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24 Cards in this Set
- Front
- Back
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Teniposide (VM-26, Vumon)
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An epipodophyllotoxin
Dose/Route: IV 70-180mg/m2 daily x 3 Q 3-6 weeks Treats: leukemia, induction for refractory ALL Side FX: Severe myelosuppression. mucositis, mild neurotoxicity, decreased BP Nursing considerations: - give over 60 mins, check BP, use non-PVC bags and tubing - Irritant, extravasation precautions - may precipitate with heparin - premed with benadryl |
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Etoposide (VP-16, Vepesid)
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An epipodophyllotoxin
Dose/Route: IV or PO Treats: leukemia, lymphomas, neuroblastoma, sarcomas, brain tumors Side FX: myelosuppression, secondary leukemia, hypersensitivity, hypotension Nursing considerations: - give over 60 minutes, check BP, monitor for crystallization, premed with benadryl - refrigerate PO capsules, do not refrigerate IV solution |
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Vinblastine (Velban)
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A Vinca alkaloid
Dose/Route: IV 30mg/m2 weekly Used to treat: Leukemia, Hodgkin's lymphoma, non-small cell lung cancer Side FX: myelosuppression, esp. neutropenia, vesicant, mild to moderate neurotoxicity Nursing considerations: - extravasation precautions - use stool softeners - neurotoxic with high doses - need thorough neuro exam |
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Vincristine (Oncovin)
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A Vinca alkaloid
Dose/Route: IV 1-1.5 mg (2mg max) weekly for 3-6 doses Treats: Leukemias, lymphomas, most solid tumors including brain tumors, Wilm’s tumor, neuroblastoma Side FX: peripheral neurotoxicity, vesicant, SIADH Nursing considerations: -extravasation precautions -use stool softeners -fatal if given intrathecally -need thorough neuro exam -peripheral neurotoxicity is cumulative -assess for constipation – increase fluids, increase fiber in diet, promote exercise |
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Carboplatin (Paraplatin)
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Alkylating agent
Dose/Route: IV 300-560mg/m2 Single dose or daily x 2 Q 28 days Treats: Brain tumors, germcell tumors, neuroblastoma, sarcomas, hepatoblastoma Side FX: myelosuppression esp. thrombocytopenia Nursing considerations: - premed with benadryl and steroids - give over 15 minutes or longer |
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Cisplatin (Platinol)
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Alkylating agent
Dose/Route: IV 50-200mg/m2 Daily x 1-5 days every 21-28 days Max: 200mg/m2/course Treats: germ cell tumors, brain tumors, osteosarcoma. neuroblastoma, hepatoblastoma Side FX: neurotoxic Nursing considerations: - hydrate well, monitor serum creatinine - audiogram, may need magnesium supplement, very emetogenic |
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Cyclophosphamide (Cytoxan)
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Alkylating agent
Dose/Route: IV: varies, 1-40mg/kg daily x 1-4 days q 21-28 days, PO - uncommon in pediatrics Treats: lymphoma, leukemia, sarcomas, rhabdomyosarcoma, brain tumors Side FX: myelosuppression esp. neutropenia Nursing considerations: - hydrate well, give mesna to prevent hemorrhagic cystitis, check urine for blood, empty bladder frequently |
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Procarbazine
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Alkylating agent
Dose/Route: IV 1600-3000 mg/m2 daily x 3-5 days Q 21-28 days Max: 9gm/m2/course Treats: brain tumors Side FX: myelosuppression esp. thrombocytopenia Nursing considerations: decreased BP or CNS symptoms can occur with cheese, wine, bananas, yogurt, barbiturates, phenothiazines, phenytoin, narcotics & alcohol |
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Ifosfamide (IFOS, IFEX)
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Alkylating agent
Dose/Route: IV 1600-3000 mg/m2 daily x 3-5 days Q 21-28 days Max: 9gm/m2/course Treats: sarcomas, relapsed Wilm's tumor Side FX: nephorotoxicity, hemorrhagic cystitis, myelosuppression Nursing considserations: - give over 30-120 minutes, give with Mesna, hydrate well - Fanconi's syndrome common with increased dose - check magnesium, KCL and phos. |
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Cytarabine (ARA-C, cytosar)
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Antimetabolite
Dose/Route: IV, SQ, IT 100-200mg/ms Q 12 hours x 5-7 days or 1000-3000mg/m2 q 12 hours x 4-8 doses Treats: leukemia, lymphoma, CNS leukemia Side FX: myelosuppression Nursing considerations: - use preservative-free normal saline with IT administration - give steroid eye drops with high doses |
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Fluorouracil (5-Fluorouracil, 5-FU)
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Antimetabolite
Dose/Route: IV 500mg/m2 1-5 days 200-400mg/m2 daily as C1 Treats: carcinomas, hepatic tumor, head and neck tumors Side FX: myelosuppression esp. with bolus doses Nursing considerations: - photosensitivity precautions - pyridoxine can be used to treat palmar=plantar erythema |
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Mercaptopurine (6-MP, purinethol)
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Antimetabolite
Dose/Route: PO 20-100mg/m2 daily Treats: leukemia Side FX Myelosuppression Nursing considerations: - reduce dose by 75% when given concurrently with allopurinol - take entire dose at the same time on an empty stomach, preferably at bedtime |
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Idarubicin (Idamycin)
