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163 Cards in this Set
- Front
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cytotoxic chemotherapy agents
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antimetabolites
antitumor antibiotics antimiotics alkylating agent topoisomerase inhibitor |
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antimetabolites
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kill cancer cells by interrupting a specific phase of cell reproduction
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antitumor antibiotics
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kill cancer cells by stopping the synthesis of RNA, DNA, or proteins
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antimitotics
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kill cancer cells by inhibiting mitosis and preventing cell division
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anklyating agents
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kill fast-growing cancer cells by altering DNA structure and preventing cell reproduction
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topisomerase inhibitors
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kill cancer cells by interrupting DNA synthesis
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other
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kill cells by various mechanisms including interrupting DNA and RN synthesis in leukemia cells
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cytotoxic chemotherapy agents adverse
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nausea, vomiting, myelosuppression, alopecia
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antimetabolites
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folic acid analog
pyrimidine analog purine analogs |
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antimetabolite agents adverse
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bone marrow suppression, GI discomfort
intervention: monitor WBC, absolute neutrophil count, platelet count, Hgb, and Hct assess clients for bruising and bleeding gums avoid crowds and contact with infectious individual administer antiemetic before beginning chemo |
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methotrexate adverse (Folic acid analog)
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mucositis, gastric ulcers, perforation
reproductive toxicity renal damage due to hyperuricemia or elevated levels of uric acid intervention: monitor for GI bleeding, provide frequent oral hygeine, advise client not to become pregnant while taking these meds and 6 months after monitor kidney function and BUN, administer allopurinol if uric acid is elevated. |
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cytarabine adverse (pyrimidine analog)
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liver disease, pulmonary edema, arachnoiditis- manifestations may be treated with dethmethasone (Decadron)
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mercaptopurine (purine)
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liver toxicity, mucositis, gastric ulcers, perforation, reproductive toxicity
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methotrexate interactions
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salicylates, NSAIDs, sulfanomides, penicillin, and tetracyclines- methotrexate toxicity
folic acid changes the body's response to methotrexate- avoid folic acid supplements |
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cytarabine interactions
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may reduce digoxin (Lanoxin) level
may reduce gentamicin response to Klebsiella pneumonae |
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Mercaptopurine interactions
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allopurinol (Zyloprim) may reduce breakdown of mercaptopurine
mercaptopurine may either increase or decrease anticoagulant effect of warfarin- monitor PT and INR |
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folic acid analog
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proto: methotrexate (Rheumatrex, Trexall)
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pyrimidine analog
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proto: cytarabine
fluorouracil (Adrucil, Carac) Capecitabine (Xeloda) floxuridine (FUDR) |
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purine analog
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prot: mercaptopurine (Purinethol)
thioguanine (Tabloid) pentostatin (Nipent) fludarabine (Fludara) |
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folic acid analog MOA
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stops cell reproduction by inhibiting folic acid conversion
S-phase specific |
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pyrimidine analog MOA
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inhibits RNA and DNA synthesis of cancer cells
S- phase specific |
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purine analogs MOA
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interrupts RNA and DNA synthesis of cancer cells
S-phase specific |
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folic acid analog use
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choriocarcinoma, solid tumors, (breast, lung, head and neck sarcomas, acute lymphocytic leukemia, non-Hodgkins lymphoma)
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pyrimidine use
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acute myelogenous leukemia
solid tumors- such as breast and colon superficial skin cancers (flourouracil) |
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purine use
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acute lymphocytic leukemia
acute nonlymphocytic leukemia |
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methotrexate contraindications
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contraindicated in renal or hepatic failure, blood dyscrasias, or lactation
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cytarabine contraindications
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liver disease
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mercaptopurine
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contraindicated in clients who are resistant to medication
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antimetabolites admin
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give with sodium bicarbonate capsules to alkalinize urine
do not use birth control during treatment avoid alcohol during treatment monitor for bleeding and bruising jaundice |
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methotrexate admin
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administer leucovorin rescue to reduce toxicity to healthy cells.
