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pharm 2 exam 1 > drug therapy for tx of cancer > Flashcards

drug therapy for tx of cancer Flashcards

1
Q

cancer is a multi step process which means

A

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

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2
Q

abnormal cells have increasing capacity for

A

survival, proliferation, invasive, metastasis

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3
Q

common areas for metastasis

A

liver, lungs, bone and brain

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4
Q

top three most types of cancer

A
  1. lung 2. breast 3. prostate
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5
Q

causes of caner

A

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

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6
Q

drugs that kill cancer cells do what

A

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

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7
Q

drugs that treat cancer are most active

A

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

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8
Q

cancer drugs are dosed on

A

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

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9
Q

cancer drugs are hard on

A

the liver and kidneys

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10
Q

how chemotherapy is given

A

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

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11
Q

goals of nursing interventions for pt with cancer

A

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

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12
Q

types of antineoplastic drugs (cancer drugs)

A

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

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13
Q

alkylating drugs

A

cyclophosphamide & cisplatin

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14
Q

alkylating drugs: cyclophosphamide

A

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)

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15
Q

alkylating drugs: cisplatin

A

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

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16
Q

check patient line when giving cisplatin because

A

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

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17
Q

antimetabolite drugs miscellaneous

A

methotrexate, fluorouracil, hydroxyurea

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18
Q

what do antimetabolite drugs do

A

mimics the molecule that a cell needs to grow

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19
Q

antimetabolite drugs: methotrexate (hazardous drugs)

A

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

20
Q

antimetabolite drugs: flourouracil

A

given as a topical, so not use metal to apply

21
Q

antimetabolite drugs: hydroxyurea

A

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

22
Q

what is chemo precautions

A

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

23
Q

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

A

extraversion/ can cause this if IV is not patent

24
Q

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?

A

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)

25
Q

antitumor antibiotics

A

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

26
Q

biologic Antineoplastics drugs work in what way

A

use your own body to fight the cancer

27
Q

biologic Antineoplastics drugs

A

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

28
Q

antineoplastic hormone inhibitors

A

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

29
Q

antineoplastic hormone inhibitors work in what way

A

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

30
Q

antineoplastic hormone inhibitors: tamoxifen

A

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

31
Q

antineoplastic hormone inhibitors: anastrozole

A

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

32
Q

cytoprotectants work in what way

A

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

33
Q

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

A

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

34
Q

cytoprotectants drugs

A

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)

35
Q

common complications of anticancer drug therapy

A

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

36
Q

common complications of anticancer drug therapy: N/V

A

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

37
Q

common complications of anticancer drug therapy: anorexia

A

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

38
Q

common complications of anticancer drug therapy: fatigue

A

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

39
Q

common complications of anticancer drug therapy: alopecia

A

counsel pts, temporary complication, hair will grow back

40
Q

common complications of anticancer drug therapy: mucositis

A

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

41
Q

common complications of anticancer drug therapy: infection

A

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

42
Q

common complications of anticancer drug therapy: bleeding

A

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

43
Q

common complications of anticancer drug therapy: hyperuricemia

A

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

44
Q

common complications of anticancer drug therapy: hand foot syndrome

A

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

45
Q

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?

A

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

46
Q

tumor lysis syndorme

A

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

47
Q

how to prevent and treat tumor lysis syndrome

A

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

pharm 2 exam 1 (7 decks)

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