Oncology Flashcards
What are antineoplastic medications?
They are medications that kill or inhibit the reproduction of neoplastic (tumor) cells.
They are used to cure, increase survival time, and decrease life-threatening complications.
General side effects of antineoplastic medications
Mucositis, alopecia, anorexia, nausea, vomiting, diarrhea, anemia, neutropenia, thrombocytopenia, infertility, neuropathy
General lab monitoring of antineoplastics
Monitor CBC (especially WBC and platelets) and electrolytes
What are the dangerous levels of platelets? (yellow and red zones)
Yellow zone: less than 50,000 mm3 (50 x 10(x9)/L), this level can cause prolonged bleeding from even minor trauma.
Red zone: less than 20,000 mm3 (20 x 10(x9)/L), this level can cause spontaneous and uncontrollable bleeding.
What signs do we monitor for thrombocytopenia?
Look for petechiae, ecchymoses (dark, bruised skin), bleeding gums and nosebleeds
What safety must nurses follow for chemo medications (4 general parameters)
Prepare in air vented space, wear PPE, discard used supplies in biohazard container, monitor for phlebitis or extravasation,
What are the signs of an anaphylactic reaction? (10)
Dyspnea, chest tightness, hives, tachycardia, dizziness, anxiety, flushed appearance, hypotension, decreased sensation, cyanosis
What are Alkylating medications?
- What are the 3 sub-types
Medications that break the DNA helix, interfering with DNA replication. They are cell phase non-specific.
- Nitrogen Mustard
- Nitrosoureas
- Alkalytic-like medications
General side effects of Alkylating medications
Anorexia, nausea and vomiting, stomatitis, rash
Name the (7) medications that are Nitrogen Mustards
Bendamustine, chlorambucil, cyclophosphamide, ifosfamide, estramustine, mechlorethamine, melphalan
Name the (3) medications that are Nitrosoureas
Carmustine, lomustine, streptozocin
Name the (8) medications that are Alkylating-like meds
Altretamine, busulfan, carboplatin, cisplatin, dacarbazine, oxaliplatin, temozolomide, thiotepa
What specific side effect does Busulfan have?
Hyperuricemia
What specific side effects do Chlorambucil and Mechlorethamine have?
Gonadal supression and hyperuricemia
What side effects does Cisplatin have?
Ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, nephrotoxicity
What side effects does Cyclophosphamide have?
Alopecia, gonadal suppression, hemmorhagic cystitis and hematuria
What side effect does Ifosamide have?
Nephrotoxicity
What must be administered with Ifosfamide to prevent cystitis?
Must administer Mesna
Special consideration for cyclophosphamide PO
Must be administered without food
What is antitumor antibiotic medication?
Medication that interferes with DNA and RNA synthesis .
They are cell phase non-specific.
Name the (9) medications that are antitumor antibiotics
Bleomycin sulfate, Dactinomycin, Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitomycin, Mitoxantrone, Valrubicin
General side effects of antitumor antibiotics
Nausea, vomiting, fever, bone marrow depression, rash, alopecia, stomatitis, gonadal suppression, hyperuricemia, vesication
What side effects does Daunorubicin have?
Heart failure and dysrhythmias
What side effects do Doxyrubicin and Idarubicin have?
- What might be given concurrently to reduce these effects
Cardiotoxicity, cardiomyopathy, electrocardiographic changes.
- Dexrazoxane is cardioprotective
What side effect does Bleomycin have?
Pulmonary toxicity
What are antimetabolite medications?
Medications that halt the synthesis of cell protein, their presence impairs cell division.
They are cell phase specific, affecting the S phase
General side effects of antimetabolite medications
anorexia, nausea, vomiting, diarrhea, alopecia, stomatitis, depression of bone marrow.
What are the (19) antimetabolite medications?
Azacitidine, Capecitabine, Cladribine, Clofarabine, Cytarabine, Decitabine, Floxuridine, Fludarabine, Fluorouracil, Gemcitabine, Hydroxyurea, Mercaptopurine, Methotrexate, Nelarabine, Pemetrexed, Pentostatin, Pralatrexate, Thioguanine, Uracil
What side effects does Cytarabine have?
Alopecia, stomatitis, hyperuricemia, hepatotoxicity
What side effects does Fluorouracil have?
Alopecia, stomatitis, diarrhea, phototoxicity, cerebellar dysfunction
What side effects does Mercaptopurine have?
Hyperuricemia and Hepatotoxicity
What side effects does Methotrexate have?
Alopecia, stomatitis, hyperuricemia, photosensitivity, hepatoxicity, hematological, gastrointestinal and skin toxicity
What might be administered with Methotrexate to reduce possibility of toxicity
Leucovorin
What are Mitotic inhibitor?