take med on empty stomach protect skin from sunlight use birth control during and 6 months after |
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cytarabine admin
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monitor for indications of neurotoxicity, such as nystagmus
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antitumor antibiotics
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anthracyclines
nonanthracyclines |
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anthracyclines (antitumor)
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proto: doxorubicin (Adriamycin)
other: liposomal doxorubicin (Doxil) daunorubicin (Cerubidine) |
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nonanthracyclines (antitumor)
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proto: dacintomycin (Cosmegen)
other: bleomycin (Belnoxane) mitomycin (Mutamycin) dacintomycin, liposomal (Doxil) |
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anthracyclines MOA
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binds to DNA, altering it's structure
cell phase nonspecific |
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anthracycline use
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includes solid tumors, such as lung, bone, stomach, and breast cancer, Hodgkin's and non-Hodgkin's lymphoma
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nonanthracyclines MOA
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binds to DNA, altering structure
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nonanthracycline use
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Wilms tumor
rhabdomyosacroma choriocarcinoma Ewings sarcoma Kaposi's sarcoma |
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all antitumor drugs adverse
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bone marrow suppression
GI manifestations severe tissue damage due to extravasations of vesicants alopecia |
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doxorubicin (antitumor) adverse
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acute cardiac toxicity, dysrhythmias- can be treated with dexraoxane (Zinecard)
cardiomyopathy- may be treated with ACE inhibitor red coloration to urine and sweat- not a harmful effect |
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doxorubicin contraindications
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contraindicated in clients who have severe myelodepression and those who have had a lifetime cumulative dose of 550 mg/m2
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dacintomycin contraindications
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acute infections
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doxorubicin interactions
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calcium channel blockers- increase cardiotoxicity
phenobarbital- may increase metabolism of doxorubicin paclitaxel (Taxol) may decrease metabolism of doxorubicin doxorubicin may reduce phenytoin (Dilantin) levels |
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dacintomycin contraindications
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none noted
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antitumor admin
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reduce dose in liver disease
monitor for bleeding monitor CBC and liver enzymes doxorubicin- monitor for delayed cardiac toxicity |
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antimitotics
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Vinca alkaloids
Taxanes |
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vinca alkaloids (antimitotics)
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proto: vincristine (Oncovin, Vincasar PFS)
other: vinblastine (Velban) vinorelbine (Navelbine) |
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taxanes (antimitotics)
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proto: paclitaxel (Abraxane)
docetaxel (Taxotere) |
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vinca alkaloids MOA
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useful in combination with other chemotherapy med
stops cell division during mitosis not bone marrow toxic M-phase specific |
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vinca alkaloids use
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acute lymphocytic leukemia, Wilms tumor, rhabdomyosarcoma, solid tumors
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taxanes use
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ovarian , non-small cell lung tumors and Kaposi's sarcoma
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taxanes MOA
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stop cell division during mitosis
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vincristine (Vinca alkaloids) adverse
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peripheral neuropathy effects
alpopecia |
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paclitaxel (Taxane) adverse
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bone marrow suppression
bleeding caused by thrombocytopenia or low platelet count, anemia, or low RBCs bradycardia heart block MI Alopecia |
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vincristine contraindications
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contraindicated in CHarcot-Marie-Tooth syndrome
liver disease of neuromuscular disease |
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paclitaxel contraindications
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neutrophil count less than 1500 mm
use with caution who have myelosuppression |
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vincristine interactions
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vincristine may reduce effects of digoxin
mitomycin may increase risk for brochospasm vincristine may decrease level of phenytoin |
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paclitaxel interactions
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cisplatin or doxorubin may increase myelosuppression
cardiac meds that decrease heart rate such as beta blockers, calcium channel blockers and digoxin, can increase bradycardia |
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paclitaxel interactions
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meds that increase risk for bleeding such as NSAIDs and anticoagulants may increase bleeding risk
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antimitotic admin
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reduce dose for clients who have liver disease
assess for bronchospasm monitor for bleeding and infection monitor CBC and liver enzymes stop chemotherapy if extravasation occurs use birth control during treatment |
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ankylating agents
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nitrogen mustards
nitrosoureas platinum compounds |
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nitrogen mustards (ankylating agent)
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proto: cyclophosphamide (Cytoxan, Neosar)
other: mechlorethamine (Mustargen) bendamustine (Treanda) chlorambucil (Leukeran) |
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nitrogen mustards MOA
