T3-Cancer Drugs

Question 1

What cancer drug has dose dependent neurotoxicity?

Answer 1

Vincristine

• observe closely for signs so dosage may be reduced
• Neurotoxicity may be permanent

Question 2

Vincristine may cause you to have dose dependent neurotoxicity. What is an early sign?

Answer 2

Do near checks frequently–Constipation is an early sign

Question 3

What drug do you need to monitor EKG, cardiac enzymes, and observe for cardiac decompensation?

Answer 3

Adriamycin

Question 4

What should we tell patients about adriamycin?

Answer 4

The drug causes a red discoloration of urine

life-time dose limit

Question 5

What are the SE to methotrexate? (MTX)

Answer 5

N/V

Stomatitis

Question 6

What must the urine pH be to give methotrexate? Why? What can be given following high doses?

Answer 6

pH 6.5 or greater (alkaline) during admin or MTX can precipitate in renal tubules

Leucovorin

Question 7

What drug has these adverse effects:

• High BP
• Hyperglycemia
• Gastric bleeding, ulceration
• Increased appetite
• Delayed healing
• Increased risk of infection
• Body appearance changes: Trunkal obesity and cushioned features (round face, hirsutism)

Answer 7

Prednisone

Question 8

What drug do you need to have good hydration prior to and during oral and IV admin. What is important about night time with this drug?

Answer 8

Cytoxan—bladder must be emptied frequently, even at night

Question 9

What drug should we be alert to possibility of allergic reactions and prepared to treat? *we should give a test dose prior to them starting this drug?

Answer 9

L-Asparaginase

Question 10

What is adriamycins adverse effect?

Answer 10

Cardiotoxicity: dose related, EKG changes, arrhythmia, CHF

Question 11

What is the adverse effect and nursing implications for mercaptopurine (6-MP)?

Answer 11

Hyperuricemia

Monitor uric acid levels

Allopurinol may be given to reduce uric acid levels

Question 12

What is the adverse effect of cytoxan (cyclophosphamine)?

Answer 12

Hemorrhagic cystitis

*good hydration!!

Question 13

What is neurotoxicity and what drug has this as an adverse effect?

Answer 13

Neurotoxicity:

• Foot, wrist drop
• Vocal cord paralysis
• Hoarseness
• Ptosis
• Ataxia
• Muscle weakness
• Paresthesia
• Constipation
• Paralytic ileus

Drug: Vincristine

Question 14

What drug has protein hypersensitivity? What is protein hypersentivity? And what is nursing implication?

Answer 14

L-asparaginase

Protein hypersensitivity: pruitis, urticaria, bronchial spasm, edema (of neck and lips), anaphylaxis

Be alert to allergic reactions

Question 15

What is the nursing action for prednisone?

Answer 15

Monitor BP, distress, and bleeding
Be alert to signs of infection
Observe for gastric bleeding

Question 16

What drug should we give with food or milk or an antacid?

Answer 16

Prednisone

Question 17

What should we know about drug Leucovorin?

Answer 17

It is a rescue drug that must follow high doses of MTX because MTX can precipitate in renal tubules