Module 16 - Anti-neoplastic Medication

Question 1

Antineoplastic - Medication Types (3)

Answer 1

1) Alkylating Agents
2) Hormones and hormone antagonist having anti-neoplastic activity
3) Biological Responses Modifiers (BRMs)

Question 2

Alkylating Agents - Action and Use

Answer 2

• Common class of drug used for chemotherapy can be taken IV/Orally
• Affects cancer cells as DNA can not be copied or replicated properly
• Kills the rapid replicating cells
• Decrease of malignant cells it the main action
  Medication: Cyclophosphamide (Cytoxan)

Question 3

Alkylating Agents - Side/Adverse Effect

Answer 3

• Bone marrow suppression
• Hair loss
• Urinary retention/pain
• Palpitations
• Hemorrhages
• Sore throat
• Bruising
• Dyspnea
• Dizziness
• Nausea
• Edema
• Weight loss

Question 4

Alkylating Agents - Role of LPN?

Answer 4

Chemotherapy administration cannot be done by the LPN

- Main role is supportive/after care, education and symptomatic relief care

Question 5

Alkylating Agents - Nursing Considerations

Answer 5

• Hypersensitive to lactose
• Vitals (BP, HR, RR and temperature)
• Monitor urine output
• Encourage fluid intake
• Monitor bone marrow depression
• Assess for bleeding
• Assess Nutrition and weight
• Assessments for Cardiac and Respiratory function
• Ensure client takes the medication in the early morning
• Ensure client has proper hand hygiene – high infection risk

Question 6

Hormonal Therapy - Actions and Use

Answer 6

• Adds/Removes hormones (estrogen) to slow or stop the growth of some cancers
• Usually combined with other cancer treatments
  Medication: tamoxifen (Apo-Tamox)
  Treatment: Breast Cancer
• Reduces the chance of developing
• Mimics estrogen

Question 7

Hormone antagonist - Actions and Uses

Answer 7

• Anti-Hormone therapy
• Competes with estrogen for binding sites in breast and other tissues
• Reduces DNA synthesis and estrogen response
• Suppresses tumor growth

Question 8

Hormone antagonist - Side/Adverse Effects

Answer 8

• Stroke
• Confusion
• Depression
• Headaches
• Weakness
• Blurred vision
• Nausea
• Vomiting
• Edema
• Thrombosis
• Hypercalcemia

Question 9

Hormone antagonist - Nursing Considerations

Answer 9

• Assess LOC
• Assess mood/behavior
• Assess Ca+ levels
• Nutrition – Take weight
• Monitor for bleeding – hemorrhage/thrombosis
• Ensure client takes medication as instructed
• Educate on bone health and skin lesions – bleeding risks
• Edema

Question 10

Biological Response Modifiers - Actions and Use

Answer 10

• Natural or engineered substances used to stimulate, boost or act like body’s immune system
• Enhance body’s response to destroy cancer cells by changing their behaviour
• Slows the growth of cancer cells
• Lessons the spread of cancer
  Medication: imatinib mesylate (Gleevec)

Question 11

Biological Response Modifiers - Side/Adverse Effect

Answer 11

• Fatigue
• Headache
• Weakness
• Urinary retention
• Edema
• Fever
• Cough
• Dyspnea
• Pneumonia
• Blurred vision
• Anorexia
• Constipation
• Nausea
• Vomiting

Question 12

Biological Response Modifiers - Nursing Consideration

Answer 12

• Vital Signs (RR, temperature)
• Assessment of respiratory
• Asses renal function
• Edema
• Encourage fluid intake
• Intake/output
• Assess LOC
• Educate on medication administration and ensure taking properly
• Ensure client does not drive or operate heavy machinery

Question 13

Identify health behavior management to minimize symptoms of cancer

Answer 13

• Healthy diet
• Positive lifestyle changes
• No Smoking
• Limit alcohol
• Ensure sunscreen is put on when in the sun – protective gear (hat, long sleeves)
• Exercise
• Ensure self testing
• Follow ups with health professional