Hematology, Oncology, & Immune Drug List for MS Flashcards
Folic Acid
Trade Name: FA-8
Classification: Coenzyme; nutritional supplement
Common use: megaloblastic and macrocytic anemias
Common Side/Adverse Effects: nausea, bloating, rash, allergic reactions
Nursing Interventions: Assess for relief of from anemia symptoms (fatigue, pallor, SOB)
Teaching points: Eat folic-rich foods such as dark leafy greens, fruits, and beans.
Cobalamin
Trade Name: Nascobal
Classification: Coenzyme; vitamin, antianemic
Common use: pernicious anemia
Common Side/Adverse Effects: diarrhea, pruritus, peripheral vascular thrombosis, pulmonary edema
Nursing Interventions: Assess for HF, hypokalemia, and pulmonary edema for pts receiving it via IM or subcu. Assess for relief of from deficiency symptoms (fatigue, pallor, ataxia)
Teaching points: Pernicious anemia may require life-long treatment. Eat vitamin B12-rich foods such as muscle meats, herring, enriched cereals, and egg yolks.
Niacin
Trade Name: Niacor, Niaspan, Slo-Niacin
Classification: antihyperlipidemic, water-soluble vitamin
Common use: dyslipidemias, hypertriglyceridemia
Common Side/Adverse Effects: Flushing in face and neck, upset BI, pruritus, dysrhythmias
Nursing Interventions: Evaluate flushing and degree of abdominal discomfort. Monitor hepatic function, cholesterol and triglyceride levels. Assess skin for dryness or rash.
Teaching points: Can cause skin to warm and blush. Report dizziness, nausea, yellowing of skin, dark urine, and weakness. Take at bedtime with a low-fat snack.
Ferrous Sulfate
Trade Names: Fer-In-Sol, Fer-Iron, Slow-Fe
Classification: iron supplements; antianemic
Common use: iron-deficiency anemia
Common Side/Adverse Effects: nausea, GI upset, constipation or diarrhea, heartburn
Nursing Interventions: Monitor iron, Hgb, reticulocyte count, and ferritin levels. Monitor bowel activity and stool consistency. Assess for relief of from anemia symptoms (paresthesia in extremities, fatigue, pallor, SOB)
Teaching points: Oral liquid may stain teeth; prevent by diluting with water or OJ and drink with a straw. Take with food or after meals. Expect darkened stools
Morphine
Black Box Alert
Trade Names: Duramorph, Embeda, Infumorph, Kadian
Classification: Opioid agonist; opioid analgesic
Common Use: Severe pain, decreases anxiety
Common Side/Adverse Effects: Confusion, sedation, HoTN, constipation, resp depression
Black Box Warning: Addiction, abuse, misuse
Nursing Interventions: Take vitals before and after administration. Watch for decreased resp and BP. Monitor bowel activity/consistency.
Teaching points: Change positions slowly, call for assistance when ambulating. Avoid tasks that require alertness. Avoid alcohol and other CNS depressants. Report constipation, urinary retention, and ineffective pain treatment.
Hydromorphone
Black Box Alert
Trade Name: Diluadid, Exalgo, Hydromorph
Classification: opioid agonist; narcotic analgesic, antitussive
Common use: moderate to severe pain
Common Side/Adverse Effects: drowsiness, dizziness, HoTN, respiratory depression
Black Box Warning: High abuse potential. Respiratory depression risk. Overdose may result in death.
Nursing Interventions: Monitor vitals, assess pain. Monitor daily stool activity and stool consistency.
Teaching points: Deep breathe and cough. Change positions slowly. Avoid tasks that required mental alertness.
Prednisone
Trade Names: Rayos, Sterapred
Classification: adrenal corticosteroid; glucocorticoid
Common Use: Arthritis, immune system and blood disorders, allergies
Common Side/Adverse Effects: Insomnia, heartburn, abd distention, diaphoresis
Nursing Interventions: Monitor BP, electrolyte levels, glucose, bone mineral density, height and weight in children. Be alert for s/s of infection. Assess oral cavity for signs of candida.
Teaching Points: Report any fever, sore throat, aching muscles, swelling, loss of appetite, or sudden weight gain. Avoid alcohol. Strictly maintain good oral hygiene.
Methylprednisolone
Trade Name: Solu-Medrol
Classification: corticosteroid; anti-inflammatory
Common use: inflammation, symptoms of cancer, allergies
Common Side/Adverse Effects: insomnia, heartburn, hypocalcemia, osteoporosis, diaphoresis
Nursing Interventions: monitor I&O, weight, edema. Monitor serum electrolytes, signs of hypocalcemia and hypokalemia.
Teaching points: Take with food or milk. Don’t abruptly discontinue taking drug. Report any muscle aches, fever, edema, loss of appetite, sudden weight gain or loss.
Ibuprofen
Black Box Alert
Trade Name: Advil, Caldolor, Motrin
Classification: NSAID; antirheumatic, analgesic, antipyretic, antidysmenorrheal
Common use: fever, rheumatoid disorders, osteoarthritis, mild to moderate pain
Common Side/Adverse Effects: n&v, dyspepsia, rash, dizziness, metabolic acidosis
Black Box Alert: Increases risk of thrombotic events (MI, CVA). Increases risk of severe GI reactions.
Nursing Interventions: Monitor CBC, renal and liver function. Assess for rash, any signs of bleeding, Evaluate for therapeutic response.
Teaching points: Avoid aspirin and alcohol. Report tinnitus, persistent abd pain, dyspnea, unusual bleeding/bruising, chest pain, or palpitations. Take with food, milk, or antacids.
How chemotherapy works
Systemic treatment because it works and goes throughout the bloodstream.
Cell cycle non-specific chemo = no particular pick in the cell cycle interruption.
