TEST 3 - ANTINEOPLASTIC DRUGS - (ANTI-CANCER) CCS

Question 1

• Cytotoxic during a specific cell cycle phase
• More effective against rapidly growing tumors
• Used to treat a variety of solid tumors and some hematological malignancies

Answer 1

CELL CYCLE-SPECIFIC (CCS)

Question 2

ANTIMETABOLITES

WHAT IS A COMMON Folate antagonists?

Answer 2

methotrexate raltitrexed disodium

Question 3

INDICATIONS FOR ANTIMETABOLITES

Answer 3

Used in combination with other drugs
**Treats solid tumors & hematological malignancies **
•Oral & topical forms are used for lose-dose maintenance and palliative cancer therapy

Question 4

WHAT ARE THE ADVERSE EFFECTS OF ANTIMETABOLITES?

Answer 4

** Myelosuppression (Bone Marrow Suppression)

Question 5

WHAT ARE THE COMMON DRUGS FOR EACH CLASS FOR MITOTIC INHIBITORS?
•Epipodophyllotoxin derivatives (1)
•Taxanes – ‘taxel’ drugs (2)
•Vinca alkaloids – ‘vin’ drugs (1)

Answer 5

•Epipodophyllotoxin derivatives
Etoposide

•Taxanes – ‘taxel’ drugs
Paclitaxel
Docetaxel

•Vinca alkaloids – ‘vin’ drugs
Vincristine

Question 6

ADVERSE EFFECTS FOR MITOTIC INHIBITORS

Answer 6

•Liver, kidney, lung toxicities
*Convulsions
•Extravasation

Question 7

Inhibits DNA function & prevent DNA relegation
TOPOISOMERASE I INHIBITORS
NAME A TOPOISOMERASE I INHIBITORS (1)

AND PROVIDE AN INDICATION FOR USE (2)

Answer 7

Irinotecan (Camptosar)

• Ovarian & colorectal cancer
• Small-cell lung cancer & others

Question 8

Synthesized using cultures of bacteria and recombinant DNA technology
ANTINEOPLASTIC ENZYMES
LIST TWO AND PROVIDE THE INDICATION

Answer 8

o Asparaginase
o Pegaspargase (not commonly used)

(Asparaguses)

USED FOR ACUTE LYMPHOCYCTIC LEUKEMIA

Question 9

ANTIMETABOLITES

WHAT ARE THREE Purine antagonists?

Answer 9

cladribine (Leustatin) – not widely used

fludarabine phosphate

allopurinol

Question 10

ANTIMETABOLITES

WHAT IS A COMMON Pyrimidine antagonists?

Answer 10

cytarabine fluorouracil

Question 11

ADVERSE EFFECTS FOR TOPOISOMERASE I INHIBITORS

Answer 11

•Cholinergic diarrhea (delayed, occurring 2 to 10 days after dosage) (irinotecan [Camptosar]) ***

Question 12

ANTINEOPLASTIC ENZYMES ADVERSE EFFECTS

Answer 12

•Impaired pancreatic function. Leads to:
Hyperglycemia
Severe or fatal pancreatitis

Question 13

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Assess ______ _______ _______before giving any antineoplastic drugs because of myelosuppression (bone marrow suppression)

Answer 13

baseline blood counts

Question 14

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Danger of _______________ of vesicants – leads to massive tissue injury or irritants – less damage if infiltrated

Answer 14

EXTRAVASATION

Question 15

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

If extravasation occurs:

Answer 15

o STOP INFUSION. CALL DR. 
o LEAVE CATHETER IN PLACE
o ATTEMPT TO ASPIRATE ANY RESIDUAL DRUG AND BLOOD FROM CATHETER
o ADMINISTER ANDIDOTE AS PER PHARMACIST.
o USE HOT/COLD PACKS AS INDICATED

Question 16

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Given IV – using _______ _______ ___ ________rather than peripheral catheters is recommended

Answer 16

central venous IV catheters

Question 17

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Remember rapidly dividing cells (normal & cancer cells) are effected: LIST THE CELLS THAT ARE MOST EFFECTED

Answer 17

o Mucus membranes
o Hair follicles
o Bone marrow component
MONITOR FOR EFFECTS OR COMPLICATIONS ON THESE TISSUES

Question 18

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS
•Monitor for complications & implement measures to reduce effects:

GI mucus membranes:

Answer 18

Stomatitis (lesions & sores in mouth) – most distressful symptom

Altered bowel function with high risk for poor appetite, nausea, vomiting, diarrhea, and inflammation and possible ulceration of GI mucosa

Question 19

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS
•Monitor for complications & implement measures to reduce effects:

Hair follicles:

Answer 19

Loss of hair (alopecia)

Question 20

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS
•Monitor for complications & implement measures to reduce effects:

Bone marrow components

Answer 20

Dangerously low blood cell counts (life-threatening)

Question 21

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Take measures to monitor for and prevent infection in patients with?

Answer 21

neutropenia or leukopenia

Question 22

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Monitor & prevent bleeding in patients with?

Answer 22

thrombocytopenia and anemia

Question 23

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

may result in severe fatigue?

Answer 23

anemia

Question 24

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

WHAT works better if given 30-60 minutes before chemo

Answer 24

Anti-emetics

Question 25

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Women of childbearing age need to use?

Answer 25

a nondrug form of contraception (DICK SOCK) during therapy & sometimes for months afterward because chemo is a teratogen

Question 26

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Monitor for __________ _________& possible ___________ _________.

Answer 26

therapeutic responses & POSSIBLE ADVERSE EFFECTS

Therapeutic responses are not always as obvious as adverse effects

Question 27

GENERAL NURSING IMPLICATIONS FOR CCS DRUGS

Advise clients to avoid?

Answer 27

crowds & persons with infections