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Antitumor antibiotic
Dose/Route: IV 10-15mg/m2 daily or weeky x 3 Treats: ALL, lymphomas Sied FX: myelosuppression esp. neutropenia, mucositis, vesicant. cardiomyopathy, radiation recall, local hives Nursing considerations: - analog of daunorubicin, extravasation precautions, - obtain baseline cardiac studies (ECHO, EKG, MUGA) - monitor cumulative dose, protect from light - more than 3 times more potent than doxorubicin |
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Doxorubicin (adriamycin)
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Antitumor antibiotic
Dose/Route: IV Cumulative life time dose is 450mg/m2 (may be lower in kids) Treats: leukemias, lymphomas, most solid tumors Side FX: myelosuppression, vesicant, facial flushing, red or pink urine, radiation recall, cardiotoxicity Nursing considerations: - extravasation precaution - obtain baseline cardiac studies (ECHO, EKG, MUGA) - monitor cumulative dose - dexrazoxone - cardiac protective drug may be given |
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Daunorubicin (Cerubidine, daunomycin)
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Antitumor antibiotic
Dose/Route: IV: 30-45mg/m2 Daily x 3 or weekly. Cumulative lifetime dose is 550 U/m2 - may be lower in kids Treats: ALL, lymphomas Side FX: myelosuppression, cardiotoxicity, radiation recall Nursing considerations: - extravasation precautions - obtain baseline cardiac studies (ECHO, EKG, MUGA) - monitor cumulative dose |
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Dactinomycin (Cosmegen, actinomycin-D)
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Antitumor Antibiotic
Dose/Route: IV 400-500mcg/m2/day (Max dose is 0.5 mg) Daily x 5 days, Q 3-6 weeks, mag 2.5mg/m2/course Treats: Wilm's Tumor, sarcomas Side FX: severe myelosuppression, radiation recall, vesicant, veno-occlusive disease Nursing considerations: - extravasation precautions - dosage may be written as mg or mcg - protect from light, do not filter |
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Bleomycin (Blenoxane, BLEO)
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Antitumor Antibiotic
Dose/Route: IV, IM, SQ - 10-20 units weekly - Cumulative lifetime dose 400 units Treats: lymphoma, germ cell tumors, sclerosing agent for pleural effusions Side FX: fever, hypersensitivity, rare anaphylaxis, chronic rash Nursing considerations: - disclose prior use before anesthesia - obtain baseline pulmonary studies - decrease dose when also getting radiation |
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Thioguanine (6-TG, 6-thioguinine)
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Antimetabolite
Dose/ROute: PO 40-200 mg/m2 daily X 5-7 days Treats: leukemia Side FX: myelosuppression esp. neutropenia Nursing considerations: - take entire dose at the same time on an empty stomach, preferably at bedtime |
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Methotrexate (MTX)
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ANtimetabolite
Dose/Route: IV. PO. IT, IVP 25-1200mg/m2. IT dose based on age Treats: leukemia, lymphoma, ostesarcoma Nursing considerations: - Alkalinize urine - prevent crystallization in kidneys - leucovorin rescue with moderate to high doses - avoid folate in vitamins - photosensitivity precautions - provide oral care |
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Aparaginase erwinia (L-asparaginase. Elspar)
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Misc Agent
Dose/Route: IV or IM Treats: ALL. lymphomas Side FX: Hypersensitivity. anaphlyaxis, pancreatitis, malais, hepatotoxicity, CNS ischemic attack Nursing considerations: - IM has decreased risk for anaphylaxis - be prepared for emergency, watch for 30 mins - educate on thrombophlebitis and bleeding |
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PEG asparginase (Oncaspar)
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Misc Agent
Dose/Route: IV or IM Treats: ALL. lymphomas Side FX: Hypersensitivity. anaphlyaxis, pancreatitis, malais, hepatotoxicity, CNS ischemic attack Nursing considerations: - IM has decreased risk for anaphylaxis - be prepared for emergency, watch for 30 mins - educate on thrombophlebitis and bleeding - PEG asparaginase has long half-life - late reactions can occur |
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Topotecan (hycentin)
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Camptothecins
Dose/Route: IV 0.6-1.5mg/M2 daily x5 days Q 3 weeks Treats: neuroblastoma, rhabdomyosarcoma Side FX: myelosuppression esp. neutropenia, mucositis, increased LFTs Nursing considerations: - may have fever with treatment |
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Prednisone
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Hormonal agent
Dose/Route: PO, IV Treats: leukemia, lymphoma Side FX: Immunosuppression, mood swings, hyperglycemia, Na+ and fluid retention, long term - Cushings Nursing considerations: - may mask fever or infections - do not stop abruptly - educate on decreased Na+ diet - take with food - perineal burning with rapid infusion - do not give at night for patients with sleep disturbances |
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Dexamethasone (decadron)
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Hormonal agent
Dose/Route: PO, IV Treats: leukemia, lymphoma, brain tumors Side FX: Immunosuppression, mood swings, hyperglycemia, Na+ and fluid retention, long term - Cushings Nursing considerations: - may mask fever or infections - do not stop abruptly - educate on decreased Na+ diet - take with food - perineal burning with rapid infusion - do not give at night for patients with sleep disturbances |