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kills rapid growing cells by interrupting DNA and RNA synthesis
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nitrogen mustards use
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acute lymphomas, solid tumors: head, neck, breast cancers, Hodgkins and non-Hodgkins lymphoma
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nitrogen mustards adverse
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acute hemmorrhagic cystitis- increase fluids (3L)
monitor for blood in urine, Mesna (Mesnex) may be given if needed alopecia |
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nitrosoureas (ankylating agent) MOA
carmustine (BiCNU, Gliadel) |
kills rapid growth cells by interrupting DNA and RNA synthesis
crosses blood brain barrier |
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nitrosoureas (ankylating agent) use
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brain tumors, Hodgkins, non-Hodgkins, and multiple myeloma
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nitrosoureas adverse
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pulmonary fibrosis
liver and kidney toxicity |
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platinum compounds (ankylating agent) MOA
cisplatin (Platinol) |
kills rapid growing cells by interrupting DNA and RNA synthesis
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platinum compounds use
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bladder, testicular, and ovarian cancers
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platinum compounds adverse
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renal toxicity
hearing loss monitor for tinnitus and hearing loss |
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nitrogen mustard (Cyclophosphamide) contraindications
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severe myelosuppression or severe infection
kidney or liver disorder or leukocytopenia or thrombocytopenia |
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nitrosoureas (Carmustine) contraindications
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severe myelosuppression or impaired liver function
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platinum compounds (Cisplatin)
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severe myelosuppression, kidney disorders, hearing loss
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cyclophasphamide interactions
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concurrent use of succinylcholine may cause increased neuromuscular blockage
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carmustine interactions
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concurrent use with cimetidine (Tagament) may increase bone marrow suppression
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cisplatin
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concurrent use with aminoglycosides may increase risk for renal toxicity
concurrent use with furosemide may increase hearing loss |
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ankylating agents admin
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monitor for blood in urine- Mesna (Mesnex) may be indicated
monitor CBC monitor hearing prior to treatment with cisplatin |
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topoisomerase inhibitors
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proto: topotecan (Hycamtin)
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topoisomerase inhibitor MOA
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kills cancer cells by interrupting DNA synthesis
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topoisomerase inhibitor use
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treats metastatic ovarian cancer, cervical cancer, and small cell lung cancer
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topoisomerase inhibitor adverse
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bone marrow suppression
bleeding caused by thrombocytopenia low platelet count anemia GI discomfort alopecia |
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topoisomerase inhibitor contraindications
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severe myelosuppression with a neutrophil count less than 1500 mm
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topoisomerase inhibitor interactions
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cisplatin may increase myelosuppression
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topoisomerase inhibitor admin
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monitor for bleeding, bruising, infection
CBC good oral hygiene use birth control during treatment |
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asparaginase (Elspar) (antineoplastic agent)
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kills cancer cells by interrupting DNA synthesis in leukemia cells
G1 specific |
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asparaginase (Elspar) use
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acute lymphocytic leukemia
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hydroxurea (Hydrea, Mylocel) (antineoplastic)
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kill cancer cells by interrupting DNA synthesis
s specific may cross blood brain barrier |
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hydroxurea use
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chronic myelogenous leukemia, ovarian, squamous cell cancers
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procarazine (Matulane) (antineoplastic agent)
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kills cancer cells by interrupting DNA and RNA synthesis
cell phase nonspecific may cross blood brain barrier |
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procarzine (Matulane) use
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brain tumors, Hodgekin, non-Hodgkin lymphoma
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asparaginase, hyroxurea, procarbazine adverse
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GI discomfort
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aspariginase adverse
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hypersensitivity
CNS effects ranging from confusion to coma, temporary tremor may occur liver and pancreas toxicity renal toxicity |
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hydroxurea and procarbazine adverse
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bone marrow suppression
may occur 4-6 weeks after infusion |
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procarbazine adverse
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peripheral neuropathy may include weakness and paresthesia
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asparaginase contraindications
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history of pancreatitis, exposure to chickenpox, herpes simplex infection
liver disease |
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hydroxyurea contraindications
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severe myelosuppression or anemia
use with caution in clients who have kidney disease |
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procarbazine contraindications
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severe myelosuppression
