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67 Cards in this Set
- Front
- Back
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What are antineoplastics used for?
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treatment of various:
solid tumors lymphomas leukemias some autoimmune disorders such as rheumatoid arthritis (cyclophospha- mide, methotrexate) |
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Antineoplastics are often used in combination to minimize individual ____ and increase response.
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toxicities
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Chemotherapy may be combined with other treatment modalities such as ______ and ______ therapy.
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surgery
radiation |
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Dosages vary greatly, depending on? (3)
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extent of disease
other agents used patient's condition |
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Some new antineoplastics including (2) encapsulated in a lipid membrane have less toxicity with greater efficacy.
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daunorubicin
doxorubicin |
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Antineoplastics work by many different mechanisms. Many affect 1______ synthesis or function; others alter 2_____ function or affect 3______ status of sensitive tumors. Action may not be limited to 4_____ cells.
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1 DNA
2 immune 3 hormonal 4 neoplastic |
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What is the MOA and what effect do the alkylating agents have on the cell cycle, specific or non-specific?
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cause cross-linking of DNA
cell cycle-nonspecific |
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What is the MOA and what effect do the anthracyclines have on the cell cycle?
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interfere with DNA and RNA
synthesis cell cycle-nonspecific |
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What is the MOA and what effect do the antitumor antibiotics have on the cell cycle?
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interfere with DNA and RNA
synthesis cell cycle-nonspecific (except bleomycin) |
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What is the MOA and what effect do antimetabolites have on cell cycle?
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take the place of norma
proteins cell cycle-specific, work mostly in S phase (DNA synthesis) |
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What is the MOA and what effect do enzymes have on cell cycle?
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deplete asparagine
cell-cycle phase-specific |
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What is the MOA and what effect do enzyme inhibitors have on cell cycle?
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inhibits topoisomerase
inhibits kinase cell cycle phase-specific |
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What is the MOA and what effect do hormonal agents have on cell cycle?
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alter hormonal status in
tumors that are sensitive unknown |
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What is the MOA and what effect do hormonal agents-aromatase inhibitors have on cell cycle?
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inhibit enzyme responsible for activating estrogen
unknown |
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What is the MOA and what is the effect of podophyllotoxin derivaties on cell cycle?
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damages DNA before mitosis
cell-cycle phase-specific |
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What is the MOA and what is the effect of taxoids on cell cycle?
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interrupts interphase and mitosis
cell-cycle phase-specific |
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What is the MOA and what is the effect of vinca alkaloids on cell cycle?
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interferes with mitosis
cell cycle-specific, work during M phase (mitosis) |
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Name 11 alkylating agents?
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busulfan
carboplatin carmustine chlorambucil cisplatin (Platinol}, Platinol-AQ cyclophosphamide ifosfamide melphalan mechlorethamine procarbazine temozolomide |
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Name 6 anthracyclines?
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daunorubicin citrate liposome
daunorubicin hydrochloride doxorubicin hydrochloride liposome doxorubicin hydrochloride epirubicin idarubicin |
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Name 3 antiandrogens?
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bicalutamide
flutamide nilutamide |
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Name 2 antiestrogens?
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tamoxifen (Alpha-Tamoxifen}, {Med Tamoxifen}, Nolvadex, {Nolvadex-D}, {Novo-Tamoxifen}, {Tamofen}, {Tamone}, {Tamoplex}
toremifene Fareston |
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Name 5 antimetabolites?
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cytarabine
fluorouracil hydroxyurea methotrexate gemcitabine |
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Name 4 antitumor antibiotics?
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bleomycin
mitomycin mitoxantrone plicamycin |
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Name 2 aromatase inhibitors?
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anastrazole
letrozole |
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Name 4 enzyme inhibitors?
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geftinib
imatinib irinotecan topotecan |
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Name 2 enzymes?
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asparaginase
pegaspargase |
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Name 4 hormones?
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goserelin
leuprolide medroxyprogesterone triptorelin |
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Name 4 monoclonal antibodies?
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alemtuzumab
gemtuzumab ozogamicin rituximab trastuzumab |
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Name 2 podophyllotoxin derivatives?