- What are the 2 sub-types?
Medications that prevent mitosis, causing cell death.
They are M cell phase specific.
- Vinca Alkaloids
- Taxanes
General side effects of Mitotic inhibitors
Leukopenia, neurotoxicity, ptosis, hoarseness, motor instability, anorexia, peripheral neuropathy, alopecia, stomatitis, hyperuricemia,
Name the (3) medications that are Vinca Alkaloids
Vinblastine sulfate, Vincristine sulfate, Vinorelbine
Name the (2) medications that are Taxanes
Docetaxel and Paclitaxel
What are Topoisomerase inhibitors?
Meds that block an enzyme needed for DNA synthesis and cell division.
They are cell phase specific, affecting phase G2 and S
General side effects of Topoisomerase inhibitors
Leukopenia, thrombocytopenia, anorexia, diarrhea, alopecia, orthostatic hypotension,
What are hormonal medications?
- Name the 5 sub-types
Meds that suppress the immune system and block normal hormones in hormones-sensitive tumors slowing their growth rate.
- Estrogens
- Antiestrogens
- Antiandrogens
- Progestins
- Others
Name the (4) Topoisomerase inhibitors
Etoposide, Irenotecan, Teniposide, Topotecan
Name the (2) Estrogens
Estramustine, Ethinyl Estradiol
Name the (7) Antiestrogens
Anastrozole, Exemestane, Fulvestrant, Letrozole, Raloxifine, Tamoxifen citrate, Toremifene
Name the (6) Antiandrogens
Bicalutamide, Flutamide, Goserelin acetate, Histrelin, Nilutamide, Triptorelin
Name the (2) Progestins
Medroxyprogesterone and Megestrol acetate
Name the (3) ‘Other’ hormonal medications
Asparaginase, Leuprolide acetate, Mitotane
General side effects of hormonal medications
Anorexia, nausea, vomiting, leukopenia, impaired pancreativ function, sex characteristic alteraion, hot flashes, weight gain, HTN, edema,
What side effects does Mitotane have?
Hemmhorragic cystitis, hypouricemia, hypercholesterolemia
What side effects does Tamoxifen have?
Edema, hypercalcemia, elevated cholesterol and elevated triglyceride levels. May decrease effect of estrogen.
What must we monitor with Asparaginase?
Must monitor pancreatic function
What are immunomodulator drugs?
- Name the 3 sub-types
Meds that stimulate the immune system torecognize cancer cells and take action to eliminate or destroy them.
- basic immunomodulator agents
- common monoclonal antibodies
- small molecule inhibitors
What are Interleukins?
Type of cell that helps immune cells to recognize and destroy abnormal body cells,
Whar are interferons?
Cell that slows tumor cell division, stimulates proliferation and causes cancer cells to differentiate into nonproliferative cells.
What are colony stimulating factors?
- Name the 4 sub-types
Medications that induce raid bone marrow recovery after supression by chemotherapy
- Granulocyte-Macrophage colony stimulating factor
- Granulocyte colony stimulating factor
- Erythropoietin
- Thrombopoietic growth factor
Name the (6) basic immunomodulators
Aldesleukin, Interferon alfa-2a, inerferon alfa-2b, interferon alfa-n3, recombinant interferon alfa-2a, recombinant alfa-2b,
Name the (7) common monoclonal antibodies
Bevacizumab, Cetuximab, Ibritumomab, Infliximab, Panitumumab, Rituximab, Trastuzumab
Name the (10) Small molecule inhibitors
Bortezomib, dasatinib, erlotinib, gefitinib, imatinib, lapatinib, nilotinib, sorafenib, sunitinib, temsirolimus
Name the Granulocyte-macrophage colony stimulating factor
Sargramostim
Name the (2) granulocyte colonony stimulating factors
Filgrastim and Pegfilgrastim
Name the (2) Erythropoeitins
Epoetin alfa and Darbepoetin alfa
Name the Thrombopoietic growth factor
Oprelvekin
What is target therapy?
Medications used as targeted therapies such as monoclonal antibodies and small molecule inhibitors that target a cellular element of the cancer cell
What is Altretamine?
Cytotoxic agent used to treat ovarian cancer
What is Denileukin Diftitox?
Recombinant DNA-derived med used to treat cutaneous T cell lymphoma
What is Pegaspargase?
Med used in combination chemotherapies for acute lymphoblastic leukemia in clients unable ot take Asparaginase
What is Bexarotene?
Med used to treat advacne stage cutaneous T-cell lymphoma