liver or kidney disease |
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asparaginase interactions
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may decrease effects of methotrexate
prednisone and vincristine may increase asparaginase toxicity decreased effect of antidiabetic meds |
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hydroxyurea interactions
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cytotoxic meds may increase hydroxyurea
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procarbazine interactions
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increase depressant effects of CNS depressants
MAOI or TCA, foods containing tyramine, and many OTC preparations such as cough medicines may cause hypertensive crisis alcohol may cause a disulfiram reaction |
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asparaginase admin
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allergic reaction
use birth control during treatment use good mouth care |
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hydroxyurea admin
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monitor for bleeding, bruising, or infection
withhold med and notify the provider for a WBC less than 2500 mm or a platelet count less than 100,000 mm3 |
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procarbazine admin
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monitor for neurologic effects such as confusion or paresthesia
withold meds and notify provider for a WBC less than 4,000 mm3 and a platelet count less than 100,000 mm3 |
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noncytotoxic chemotherapy agents
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gonadotropin-releasing hormone agents
androgen receptor blockers |
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gonadotropin-releasing hormone agents
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testes stop producing testosterone
use: palliative treatment for advanced prostate cancer |
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androgen receptor blockers
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blocks testosterone at receptor site
used in conjunction with gonadotropin-releasing hormone agonists to block androgen receptors and suppress the growth of prostate cancer use: treatment of prostate cancer |
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gonadotropin-releasing hormone agonist proto
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leuprolide (Eligard, Lupron)
other: triptorelin (Trestar Depot) |
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androgen receptor blockers proto
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flutamide (Eulexin)
other: bicalutamide (Casodex) |
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leuprolide adverse (GRH)
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hot flushes, decreased libido, gynecomastia
decreased bone density arrythmias, pulmonary edema |
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flutamide adverse
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hot flushes, decreased libido, gynecomastia
nausea, vomiting, diarrhea hepatitis |
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leuprolide contraindications
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hypersensitive to gonadotropin-releasing agents
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flutamide contraindications
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severe liver disease
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leuprolide interactions
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none noted
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flutamide interactions
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concurrent use with warfarin may increase anticoagulation
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leuprolide admin
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increase calcium and vit D intake
minimize bone loss with weight-bearing exercises monitor PSA and testosterone levels, which should both decrease with treatment |
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flutamide admin
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administered with gonadotropin-releasing hormone agonist or alone following a surgical castration
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hormonal agents- breast cancer meds
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estrogen receptor blockers
aromatase inhibitors monoclonal antibody |
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estrogen receptor blockers
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prototype: tamoxifen (Nolvadex)
other: raloxifene (Evista) fulvestrant (Faslodex) |
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aromatase inhibitors
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proto: anastrozole (Arimidex)
letrozole (Femara) exemestane (Aromasin) |
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monoclonal antibody
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trastuzumab (Herceptin)
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estrogen receptor blocker MOA
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stops growth of breast cancer cells, which are estrogen dependent cancers
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estrogen receptor blocker use (tamoxifen)
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used to treat or prevent breast cancer
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aromatase inhibitors use (anastrozole)
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treats breast cancer in postmenopausal women
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monoclonal antibody use (trastuzumab)
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treat metastatic breast cancer
alone or in conjunction with paclitaxel |
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tamoxifen adverse
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endometrial cancer
hypercalcemia nausea and vomiting pulmonary embolus hot flushes vaginal discharge or bleeding |
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anastrozole adverse
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muscle and joint pain
nausea vaginal bleeding increased risk for osteoporosis hot flushes |
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trastuzumab adverse
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cardiac toxicity, tachycardia, heart failure
hypersensitivity nausea and vomiting |
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tamoxifen contraindications
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taking warfarin or history of blood clots or pulmonary embolism
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anastrozole contraindications
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women before menopause and in severe liver disease
mild to moderate liver disease |
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trastuzumab contraindications
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hypersensitive
heart disease |
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tamoxifen interactions
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anticoagulation action of warfarin
