drug therapy for tx of cancer

Question 1

cancer is a multi step process which means

Answer 1

it starts with one abnormal cell, a mutation or tumor initiation

Question 2

abnormal cells have increasing capacity for

Answer 2

survival, proliferation, invasive, metastasis

Question 3

common areas for metastasis

Answer 3

liver, lungs, bone and brain

Question 4

top three most types of cancer

Answer 4

1. lung 2. breast 3. prostate

Question 5

causes of caner

Answer 5

radiation (solar UV radiation), chemicals (smoking), viruses (HPV),

Question 6

drugs that kill cancer cells do what

Answer 6

interfere with cell replication, nutrient use or supply, genetic materials

Question 7

drugs that treat cancer are most active

Answer 7

against rapidly dividing cells, responsible for the negative side effects (bone marrow, GI tract)

Question 8

cancer drugs are dosed on

Answer 8

weight, so do not become pregnant while on this drug or months after drug treatment (teratogenic)

Question 9

cancer drugs are hard on

Answer 9

the liver and kidneys

Question 10

how chemotherapy is given

Answer 10

oral, IV, topical (for skin cancers), injection into deep muscle, intrathecal (directly given into space that occupies brain and spinal cord), intra-arterial

Question 11

goals of nursing interventions for pt with cancer

Answer 11

education!!, provide supportive care, strengthen host defenses, safe chemotherapy administration, assess for reduction of tumor size and normal lab values, assess for adverse reactions

Question 12

types of antineoplastic drugs (cancer drugs)

Answer 12

alkylating drugs, antimetabolites/ antifolates, anti tumor antibiotics/ plant alkaloids, biologic antineoplastic drugs, antineoplastic hormone inhibitors, cytoprotectant drugs

Question 13

alkylating drugs

Answer 13

cyclophosphamide & cisplatin

Question 14

alkylating drugs: cyclophosphamide

Answer 14

treats many different types of cancer, given oral or IV, different dosages, *can cause bladder toxicity, you want to drink 2 L fluid (flush out chemo/ over hydrate 1-2 days after taking), administer antiemetics (will vomit a lot)

Question 15

alkylating drugs: cisplatin

Answer 15

treatment of advanced bladder, ovarian and testicular cancer, given IV only, *must verify patent line prior to administration

Question 16

check patient line when giving cisplatin because

Answer 16

it can cause severe extravasation (give sodium thiosulfate which is the antidote)

Question 17

antimetabolite drugs miscellaneous

Answer 17

methotrexate, fluorouracil, hydroxyurea

Question 18

what do antimetabolite drugs do

Answer 18

mimics the molecule that a cell needs to grow

Question 19

antimetabolite drugs: methotrexate (hazardous drugs)

Answer 19

**teratogenic (prevents folic acid from being produced), given oral, IM, IV, subQ, intrathecally/ used for arthritis as well

Question 20

antimetabolite drugs: flourouracil

Answer 20

given as a topical, so not use metal to apply

Question 21

antimetabolite drugs: hydroxyurea

Answer 21

given orally only, Do not crush or break (treats sickle cell as well)

Question 22

what is chemo precautions

Answer 22

avoid direct contact with drug and bodily fluids/ wear gloves, goggles, gowns and masks

Question 23

the nurse is caring for a patient receiving cisplatin. The nurse is most concerned about which of the following complications?

Answer 23

extraversion/ can cause this if IV is not patent

Question 24

The pt has a new diagnosis of cancer and will be receiving cyclophosphamide. The nurse is teaching the pt about this new medication. Which of the following response by the nurse is correct?

Answer 24

it is important to drink at least 2 L of water per day for 1-2 days after your dose (because it can cause bladder toxicity)

Question 25

antitumor antibiotics

Answer 25

interfere with DNA replication, does not treat infection, they are used to kill cancer cells

Question 26

biologic Antineoplastics drugs work in what way

Answer 26

use your own body to fight the cancer

Question 27

biologic Antineoplastics drugs

Answer 27

monoclonal antibodies (rituximab), growth factor and tyrosine kinase inhibitors (must be swallowed whole or completely dissolved in water), proteasome inhibitors

Question 28

antineoplastic hormone inhibitors

Answer 28

tamoxifen, anastrozole (normally taken for several years, need bone mineral density testing)

Question 29

antineoplastic hormone inhibitors work in what way

Answer 29

decreasing or lowering the amount of estrogen produced by the body, which helps stop or slow done the product of breast tumors

Question 30

antineoplastic hormone inhibitors: tamoxifen

Answer 30

treats and reduces risk of breast cancer, given orally, double glove is handling or splitting the pill

Question 31

antineoplastic hormone inhibitors: anastrozole

Answer 31

treats breast cancer, given orally, do not need to double gloves

Question 32

cytoprotectants work in what way

Answer 32

used to reverse the adverse effects of cancer drugs (protectors of the body)

Question 33

bone marrow produces RBCs, WBCs, and platelets. Chemo does what to bone marrow

Answer 33

nuking the bone marrow, chemo pts will normally have low RBC and WBC and platelet count

Question 34

cytoprotectants drugs

Answer 34

epoetin alfa (used for anemia), filgrastim (helps with WBC production), leucovorin (acts as folic acid, used with methotrexate), recombinant human interleukin-11 (help with thrombocytopenia/ get platelets up)(oprelvekin), colony stimulating factor (immune booster help with WBC)(sargramostim)

Question 35

common complications of anticancer drug therapy

Answer 35

N/V, anorexia, fatigue, alopecia, mucositis, infection, bleeding, hyperuricemia, hand foot syndrome

Question 36

common complications of anticancer drug therapy: N/V

Answer 36

treat with serotonin receptor antagonist and a corticosteroid/ palonosetron/ benzodiazepines also effective

Question 37

common complications of anticancer drug therapy: anorexia

Answer 37

supplements will help (taste buds change, don't want to eat)

Question 38

common complications of anticancer drug therapy: fatigue

Answer 38

alternate periods of activity and rest (don't have enough RBC which carry oxygen throughout the body, cancer pts have low hemoglobin)

Question 39

common complications of anticancer drug therapy: alopecia

Answer 39

counsel pts, temporary complication, hair will grow back

Question 40

common complications of anticancer drug therapy: mucositis

Answer 40

lasts 7-10 days, use measures ro decrease ulcerations (ulcers of oral cavity), chew on ice prior to chemotherapy

Question 41

common complications of anticancer drug therapy: infection

Answer 41

pt teaching about infection control (has a very week immune system, low WBC), administer filgrastim or colony stimulation factor (sargramostim)

Question 42

common complications of anticancer drug therapy: bleeding

Answer 42

administer thrombopoeitin (oprelveki) and platelets (low platelet count so they do not have those clotting factors -> do not want pt to fall)

Question 43

common complications of anticancer drug therapy: hyperuricemia

Answer 43

encourage high fluid intake, administer allopurinol (decreases uric acid)

Question 44

common complications of anticancer drug therapy: hand foot syndrome

Answer 44

have decreased heat and friction, use ice and acetaminophen (this is very painful)

Question 45

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

Answer 45

recombinant human interleukin-11 (oprelveki)/ stimulates platelet production

Question 46

tumor lysis syndorme

Answer 46

killing a bunch of cells at once, will get dumped out into the blood stream causing hyperkalemia, hyperphosphatemia, hyperuricemia, hypomagnesemia, hypocalcemia, acidosis / peeing a lot out

Question 47

how to prevent and treat tumor lysis syndrome

Answer 47

aggressive hydration, sodium bicarbonate (treats the acidosis) and allopurinol (treats the hyperuricemia) (treats each electrolyte separately)