Part 2 Flashcards
Chlorambucil
Alkylating
i - leukemia, lymphoma
ta - non cell cycle dependent, just kill, alkylates DNA and breaks DNA strands
ci - preg C/lact
c - BM sup, hep/renal dysfx (exacerbate)
ae - hemorrhagic cystitis, secondary leukemia, bladder cancer, BM sup
di - doxorubicin inc card toxicity
ni - pre-medicate N/V, inc fluid, empty stomach (stomatitis), daily weight (card toxicity), I/O (renal fx), monitor CBC, follow up lab for 3 weeks, mesna if cystitis, barrier contraceptive, adhere to med regimen (rebound tumor growth)
Methotrexate
Antimetabolite
i - cancer, arthritis
ta - s phase specific, inhibit folic acid - inhibit DNA replication - replace needed metabolites to produce DNA - inhibit folic acid
ci - GI ulcers, preg
c - BM sup, hep/renal dysfx
ae - GI (gastric ulcers, perforation, stomatitis), CNS, pulmonary toxicity, r/t BM sup,
di - dec digoxin
ni - leucovorin protect healthy cells (post-infusion 24 hrs only), monitor bleeding/bruising, platelet, breath sound; caution vitamin (folic acid), premedicate N/V, no driving
Doxorubicin
Antineoplastic ABX
i - cancer
ta - S phase specific, distort DNA structure and prevent repair - cell death
ci - GI ulcers, pulmonary dz, preg
c - BM sup, hep/renal dysfx
ae - red body fluid, card/pulm toxicity, superinfection
di - lung/heart toxic drug
ni - monitor heart ECG, breath sound; report fever, vaginal itching, thrush, hair regrows, support nutrition, vesicant
Vincristine
Mitotic inhibitor
i - x
ta - M phase specific, kill cells as mitosis begins
ci - BM sup, preg/lact
c - GI ulcer, neuro dz, hazardous (absorbed thru skin), BM sup, hep/renal dysfx
ae - extravasation, ataxia, cranial nerve dysfx, nerve pain/peripheral neuropathy, severe constipation/impaction, death
di - CNS/hep toxic drug
ni - monitor IV, neuro exam; stool softener/inc fluid
Tamoxifen
Hormone modulator
i - cancer sensitive to estrogen stimulation (breast tissue, ovaries, uterus)
ta - estrogen receptor blocker - blocks estrogen sensitive cancer growth
ci - hypercalcemia, preg
c - clot hx
ae - N/V, CVA, PTE, endometrial cancer, hypercalcemia, menustral irregularity, vaginal discharge/bleeding, hot flashes
di - inc warfarin, chemo thrombus
ni - monitor s/s VTE, PTE, CVA; report bleeding/spotting, inc weight bearing exercise, monitor Ca, bone density, PAP smear, hormone lv
Interferon a-2b
immunomodulator
i - autoimmune dz, hep B/C, cancer
ta - prevent virus from invading cells and inhibit cancer growth/replication
ci - preg
c - CNS dysfx, card dz
ae - immune/inflammatory dz r/t (flu s/s, neuropathy, depression, anxiety, insomnia, AMS, BM sup, HTN, arrhy)
di - vaccine
ni - monitor CNS (depression/personality change, SI), acetaminophen if body ache, refrigerate after mixing, give at room temp, do not shake
filgrastim
colony stimulating
i - reduce infection risk, dec neutropenia in transplant/cancer
ta - inc neutrophil production in bone marrow
ci - e-coli allergy, 24 hours before/after chemo
c - preg
ae - GI, HA, fatigue, weak, alopecia, dermatitis/rash, generalized bone pain, leukocytosis (high WBC), splenomegaly, splenic rupture risk
di - x
ni - tx bone pain, contraceptives, monitor skin, lab
aldesleukin
synthetic interleukins
i - metastatic melanoma, renal cancer
ta - stimulate immunity, inc killer cells - inhibit tumor growth
ci - e-coli allergy
c - preg, hep/renal dz
ae - MS change, hypoT, resp difficulty, fever/chills, aches/pains, GI bleed, dysarrhy
di - live vaccine
ni - monitor ECG, BP, breath sounds/pattern, CNS changes
cyclosporine
t/b cell suppressor
i - transplant rejection/prevention, psoriasis, RA
ta - block antibody production by B cells, inhibit suppressor and helper T cells, used w/ glucocorticoid
ci - neoplasm
c - preg
ae - renal damage (75%), infection (74%), HTN (50%), tremor, hirsutims, gingival hyperplasia, gynecomastia, malignancy lymphomas
di - nephrotoxic drugs (aminoglycoside), grapefruit inc toxicity
ni - monitor renal fx/labs, BP, cancer screening; reduce infection risk, ed body changes, use plastic/glass to mix liquid in milk/OJ, add liquid to empty cup/glass and drink remainder, inc fluid
bevacizumab
monoclonal antibody
i - colorectal/lung cancer, organ rejection
ta - inhibit vascular growth factor, dec angiogenesis and cell growth
ci - preg, purine allergy, fever, MAB received, fluid overload
c - same
ae - acute pulmonary edema, fluid retention, GI perforation/hem, would healing complication, cytokine release syndrome, N/V/D, infection, thrombotic events, cancer development
di - other immunosuppressive
ni - premedicate w/ diphenhydramine, monitor drug effect, s/s thrombosis, resp assessment; barrier contraceptive, infection risk, ed cannot stop this med
