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14 Cards in this Set

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  • Back
Allopurinol
works by inhibiting the enzyme xanthine oxidase, which prevents uric acid production; anti gout drug
Colchicine
has no effect on urinary excretion of uric acid, but reduces the inflammatory response to the deposits of urate crystals in joint tissue
Probenecid
increases urate excretion. Has no anti-inflammatory or analgesic activity. Used to treat chronic gout but not acute gout attacks.
Tamoxifen
indicated for advanced breast cancer; major contraindications: allergy to drug, pregnancy, and lactation; most common adverse effects: hot flashes; most serious adverse effects: risk of endometrial cancer and thromboembolic events; maximizing therapeutic effects: take pills bid in morning and evening, should not be discontinued w/o doctor's instructions; minimize adverse effects: keep home at cooler temp, notify physician immediately if symptoms of muscle weakness, pain and swelling of legs and ankles, mental confusion, and constipation are noted; most important pt education: counsel women about possible risk of endometrial cancer
Doxorubicin HCl
indicated for treating acute leukemias, soft tissue and bone sarcoma, hodgkin's and non-hodgkin's lymphoma, breast and ovarian cancers; major contraindication: suppression of bone marrow; most common adverse effects: alopecia and n/v; most serious adverse effects: cardiac damage, bone marrow depression, and extravasation; maximizing therapeutic effects: administer cardioprotective therapy; minimizing adverse effects: maintain max dose of 550 mg/m2; most important pt education: warn of the appearance of red urine discoloration after administration
Carmustine
indicated for treating brain tumor, multiple myelomas, hodgkin's and non-hodgkin's lymphomas, and malignant melanoma; major contraindication: poor pulmonary function which places pt at risk for pulm toxicity; most common adverse effects: acute n/v; dose-limiting effect: delayed myelosuppression; most serious adverse effects: pain and burning at site during infusion; maximizing therapeutic effects: solution is stable in glass container for 24 hrs @ 4 degrees C or for 8 hrs @ 25 degrees C and protected from light; minimizing adverse effects: decrease pain and burning during administration, infuse IV slowly over 1-2 hrs, infuse 125 mL of NS; most important pt education: instruct pt to comply with prescribed hematologic monitoring
Cyclophosphamide
indicated for testicular, ovarian, and bladder cancers; major contraindication: severe depression of bone marrow function, serious infections, nursing mothers, and those with reproductive potential; most common adverse effect: hemorrhagic or nonhemorrhagic cystitis; dose limiting effect: leukopenia; LIFE SPAN ALERT: pts on long term therapy should be counseled about the risks of secondary malignancy; maximizing therapeutic effects: ensure that pt has adequate bone marrow reserve and good renal function; minimizing adverse effects: promote vigorous hydration and diuresis, administer mesna to prevent hemorrhagic cystitis; most important pt education: instruct pt to drink plenty of fluids and empty bladder q 2 hr; SAFETY ALERT: obtain current height and weight in order to calculate surface area to ensure proper dose, death can occur if inappropriate doses are administered
Paclitaxel
indicated for pts who have metastatic carcinoma of the ovary after failure of first line or subsequent chemotherapy and pts with breast carcinoma after failure of combo chemo; major contraindication: hypersensitivity to Cremophor El, baseline neutrophil count <1,500/mm3, pregnancy and lactation; most common adverse effects: n/v, alopecia, joint pains; dose limiting effect: depression of bone marrow function, mainly neutropenia; safety alert: most serious adverse effects are severe hypersensitivity rxns which occur w/in 20 mins of administration; max therapeutic effects: use glass containers, and in line filtration for drug admin.; minimizing adverse effects: administer paclitaxel first when given in combo with other drugs to prevent profound myelosupporession, premedicate pts with corticosteroid 60 mins before paclitaxel to avoid anaphylactic rxns; most important pt education: taking the corticosteroids as prescribed
Etoposide
for tx of testicular carcinoma, small cell and non small cell lung cancer, lymphoma, hodgkin's disease and multiple myeloma; major contraindication: known hypersensitivity; safety alert: most common adverse effect is hypersensitivity or anaphylaxis; dose limiting effect: myelosuppression; LIFE SPAN ALERT: radiation recall may occur, safety not est. in children; max therapeutic effects: always infuse slowly-30-60 mins or slower-never by IVP; min adverse effects: monitor results of CBC count before and at expected nadir, monitor for s/s of myelosuppression incl bleeding and infection; most important pt educating: forewarn pt that infusion causes metallic taste
Vincristine
tx for acute leukemia, breast cancer, neuroblastoma, multiple myeloma; major contraindication: demyelinating for of Charcot-Marie-Tooth syndrome; most common adverse effect: tissue necrosis if the drug extravasates; most serious adverse effects: neurotoxic deficits ie. paresthesias, myalgias, loss of deep tendon reflexes, and jaw pain, paralytic ileus aeb constipation may occur; LIFE SPAN ALERT: caution elderly pts regarding potential for motor and sensory deficits, may cause fetal harm or risk to mothers who are breast feeding; safety alert: fatal if given intrathecally; max therapeutic effects: drug is light sensitive, infuse slowly over 1 min; min adverse effects: assess bowel elimination pattern because of the danger of paralytic ileus; ensure good vascular access and monitor for s/s of extravasation; most important pt education: pt needs to obtain rx for prophylactic stool regimen
5-FU
tx for predominantly solid tumors-carcinoma of colon, rectum, breast, stomach, pancreas; major contraindications: poor nutritional status, decreased bone marrow reserve; most common adverse effects: alopecia, photosensitivity, increased skin pigmentation; dose limiting effects: myelosuppression, n/v, diarrhea, stomatitis; LIFE SPAN ALERT: breast feeding not advised, practice contraception; max therapeutic effects: potentiate antineoplastic activity by adding reduced folates; min adverse effects: monitor CBC and assess for s/s of myelosuppression which include infection and bleedng; most important pt education: teach pt good oral care and to monitor for early s/s of stomatitis and infection
Prednisone
anti-inflammatory or immunosuppressive therapy; hepatic dysfunction may impair prednisone conversion into active prednisolone; pt at risk for adrenal insufficiency; major contraindication: hypersensitivity to prednisone, systemic fungal infections; most common adverse effects: CNS complaints of euphoria, headache, vertigo, GI complaints of n/v, increased appetite, wt. gain, dyspepsia; most serious adverse effect: acute adrenal insufficiency ; max therapeutic effects: administer according to schedule; min adverse effects: give with meal and/or antacids; most important pt education: advise pt to wear medical ID tag
Filgrastim
used in pts with cancer to increase their neutrophil counts; administered by IV infusion of daily SQ injections; most common adverse effect: medullary bone pain; LIFE SPAN ALERT: older adults are more at risk from complications with neutropenia; prophylactic use of G-CSF is usually appropriate; SAFETY ALERT: pts have a high risk of infection until neutropenia is corrected; max therapeutic effects: do not dilute in saline, avoid shaking, administer with first cycle of chemo; min adverse effects; do not decrease the dose before the expected neutrophil nadir, keep refrigerated and use aseptic technique to minimize risk of bacterial growth; most important pt teaching: how to decrease risk of infection
Epoetin-Alfa
used to treat anemia in CKD, HIV, and cancer; major contraindication: uncontrolled HTN; most common adverse effects: HTN, fever; most serious adverse effect: thrombotic effects; SAFETY ALERT: raising the Hb level too quickly can result in seizures; max therapeutic effects: consult with prescriber about dose adjustment and verify iron availability; min adverse effects: montior Hb; most important pt education: advise pts of the need for follow up blood work and the importance of dietary iron