropoietin
- stimulates RBC production alongside chemotherapy
- used for anemia
cytoprotectants
describe filgrastim
helps with WBC production
cytoprotectants
describe leucovorin
- acts as folic acid in body
- used for high doses of methotrexate since methotrexate decreases folic acid
cytoprotectants
describe recombinant human interleukin-11 (oprelvekin)
- helps with thrombocytopenia
- helps get platelets up and prveent bleeding
cytoprotectants
describe colony stimulating factor (sargramostim)
- immune booster
- helps with WBC production
common complications of anticancer drug therapy
how do you treat nausea and vomiting
- treat with serotinin receptor antagonist and corticosteroid
- palonostron
- benzodiazepines may also be effective bc the nausea and vomiting is CNS related
common complications of anticancer drug therapy
describe the treatment of anorexia
supplements may be helpful
common complications of anticancer drug therapy
describe the treatment of fatigue
- alternate periods of activity and rest
- cluster care
common complications of anticancer drug therapy
describe the treatment of alopecia
counsel patients - temporary, hair will grow back
common complications of anticancer drug therapy
describe treatment musocitis
oral ulcers that may extend down GI tract
- condition is temporary: lasts 7 -10 days
- use measures to decrease ulcerations: chewing ice before chemotherapy has been shown to help
common complications of anticancer drug therapy
describe treatment of infection
- infection control patient teaching
- filgrastim or colony stimulating factors (sargramostim) administration
common complications of anticancer drug therapy
describe bleeding prevention
- bleeding preacutions
- thrombopoietin or recombinant human interleukin-11 (oprelvekin) administration
- platelet administration
common complications of anticancer drug therapy
describe treatment of hyperuricemia
- encourage high fluid intake
- allopurinol adminstration
common complications of anticancer drug therapy
describe treatment of hand-foot syndrome
- decrease heat and friction
- ice and acetaminophen
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?
recombinant human interleukin-11 (oprelvekin)
to stimulate platelet production
what are some symptoms of tumor lysis syndrome and why does it happen
- hyperkalemia
- hyperphosphatemia
- hyperuricemia
- hypomagnesia
- hypocalcemia
- acidosis
cells die and stuff inside is released into the bloodstream
how do you treat and prevent tumor lysis syndrome
treat each lab value individually
- aggressive hydration
- sodium bicarbonate (for acidosis)
- allopurinol (hyperuricemia)
- insulin (for hyperkalemia)
- kayexalate (hyperphosphatemia)
