Chemotherapeutic Agents

Front 1

3 ways that Chemotherapeutic agents are used in the tx. of malignant neoplasms.

Back 1

1. to cure disease
2. relieve symptoms
3. induce or maintain remissions.

Front 2

This is the sequence of events that a cell goes through from one mitotic division to the next.

Back 2

Cell Cycle
4 active phases
1 resting phase

Front 3

The resting phase of the cell.

Back 3

GO phase

Front 4

The first active phase of the cell where the cell is preparing to make DNA

Back 4

G1 phase

Front 5

Synthesis of DNA takes place in what phase?

Back 5

S phase

Front 6

In this phase the cell is preparing for mitosis, the RNA is synthesized and mitotic spindle is formed.

Back 6

G2 phase

Front 7

The final stage in which mitosis occurs.

Back 7

M phase

Front 8

The ratio of proliferating cells to GO cells is called the _____.

Back 8

Growth Fraction

Front 9

These 2 labs are performed before each cycle of chemo to determine dosage & frequency of drug administration.

Back 9

CBC & WBC differential

Front 10

A type of bone marrow suppression characterized by a decrease in circulating neutrophils.

Back 10

Neutropenia

Front 11

a type of bone marrow suppression characterized by a decreased number of platelets.

Back 11

Thrombocytopenia

Front 12

Teaching r/t Neutropenia includes _______?

Back 12

teach to avoid infections and use good handwashing. Notify Phy if fever, chills, sore throat, or cough on chemo.

Front 13

Teaching r/t thrombocytopenia includes _______?

Back 13

shave w/ electric razor, avoid aspirin & NSAIDs, avoid inj., cuts, injuries.report exc.bruising, bleeding gums, or blood in urine or stool.

Front 14

This drug is used to treat thrombocytopenia by stimulating platelet production.

Back 14

oprelvekin
(Neumega)

Front 15

a type of bone marrow suppression; a decreased number of RBCs.

Back 15

Anemia

Front 16

Used to treat anemia; this is a hormone that stimulates the production of RBCs

Back 16

erythropoeitin
(Epogen)

Front 17

Most effective tx. for nausea & vomiting r/t chemotherapy; is given IV.

Back 17

serotonin receptor antagonist-ondansetron(Zofran) & corticosteroid dexamethasone combination.

Front 18

Usually given for anticipatory nausea and vomiting r/t chemo.

Back 18

benzodiazepine
(lorazepam)

Front 19

Possible reproductive effects r/t chemotherapy.

Back 19

-amenorrhea
-oligospermia
-permanent sterility

Front 20

cancer cell destruction causes increased uric acid in blood which can cause______and ________.

Back 20

-hyperuricemia
-uric acid nephropathy

Front 21

a possible adverse effect of chemo, pulmonary toxicity (Fibrosis) includes:

Back 21

-cough
-dyspnea
-chest x-ray changes

Front 22

Cardiac Toxicity r/t chemo consists of:

Back 22

-CHF(dyspnea, edema, fatigue)
-arrythmias
-EKG changes

Front 23

Characterized by blood in urine, dysuria, burning on urination.

Back 23

Hemorrhagic Cystitis-can be decreased if fluids are increased

Front 24

This is thought to occur in approx. 10% of pts who receive cyclophoshamide and results from irritating effects of drug metabolites on bladder mucosa.

Back 24

Hemorrhagic Cystitis

Front 25

characteristics of peripheral neuropathy r/t chemo include:

Back 25

-muscle weakness
-numbness & tingling of extremeties
-foot drop
-decreased ability to walk

Front 26

Several drugs cause severe local injury such as inflammation, pain, ulceration, and tissue necrosis is they leak into soft tissues around veins. These are called ____.

Back 26

Vesicants
(extravasation of vesicants)

Front 27

These agents interfere w/ cell division & the dividing & resting stages of the malignant cell cycle and have a broad spectrum of activity.

Back 27

Alkalating agents

Front 28

Alkalating agents include_____.(3)

Back 28

-nitrogen mustard derivatives
-nitrosureas
-platinum compounds

Front 29

Most effective in hematologic malignancies but are also used to treat breast, lung, & ovarian tumors.

Back 29

Alkalating agents

Front 30

A downside for patients who are given alkalating agents ahd who survive their illness is what?

Back 30

They have a relatively high risk for developing leukemia for approx. 15-20 years.

