Exam 3 Flashcards
Mercaptopurine
Bone marrow suppression liver toxicity take antiemetic prior to emesis monitor weight and I&Os Wash fresh fruit & veggies, cook food properly Frequent oral care prevent stomatitis
Intrathecal Cytarabine
arachnoiditis-N/V, headache & fever
bone marrow suppression- Nadir 5-7 days WBC & platelets
Methotrexate
bone marrow suppression
leucovorin antidote
neutropenic precautions neutrophils < 500
Cyclophosphamide
Hyperkalemia, hyponatremia, leukopenia, hemorrhagic cystitis
Alopecia
Hemorrhagic cystitis prevented by giving mensa, voiding before each dose, and increasing fluid intake
Carmustine
bone marrow suppression. Nadir 4-6 weeks
decreased lung function, monitor PFT
Not in joints or AC bc increased risk infiltration and extravasation. NaHCO3 0.9% NS in line and subq. cold compress.
Cisplatin
bone marrow suppression, kidney toxicity, ototoxicity, peripheral neuropathy
antiemetic 30 mins prior. audiometric and KFT before each dose. 1-2 L fluid before tx with hydration for 24 hrs after
Doxorubicin
Cardiac Toxicity (rapid HR, palp., SOB, angina) -dexrazoxane infil./extrav- not in joint or AC. Stop immediately red streak bc histamine, slow rate
Tamoxifen
Hot flashes, retinopathy, cataracts, decreased visual acuity. Thromboembolism (Stroke or PE). Endometrial hyperplasia (increased risk uterine cancer, vaginal bleeding)
Anastrozole
Osteoporosis
Tylenol for muscle pain
Alendronate prevent osteoporosis, increase vitamin d and calcium.
Contraindicated: postmenopausal estrogen therapy
Vincristine
Alopecia in 20%. Damage if infil & extrav-subQ hyaluronidase. Severe constipation. Peripheral neuropathy. IV in forearm
Topotecan
Infused over 30 minutes. Bone marrow suppression- Neutropenia 12 days, thrombocytopenia 15 days. Alopecia in 50%. Frequent oral cares to prevent stomatitis
Filgrastim
increases bone marrow suppression with topotecan. give 24 hrs topotecan infusion complete.
Flutamide
gynecomastia, hot flashes, decreased libido and impotence. Liver toxicity-monitor AST & ALT. Begins when GnRH (leuprolide) starts. used to stop testosterone which promotes growth of prostate cancer.
Interferon alfa-2a
Flu-like and CNS symptoms. Bone marrow suppression. GI symptoms (Severe enough for wt loss)
Imatinib
fluid retention may lead to pulm edema. bone marrow suppression (WBCs & platelets). GI symptoms (Severe enough for wt loss).
Paclitaxel
bradycardia (w/o symptoms continue med). Peripheral neuropathy. Allergic reaction (Premedicate with antihistamine, corticosteroid, and PPI 30 mins before infusion). Pt report s/s allergic reaction.
Taxol
Non-PVC tubing and IV bag, in-line filter and infused over 3 hours.
Trastuzumab
allergic reaction (wheezing, hypotens, SOB, urticaria) Infusion reaction (flu-like symptoms) Cardiac symptoms (HF and dysrhythmias) CNS Symptoms
Maraviroc
cough and URI. Allergic reaction signs lead to liver damage. Liver toxicity.
Delavirdine ^ blood levels, decrease dose.
Penytoin decrease blood levels, ^ dose.
Ritonavir
Hyperglycemia and DM
Fat redistribution (abdominal fat, buffalo hump)
Increases cholesterol and triglycerides.
Decreased bone density (lead to osteoporosis)
Zidovudine
Bone marrow suppression (Anemia 2-4 weeks, neutropenia 6 weeks).
Decrease/withhold for hemoglobin < 7.5 of 25% less baseline and neutrophils < 750 or 50% less baseline.
Filgrastim PRN to increase WBC.
Enfuvirtide
pneumonia and allergic reaction.
inject subq, prep with sterile water, let vial sit until clear and no particulate (up to 45 minutes)
Delavirdine
Rash, steven-johnson’s syndrome (fever, lesions mouth or eyes, blisters, muscle pain. DISCONTINUE DRUG).
Persistent N/V/D can lead to wt loss.
Increases liver enzymes.