some SSRI antidepressants decrease effectiveness of tamoxifen |
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anastrozole interactions
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tamoxifen and estrogenlike meds may reduce anstrozole effects
anastrozole and anthracyclines may increase the risk for cardiac effects |
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breast cancer meds admin
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increase calcium and vit d
perform monthly breast exam monitor CBC use birth control |
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biologic response modifiers
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proto: interferon alfa-2b (Intron A)
other: aldesleukin (Inteleukin 2) BCG vaccine (TheraCys) |
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biologic response modifiers MOA
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increases immune response and decreases production of cancer cells
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biologic response modifiers use
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treat or prevent hairy cell leukemia, chronic myelogenos leukemia, malignant melanoma, and AIDS-related Kaposi's sarcoma
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biologic response modifier adverse
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flulike symptoms
bone marrow suppression, alopecia, cardiotoxicity, neurotoxicity depression, anxiety, insomnia, altered mental states. |
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biologic response modifier contraindications
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hypersensitivity to the medication, suicidal thoughts, colitis, pancreatitis
severe liver, kidney, heart, or pulmonary disease and in DM or history of depression |
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biologic response modifier interactions
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concurrent use of theophylline (Theo-Dur) can lead to theophylline toxicity
Zidophine (Retrovir) may increase the risk of neutropenia or thrombocytopenia concurrent use with meds that are cardiotoxic or netrotoxic may increase cardiotoxicity or neurotoxicity concurrent use with vaccines using a live virus may reduce antibody response |
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biologic response modifier admin
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monitor for flu symptoms
monitor CBC, platelets, electrolytes monitor fluid status |
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Targeted antineoplastic meds
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EGFR-tyrosine Kinase inhibitors
BCR_ABL tyrosine kinase inhibitors CD2- Directed antibodies angiogenesis inhibitors |
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EGFR-tyrosine kinase inhibitor
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proto: cetuximab (Erbitux)
other: panitumumab (Vectibix) |
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BCR-ABL tyrosine kinase inhibitor
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prototype med: imatinib (Gleevec)
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CD20-Directed antibodies
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proto: rituximab (Rituxan)
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angiogenesis inhibitors
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proto: bevacizumab (Avastin)
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cetuximab MOA and use
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antibody that stops cancer cell growth and increases cell death
USE: treat cancers that are EGRF positive, such as colorectal nd solid tumors of the head and neck |
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imatinib MOA and use
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stops cancer growth by inhibiting intracellular enzymes
use: treat chronic myeloid leukemia |
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rituximab MOA and use
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antibody that stops cancer cell growth and increases cell death
use: treats non-Hodgkins lymphoma |
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bevacizumab MOA and use
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antibody that stops cancer cell growth and increases cell death
use: treat colorectal and lung cancer |
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cetuximab adverse
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infusion reaction, rash, hypotension, wheezing
pulmonary emboli skin toxicity, rash |
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imatinib adverse
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GI discomfort
flulike symptoms edema hypokalemia neutropenia, anemia |
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rituximaba adverse
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infusion reaction, rash, hypotension, wheezing
flulike symptoms tumor lysis syndrome due to rapid cell death, may lead to kidney failure, hypocalcemia and hyperuricemia |
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bevacizumab adverse
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thromboembolism, including CVA, MI, TIA
alopecia hemorrhage, GI, vaginal, nasal, intracranial, or pulmonary hypertension gastric perforation |
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cetuximab contraindications
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hypersensitivity
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imatinib adverse
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liver disease
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rituximab adverse
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liver or kidney failure
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bevacizumab adverse
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low WBC, nephrotic syndrome, recent surgery or dental work, hypertensive crisis
cardiac, renal disease history or hypersensitivity |
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cetuximab interactions
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sun exposure may increase skin toxicity
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imatinib interactions
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may increase chance of liver failure
concurrent use with warfarin may increase anticoagulant effect clarithromycin, erythromycin, and ketoconazole may slow imatinib metabolism and cause toxicity carbamazepine and phenytoin may increase imatinib metabolism |
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rituximab interactions
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calcium channel blockers and other antihypertensive meds increase chance of hypotension
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bevacizumab interactions
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may increase irinotecan level
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targeted antineoplastic meds admin
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monitor for infusion reaction
protect skin from sun notify provider for shortness of breath good oral hygiene CBC, platelets, and electrolytes fluid status edema abdominal pain, skin lesions, headache, episodes of bleeding |