Front 31

These agents enter cancer cells b/c they are similar to nutrients needed by the cells for reproduction.

Back 31

Antimetabolite agents

Front 32

Why are antimetabolite agents cell cycle specific only?

Back 32

B/c they exert their cytotoxic effects only during the S phase when DNA is being synthesized.

Front 33

These drugs are most effective against rapidly growing tumors

Back 33

Antimetabolite agents

Front 34

This drug is an example of a antimetabolite agent.

Back 34

Folic acid antagonist
(methotrexate)

Front 35

Toxic effects of antimetabolite agents include:

Back 35

-bone marrow suppression
-GI tract
-hair follicles

Front 36

These agents are active in all phases of the cell cycle.

Back 36

Antibiotic Antineoplastic Agents

Front 37

These agents bind to DNA so that DNA & RNA transcription is blocked

Back 37

antibiotic antineoplastic agents

Front 38

major toxicities of antibiotic antineoplastic agents

Back 38

-bone marrow suppression
-GI upset

Front 39

this drug is an ex. of an antibiotic antineoplastic agent which also causes cardiotoxicity & tissue necrosis if extravasion occurs.

Back 39

doxorubicin

Front 40

which antibiotic antineoplastic agent can not be given IV?

Back 40

bleomycin

Front 41

these agents interfere w/ protein synthesis & attempt to stop tumor growth in hormone dependent tissues.

Back 41

Hormonal agents

Front 42

What is the goal of hormonal therapy?

Back 42

-control of tumor growth and palliation of symptoms rather than cure.

Front 43

What are hormonal agents usually used to treat?

Back 43

breast or prostate cancer

Front 44

This anticancer drug is one that causes little toxicity to bone marrow and so is used for combined therapy w/ other anticancer drugs.

Back 44

vincristine
(Oncovin)

Front 45

this drug is an ex. of a plant Alkaloid agent.

Back 45

vincristine
(Oncovin)

Front 46

these drugs reduce the adverse effects of cytotoxic drugs which may be severe, debilitating, and life-threatening to pts.

Back 46

Cytoprotectant Drugs

Front 47

Which Cytoprotectant drug decreases kidney damage caused by cisplatin?

Back 47

Amifostine

Front 48

Which cytoprotectant drug decreases cardiac toxicity of doxorubicin?

Back 48

Dexrazoxane

Front 49

Which cytoprotectant drug stimulates bone marrow to produce blood cells and is used in tx of anemias?

Back 49

Erythropoietin

Front 50

drugs used in combination therapy for cancer:
M.O.P.P.

Back 50

M- mechlorethamine
O- oncovin
P- procarbazine
P- prenisone

Front 51

Mechlorethamine is _____specific.

Back 51

cell cycle specific

Front 52

Oncovin is _____specific.

Back 52

M phase specific

Front 53

Procarbazine is _____specific.

Back 53

G1 phase specific

Front 54

Prednisone is _____specific.

Back 54

M phase specific

Front 55

the pharmacological treatment of cancer is called______

Back 55

chemotherapy

Front 56

3 benefits to chemotherapy.

Back 56

-cure
-palliation
-prolongation of useful life

Front 57

5 kinds of Antineoplastic drug classes.

Back 57

1. alkylating agents
2.antimetabolites
3.antitumor antibiotics
4.plant alkaloids
5.antineoplastic hormone inhibitors

Front 58

3 major anti-neoplastic groups are _____.

Back 58

-cell cycle specific
-cell cycle non-specific
-combination therapy

Front 59

what is the primary example drug for alkylating agents?

Back 59

cyclophosphamide
(Cytoxan)

Front 60

Indications for alkylating agents include:

Back 60

-HL and NHL
-leukemia
-breast cancer
-ovarian
-testicular
-many solid tumors

Front 61

Primary example drug for antimetabolites.

Back 61

methotrexate (MTX)-folic acid antagonist
(Rheumatrex)

Front 62

Antimetabolites are specific for which cell cycle?

Back 62

S phase

Front 63

Indications for Antimetabolites include:

Back 63

-solid tumors
-hematologic cancers
-severe psoriasis
-rheumatoid arthritis

Front 64

Toxic effects of antimetabolites include:

Back 64

-hepatic
-GI
-CV
-pulmonary
-dermatologic

Front 65

This cytotoxic antibiotic blocks DNA synthesis by changing the shape of the helix and ultimately changing its structure.

