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67 Cards in this Set

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What are antineoplastics used for?
treatment of various:
solid tumors
lymphomas
leukemias
some autoimmune disorders
such as rheumatoid
arthritis (cyclophospha-
mide, methotrexate)
Antineoplastics are often used in combination to minimize individual ____ and increase response.
toxicities
Chemotherapy may be combined with other treatment modalities such as ______ and ______ therapy.
surgery
radiation
Dosages vary greatly, depending on? (3)
extent of disease
other agents used
patient's condition
Some new antineoplastics including (2) encapsulated in a lipid membrane have less toxicity with greater efficacy.
daunorubicin
doxorubicin
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.
1 DNA
2 immune
3 hormonal
4 neoplastic
What is the MOA and what effect do the alkylating agents have on the cell cycle, specific or non-specific?
cause cross-linking of DNA

cell cycle-nonspecific
What is the MOA and what effect do the anthracyclines have on the cell cycle?
interfere with DNA and RNA
synthesis

cell cycle-nonspecific
What is the MOA and what effect do the antitumor antibiotics have on the cell cycle?
interfere with DNA and RNA
synthesis

cell cycle-nonspecific
(except bleomycin)
What is the MOA and what effect do antimetabolites have on cell cycle?
take the place of norma
proteins

cell cycle-specific, work mostly in S phase (DNA synthesis)
What is the MOA and what effect do enzymes have on cell cycle?
deplete asparagine

cell-cycle phase-specific
What is the MOA and what effect do enzyme inhibitors have on cell cycle?
inhibits topoisomerase
inhibits kinase

cell cycle phase-specific
What is the MOA and what effect do hormonal agents have on cell cycle?
alter hormonal status in
tumors that are sensitive

unknown
What is the MOA and what effect do hormonal agents-aromatase inhibitors have on cell cycle?
inhibit enzyme responsible for activating estrogen

unknown
What is the MOA and what is the effect of podophyllotoxin derivaties on cell cycle?
damages DNA before mitosis

cell-cycle phase-specific
What is the MOA and what is the effect of taxoids on cell cycle?
interrupts interphase and mitosis

cell-cycle phase-specific
What is the MOA and what is the effect of vinca alkaloids on cell cycle?
interferes with mitosis

cell cycle-specific, work during M phase (mitosis)
Name 11 alkylating agents?
busulfan
carboplatin
carmustine
chlorambucil
cisplatin (Platinol}, Platinol-AQ
cyclophosphamide
ifosfamide
melphalan
mechlorethamine
procarbazine
temozolomide
Name 6 anthracyclines?
daunorubicin citrate liposome
daunorubicin hydrochloride
doxorubicin hydrochloride liposome
doxorubicin hydrochloride
epirubicin
idarubicin
Name 3 antiandrogens?
bicalutamide
flutamide
nilutamide
Name 2 antiestrogens?
tamoxifen (Alpha-Tamoxifen}, {Med Tamoxifen}, Nolvadex, {Nolvadex-D}, {Novo-Tamoxifen}, {Tamofen}, {Tamone}, {Tamoplex}

toremifene Fareston
Name 5 antimetabolites?
cytarabine
fluorouracil
hydroxyurea
methotrexate
gemcitabine
Name 4 antitumor antibiotics?
bleomycin
mitomycin
mitoxantrone
plicamycin
Name 2 aromatase inhibitors?
anastrazole
letrozole
Name 4 enzyme inhibitors?
geftinib
imatinib
irinotecan
topotecan
Name 2 enzymes?
asparaginase
pegaspargase
Name 4 hormones?
goserelin
leuprolide
medroxyprogesterone
triptorelin
Name 4 monoclonal antibodies?
alemtuzumab
gemtuzumab ozogamicin
rituximab
trastuzumab
Name 2 podophyllotoxin derivatives?
etoposide phosphate
etoposide
Name 1 progestin?
megesterol
Name 2 taxoids?
docetaxel
paclitaxel
Name 3 vinca alkaloids?
vinblastine
vincristine
vinorelbine
Name 5 miscellaneous antineoplastics?
abarelix
arsenic trioxide
aldesleukin
alitretinoin
altretamine
Name 13 groups of antineoplastics?
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
Antineoplastics are contraindicated in previous ____ _____ depression, hypersensitivity, pregnancy, and lactation.
bone marrow
Use antineoplastics cautiously in patient with active 1_____, decreased 2____ ____ reserve, 3_____ therapy, or other debilitating illnesses. Use cautiously in patients with childbearing potential.
1 infections
2 bone marrow
3 radiation
Allopurinol ______ metabolism of mercaptopurine.
decreases
Toxicity from methotrexate may be increased by other _____ drugs or larger doses of aspirin or NSAIDs
nephrotoxic
______ ______ depression is additive.
Bone marrow
Monitor for ____ _____ depression.
bone marrow
Assess for bleeding where? (6)
bleeding gums
bruising
petechiae
guaiac stools
urine
emesis
Avoid IM injections and rectal temperatures if _____ count is low.
platelet
Apply pressure to venipuncture sites for ____ min.
10
Assess for signs of infectionduring _____.
neutropenia
What blood disorder may occur?
anemia
Monitor for these increased symptoms? (3)
fatigue
dyspnea
orthostatic hypotension
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
Prophylactic _____ may be used to inhibit nausea and vomiting.
antiemetics
Monitor IV site carefully and ensure patency. Discontinue infusion immediately if there is? (3)
discomfort
erythema along vein
infiltratation
What two conditions may result from infiltration?
tissue ulceration
necrosis
Monitor for 3 symptoms of gout?
increased uric acid
joint pain
edema
Encourage patient to drink at least ____ of fluid each day.
2L
Allupurinol may be given to decrease ____ acid levels.
uric
Alkalinization of urine may be ordered to increase excretion of ___ ____.
uric acid
3 potential Nursing Diagnoses?
Infection, risk for
Nutrition, imbalanced: less
than body requirements
Knowledge, deficient,
related to disease
processes and medication
regimen
Solutions for injection should be prepared in a ____ ______.
biologic cabinet.
Wear _____, _____, and ____ while handling medication.
Check dose carefully...fatalities have resulted from dosing errors.
gloves
gown
mask
Caution patient to avoid ____ and persons with known _____. Notify hcp immediately if symptoms of infection occur.
crowds
infection
Instruct patient to report unusual _____. Advise patient of ______ precautions.
bleeding
thrombocytopenia
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.
gonadal
Discuss with patient the possibility of ____ loss.
Explore methods of coping.
hair
Instruct patient to inspect oral mucosa for ____ and ____.
erythema
ulceration
If there is ulceration of _____ _____, advise patient to use sponge brush and rinse mouth with water after eating and drinking.
oral mucosa
What type of agent may be used if mouth pain (ulceration of oral mucosa) interferes with eating?
topical
Stomatitis pain may require treatment with ____ analgesics.
opioid
Instruct patient not to receive any _____ without advice of hcp. Antineoplastics may decrease antibody response and increase risk of adverse reactions.
vaccinations
Patient will need medical follow-up and frequent ____ tests.
lab