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etoposide phosphate
etoposide |
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Name 1 progestin?
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megesterol
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Name 2 taxoids?
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docetaxel
paclitaxel |
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Name 3 vinca alkaloids?
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vinblastine
vincristine vinorelbine |
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Name 5 miscellaneous antineoplastics?
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abarelix
arsenic trioxide aldesleukin alitretinoin altretamine |
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Name 13 groups of antineoplastics?
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alkylating agents
anthracyclines antiandrogens antiestrogens antimetabolites antitumor antibiotic enzymes enzyme inhibitors hormonal agents hormonal agents - aromatase inhibitors immune modulators monoclonal antibodies podophyllotoxin derivatives progestins taxoids vinca alkaloids miscellaneous |
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Antineoplastics are contraindicated in previous ____ _____ depression, hypersensitivity, pregnancy, and lactation.
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bone marrow
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Use antineoplastics cautiously in patient with active 1_____, decreased 2____ ____ reserve, 3_____ therapy, or other debilitating illnesses. Use cautiously in patients with childbearing potential.
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1 infections
2 bone marrow 3 radiation |
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Allopurinol ______ metabolism of mercaptopurine.
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decreases
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Toxicity from methotrexate may be increased by other _____ drugs or larger doses of aspirin or NSAIDs
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nephrotoxic
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______ ______ depression is additive.
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Bone marrow
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Monitor for ____ _____ depression.
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bone marrow
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Assess for bleeding where? (6)
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bleeding gums
bruising petechiae guaiac stools urine emesis |
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Avoid IM injections and rectal temperatures if _____ count is low.
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platelet
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Apply pressure to venipuncture sites for ____ min.
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10
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Assess for signs of infectionduring _____.
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neutropenia
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What blood disorder may occur?
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anemia
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Monitor for these increased symptoms? (3)
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fatigue
dyspnea orthostatic hypotension |
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Monitor these 3?
(Starts with I, A, N ) Adjusting diet as tolerated may help maintain fluid and electrolyte balance and nutrional status. |
I & O
appetite nutritional intake |
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Prophylactic _____ may be used to inhibit nausea and vomiting.
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antiemetics
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Monitor IV site carefully and ensure patency. Discontinue infusion immediately if there is? (3)
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discomfort
erythema along vein infiltratation |
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What two conditions may result from infiltration?
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tissue ulceration
necrosis |
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Monitor for 3 symptoms of gout?
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increased uric acid
joint pain edema |
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Encourage patient to drink at least ____ of fluid each day.
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2L
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Allupurinol may be given to decrease ____ acid levels.
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uric
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Alkalinization of urine may be ordered to increase excretion of ___ ____.
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uric acid
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3 potential Nursing Diagnoses?
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Infection, risk for
Nutrition, imbalanced: less than body requirements Knowledge, deficient, related to disease processes and medication regimen |
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Solutions for injection should be prepared in a ____ ______.
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biologic cabinet.
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Wear _____, _____, and ____ while handling medication.
Check dose carefully...fatalities have resulted from dosing errors. |
gloves
gown mask |
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Caution patient to avoid ____ and persons with known _____. Notify hcp immediately if symptoms of infection occur.
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crowds
infection |
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Instruct patient to report unusual _____. Advise patient of ______ precautions.
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bleeding
thrombocytopenia |
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These drugs may cause ______ suppression; however patient should still use birth control, as most antineoplastics are teratogenic. Advise patient to inform hcp immediately if pregnancy is suspected.
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gonadal
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Discuss with patient the possibility of ____ loss.
Explore methods of coping. |
hair
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Instruct patient to inspect oral mucosa for ____ and ____.
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erythema
ulceration |
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If there is ulceration of _____ _____, advise patient to use sponge brush and rinse mouth with water after eating and drinking.
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oral mucosa
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What type of agent may be used if mouth pain (ulceration of oral mucosa) interferes with eating?
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topical
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Stomatitis pain may require treatment with ____ analgesics.
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opioid
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Instruct patient not to receive any _____ without advice of hcp. Antineoplastics may decrease antibody response and increase risk of adverse reactions.
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vaccinations
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Patient will need medical follow-up and frequent ____ tests.
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lab
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