Cell cycle specific chemo = likes to interrupt a specific cell cycle.
Combination on both can work too because the cell can be smart and adapt/mutate.
Trastuzumab
Black Box Alert
Trade Name: Herceptin
Classification: antineoplastic
Common use: HER2 breast cancer, cancer of stomach, and esophagus
Common Side/Adverse Effects: Pain, asthenia, fever, chills, n&v
Nursing Interventions: Monitor for deteriorating cardiac function. Assess for asthenia. Monitor for fever, chills, back and abd pain, nausea.
Teaching points: Avoid those who recently got the oral polio vaccine. Avoid crowds of people. Don’t get immunizations w/o physician’s approval.
Bevacizumab
Black Box Alert
Trade Name: Avastin
Classification: antineoplastic
Common use: ovarian, lung, kidney, cervical, breast, brain, and colorectal cancer
Common Side/Adverse Effects: asthenia, anorexia, HTN, vomiting, UTI
Nursing Interventions: Monitor bp for HTN. Monitor for fever, chills, pain, epistaxis. Give antiemetic for n&v.
Teaching points: Avoid crowds. Avoid anyone who recently got a live virus vaccine. Don’t get immunizations w/o physician’s approval.
Erythropoietin
aka EPO; hormone made by the kidneys
Classification: hormone
Common Use: anemia, myelodyplasia, along with blood transfusions because of chemo
Common Side/Adverse Effects: diarrhea, anaphylaxis, headache HTN
Nursing Interventions:
Teaching points:
Filgrastim
Trade Name: Neupogen
Classification: biologic modifier; colony-stimulating factor
Common use: stimulates growth and activation of neutrophils
Common Side/Adverse Effects: n&v, mild to severe bone pain, alopecia
Nursing Interventions: Watch for adult respiratory distress syndrome in septic pts. Closely monitor those w/ preexisting cardiac disorders. Monitor platelet count, HFT, temperature, CBC w/ differential, BP.
Teaching points: Report chills, fever, palpitations, severe bone pain, and chest pain.
Tamoxifen
Black Box Alert
Trade Name: Soltamox
Classification: nonsteroidal antiestrogen; antineoplastic
Common use: breast cancer
Common Side/Adverse Effects: hot flashes, n&v, retinopathy
Black Box Warning: Serious, possibly fatal, stroke, PE, uterine malignancy
Nursing Interventions: Be alert for bone pain. Monitor for edema. Assess for hypercalcemia.
Teaching points: Report vaginal bleeding/discharge/itching, leg cramps, SOB, weakness. May initially experience bone pain. Report persistent n&v
Raloxifene
Black Box Alert
Trade Name: Evista
Classification: selective estrogen receptor modulator; osteoporosis preventive
Common use:prevention of osteoporosis and risk of invasive breast cancer
Common Side/Adverse Effects: hot flashes, flu-like symptoms, arthralgia, pneumonia
Black Box Warning: Increases risk of DVT. Women w/ coronary hr disease are at increased risk for death due to stroke
Nursing Interventions: Monitor total cholesterol, calcium, inorganic phosphate, protein, albumin, platelet count, and bone mineral density.
Teaching points: Avoid prolonged periods of not moving while traveling. Take calcium and vitamin D. Engage in weight-bearing exercise.
Marijuana
Mainly from Cannabis sativa plant
High THC = usually for recreational use
High CBD = for seizures, anxiety, paranoia
Can help treat n/v from chemo and relieve neuropathic pain.
Methotrexate
Black Box Alert
Trade Names: Otrexup, Rasuvo, Trexall, Xatmep
Classification: Antimetabolite; Antineoplastic, antiarthritic, antipsoriatic
Common Use: Rheumatoid arthritis, psoriasis; cancer of the lung, head and neck, blood, bone, breast,
Common Side Effects: N&V, low blood count, kidney toxicity
Black Box Warning: May cause fetal abnormalities or death. May produce fatal chronic hepatotoxicity. Do not use for psoriasis or rheumatoid arthritis treatment in pregnant women.
Nursing Interventions: Monitor CBC, LFT, urinalysis, chest XR, uric acid hematologic toxicity. Assess skin for dermatologic toxicity.
Teaching Points: Strictly maintain oral hygiene. Don’t have immunizations w/o physician’s approval. Avoid crowds (risk of infection). Avoid alcohol, aspirin, UV light.
Hydroxyurea
Black Box Alert
Trade Name: Droxia, Hydrea
Classification: synthetic urea analogue; antineoplastic
Common use: leukemia, head and neck cancer
Common Side/Adverse Effects: n&a, anorexia, constipation/diarrhea, myelosuppression
Black Box Warning:Must be administered by trained personnel in handling chemo agents. Carcinogenic risk.
Nursing Interventions: Monitor for hematologic toxicity, s/s of anemia. Monitory daily pattern of bowel activity and stool consistency. Monitor CBC w/ differential, renal/hepatic function, uric acid
Teaching points: immediately report fever, sore throat, unusual bleeding or bruising at any site.
Aspirin 81 mg
Low-dose aspirin.
Usual info:
Trade Names: Bayer, Ascriptin, Bufferin, Durlaza, Ecotrin
Classification: Nonsterioidal salicylate; anti-inflammatory, antipiuretic, anticoagulant
Common Use: mild/mod pain, fever, platelet aggregation
Common side/adverse effects: GI discomfort, nausea, vomiting, tinnitus
Nursing Interventions: Monitor urinary pH for toxicity. Assess for ecchymosis (bruising). Evaluate for therapeutic response.
Teaching Points: Don’t chew/crush/dissolve/divide enteric-coated tabs. Avoid alcohol. Report tinnitus or GI pain/bleeding.
