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14 Cards in this Set
- Front
- Back
Allopurinol
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works by inhibiting the enzyme xanthine oxidase, which prevents uric acid production; anti gout drug
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Colchicine
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has no effect on urinary excretion of uric acid, but reduces the inflammatory response to the deposits of urate crystals in joint tissue
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Probenecid
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increases urate excretion. Has no anti-inflammatory or analgesic activity. Used to treat chronic gout but not acute gout attacks.
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Tamoxifen
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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
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Doxorubicin HCl
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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
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Carmustine
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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
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Cyclophosphamide
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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
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Paclitaxel
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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
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Etoposide
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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
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Vincristine
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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
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5-FU
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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
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Prednisone
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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
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Filgrastim
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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
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Epoetin-Alfa
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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
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