Back 65

doxorubicin
(Adriamycin)

Front 66

cell cycle specificity of doxorubicin (adriamycin).

Back 66

non-specific

Front 67

toxic effects of doxorubicin (adriamycin) include:

Back 67

liver and cardiovascular

Front 68

indications for doxorubicin (adriamycin)-cytotoxic antibiotic

Back 68

-breast
-bone
-ovarian
-leukemia
neuroblastoma
-HL and NHL

Front 69

Mitotic Inhibitors are also known as ______

Back 69

plant alkaloids

Front 70

Mitotic Inhibitors
primary ex drug

Back 70

vincristine
(Oncovin)

Front 71

cell cycle specificity of vincristine (Oncovin)

Back 71

late S phase and G2 phase

Front 72

indications for vincristine (oncovin)

Back 72

solid tumors
hematologic malignancies

Front 73

Mitotic inhibitors
adverse reactions?

Back 73

neurologic
pulmonary
dermatologic
CV
GI
otic
metabolic

Front 74

Hormonal agents-
primary ex drug which blocks the sex homonal receptors

Back 74

nolvadex (Tamoxifen)-antiestrogen
bicalutamide (Casodex)-antiandrogen

Front 75

A cytoprotectant drug which stimulates production of WBCs is _______.

Back 75

filgrastim (Neupogen)

Front 76

Cytoprotectant drugs used to stimulate bone marrow to produce RBCs for tx of anemia

Back 76

epoietin (Epogen)
Procrit

Front 77

a type of bone marrow suppression when WBCs are less than 3,500/mm^3

Back 77

Neutropenia

Front 78

Leading cause of death for cancer pts is ______

Back 78

Infection

Front 79

5 priority nursing implications for pts w/ neutropenia.

Back 79

1.no ill or young children visitor
2.no fresh flowers or produce
3.no rectal temps
4.strict hand washing
5.avoid indwelling catheters

Front 80

This name defines the lowest pt, for ex., the lowest blood count after chemo and is unique for each drug(when pt is more susceptible to infection)

Back 80

Nadir

Front 81

Priority nursing implications for pts w/thrombocytopenia (5)

Back 81

1.use electric razors & soft toothbrush
2.avoid venipunctures/injections
3.check for bloody stools or urine
4.prevent constipation
5.avoid valsalva manuever

Front 82

4 more nursing implications r/t thrombocytopenia

Back 82

1.avoid blowing nose/suppress cough
2.avoid ASA and NSAIDs
3.no sexual intercourse
4.menstruating-tk pills w/out sugar

Front 83

bone marrow suppression in which hemoglobin is less than 10?

Back 83

anemia

Front 84

nursing intervention for anemia?

Back 84

minimize exertion

Front 85

the #1 patient concern for cancer patients

Back 85

nausea/vomiting

Front 86

nursing implications for nausea/vomiting

Back 86

-dietary restrictions
-diversional activities
-fresh air/cool clothes
-meticulous mouthcare

Front 87

This lasts about 7-10 days & occurs mostly w/ antimetabolites, antibiotics, & plant alkaloids.

Back 87

Stomatitis aka Mucositis

Front 88

dietary restrictions for stomatitis includes:

Back 88

encourage soft, bland, cold, non-acidic foods
avoid spicy foods

Front 89

hair loss which occurs 2-3 wks after chemotherapy

Back 89

Alopecia

Front 90

a possible reproductive effect r/t chemo where there is a permanent or temporary dificiency of spermatazoa in seminal fluid

Back 90

Oligospermia

Front 91

2 important adverse reactions for antibiotics

Back 91

Nephrotoxicity
Ototoxicity

Front 92

Adverse reaction for Bleomycin

Back 92

pulmonary toxicity/fibrosis

Front 93

adverse reaction of Adriamycin

Back 93

cardiac toxicity

Front 94

adverse reaction of alkylating agents

Back 94

hemorrhagic cystitis

Front 95

adverse reaction of plant alkaloids

Back 95

neurotoxicity

Front 96

When handling antineoplastic agents:

Back 96

-avoid contact w/solutions
-wear PPE
-proper disposal in special

Front 97

When handling antineoplastic agents:

Back 97

-blood/body fluids contaminated for 48hrs after dosing
-wash hands thoroughly
-follow p/p