drug therapy for the treatment of cancer

Question 1

describe the multi step process of the path of cancer

Answer 1

starts with on abnormal cell then mutation or tumor initiation

Question 2

pathophysiology

abnormal cells have increasing capacity for…

Answer 2

• survival
• proliferation
• invasive
• metastasis

Question 3

where are the most common sites for metastasis

Answer 3

liver, lungs, bone, and brain

Question 4

what are three types of cancer with the higest mortality rates

Answer 4

1) lung
2) breast
3) prostate

Question 5

name some different causes of cancer

Answer 5

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

Question 6

do hormones cause cancer?

Answer 6

nope but they promote it

Question 7

describe drug therapy to treat cancer

Answer 7

• 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

Question 8

how is chemotherapy given

Answer 8

• oral
• intravenous
• injection
• intrathecal
• intra-arterial
• topical
• intraperitneal

Question 9

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

Answer 9

education

Question 10

name some different goals of nursing interventions for cancer patients

Answer 10

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

Question 11

name some types of different antineoplastic drugs

Answer 11

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

Question 12

alkylating agents work by…

Answer 12

preventing cancer cells from replicating

Question 13

name two alkylating agents

Answer 13

cyclophosphamide and cisplatin

Question 14

alkylating agents

describe cyclophosphamide

Answer 14

• 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

Question 15

alkylating agents

describe cisplatin

Answer 15

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

Question 16

what do you do for cisplatin extravasation

Answer 16

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

Question 17

what is the antidote for cisplatin extravasation

Answer 17

sodium thiosulfate

Question 18

antimetabolites work by…

Answer 18

mimicking the molecule that cells need to grow

Question 19

name some antimetabolites

Answer 19

• methotrexate
• fluorouracil
• hydroxyurea

Question 20

antimetabolites

describe methotrexate

Answer 20

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

also used for lupus and rheumatoid arthritis, hazardous drug

Question 21

antimetabolites

describe fluorouracil

Answer 21

• topical
• do not use metal to apply

Question 22

antimetabolites

describe hydroxyurea

Answer 22

• oral only
• do not crush or break

hazardous drug, also used to treat sickle cell

Question 23

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

Answer 23

extravasation

cisplatin can cause extravasation if IV is not patent

Question 24

what does the nurse incldue in pt teachig fro cyclophosphamide

Answer 24

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

Question 25

how do biologic antineoplastics work

Answer 25

use your own body to fight cancer | stimulate body to detect cancer cells and attack

Question 26

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

Answer 26

swallow whole or completely dissolve in water

Question 27

name two antineoplastic hormone inhibitors

Answer 27

- tamoxifen - anastrozole

Question 28

# antineoplastic hormone inhibitors describe tamoxifen

Answer 28

- treats and reduces risk of breast cancer - oral - double glove if splitting the pill

Question 29

what is important to remember about antineoplastic hormone inhibitors

Answer 29

need baseline and periodic bone mineral density testing for both meds | this is bc estrogen is important for bones

Question 30

what are cytoprotectants used for

Answer 30

used to reverse the adverse effects of cancer drugs

Question 31

name some different cytoprotectants

Answer 31

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

Question 32

# cytoprotectants describe epoetin alfa

Answer 32

- human erythropoietin - stimulates RBC production alongside chemotherapy - used for anemia

Question 33

# cytoprotectants describe filgrastim

Answer 33

helps with WBC production

Question 34

# cytoprotectants describe leucovorin

Answer 34

- acts as folic acid in body - used for high doses of methotrexate since methotrexate decreases folic acid

Question 35

# cytoprotectants describe recombinant human interleukin-11 (oprelvekin)

Answer 35

- helps with thrombocytopenia - helps get platelets up and prveent bleeding

Question 36

# cytoprotectants describe colony stimulating factor (sargramostim)

Answer 36

- immune booster - helps with WBC production

Question 37

# common complications of anticancer drug therapy how do you treat nausea and vomiting

Answer 37

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

Question 38

# common complications of anticancer drug therapy describe the treatment of anorexia

Answer 38

supplements may be helpful

Question 39

# common complications of anticancer drug therapy describe the treatment of fatigue

Answer 39

- alternate periods of activity and rest - cluster care

Question 40

# common complications of anticancer drug therapy describe the treatment of alopecia

Answer 40

counsel patients - temporary, hair will grow back

Question 41

# common complications of anticancer drug therapy describe treatment musocitis | oral ulcers that may extend down GI tract

Answer 41

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

Question 42

# common complications of anticancer drug therapy describe treatment of infection

Answer 42

- infection control patient teaching - filgrastim or colony stimulating factors (sargramostim) administration

Question 43

# common complications of anticancer drug therapy describe bleeding prevention

Answer 43

- bleeding preacutions - thrombopoietin or recombinant human interleukin-11 (oprelvekin) administration - platelet administration

Question 44

# common complications of anticancer drug therapy describe treatment of hyperuricemia

Answer 44

- encourage high fluid intake - allopurinol adminstration

Question 45

# common complications of anticancer drug therapy describe treatment of hand-foot syndrome

Answer 45

- decrease heat and friction - ice and acetaminophen

Question 46

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?

Answer 46

recombinant human interleukin-11 (oprelvekin) | to stimulate platelet production

Question 47

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

Answer 47

- hyperkalemia - hyperphosphatemia - hyperuricemia - hypomagnesia - hypocalcemia - acidosis | cells die and stuff inside is released into the bloodstream

Question 48

how do you treat and prevent tumor lysis syndrome

Answer 48

treat each lab value individually - aggressive hydration - sodium bicarbonate (for acidosis) - allopurinol (hyperuricemia) - insulin (for hyperkalemia) - kayexalate (hyperphosphatemia)