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37 Cards in this Set
- Front
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Cell cycle-specific drugs
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toxic to the cell at a particular phase of the cell cycle cause no significant harm during other phases
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Major toxicities of antineoplastic drugs seen on rapidly dividing cells
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bone marrow = decreased RBC, WBC, major reason for infection, GI mucosa = N&V, Gonadal cells = sperm banking, do not use during pregnancy
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Chemo routes
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central line is choice for vesicant but peripheral can be used for pushes no piggybacks with vesicants
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what is the most common side effect of chemo
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bone marrow toxicity we are killing both good and bad cells
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Antimetabolites 5 FU treats solid tumors especially GI, pallative care of carcinoma of colon, breast, liver, ovary, pancreas, rectum head & neck, stomach
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5FU: hepatic metabolism
dose limiting: myelosuppression, anemia, leukopenia, thrombocytopenia |
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5FU is does dependant = N&V, anorexia, diarrhea adn stomatitis, GI ulceration, cardiac events occur during the firs 72hours
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5FU cutaneous does dependant : alopecia, hyperpigmentation, brittle and cracking nails, maculopapular rash painful erythematous desquamation, fissrues of the palms and soles so think 5 = hands and feet
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5FU is cardiotixic, acute cerebella syndrom and photophibia and ocular changes
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ALL CHEMOS
risk for infection, risk for injury, imbalanced nutrition - less than body requirements, distrubed body image, distrubed sensory perception, |
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5fu daily dose s/n exceed 800 mg d/c drug if stomatitis, esophagopharyngitis, leukipenia, throbocytopenia, intractable vomiting, diarrhea, gi ulceration and bleeding do not use aspirin
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mitotic inhibitors - vinca alkaloids: vincristine the terrible v sisters = vesicant
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Vincristine used for acutre lymphoblastic and hodkgin disease, malignant lymphomas, sarcoma, breast cancer, small-cell lung cancer
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Vincristine bind to plasma proteins and poor bbb penetration
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Vincristine dose limiting is
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neurologic effects most common: motor, sensory and autonomic eruopathies
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nursing diagnosis for most chemo drugs are
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disturbed sensory perception
risk for constipation risk for infection impaired skin integrity disturbed body image ineffective sexuality patterns |
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Vincristine mazimizing theraputic effects the nurse needs to do
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monitor cbc before each dose
protect drug from light uses central venous access for continous IV infustion |
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Vincristine minimizing adverse effects the nurse
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conducts neurologic evaluation before each cycle, report changes in sensory functioning and prevent extravasion
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with Vincristine ongoing assessments are
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measuring uric acid levels
assessing bowel, motor and sensory functions |
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what to teach patients to limit infection:
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handwashing, avoid children / crowds,pet excretion, fresh fruit and veggies and fresh flowers
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Mitotic inhibitors Etoposide vespid vp16
used for |
testicula tumors and small lung cancer
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Etoposide vespid vp16
contraindications & precautions |
never IV push danger of hypotension insufed over 30 to 60 minutes or longer. if taking warfarin monitor prothrobin
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Etoposide vespid vp16
adverse side effects |
hypersensitivity or anaplyatic-like reactions
hypotension, chill, fever, facial flushing, bronchospasms, dyspnea tachycardia and radiation recall, secondary malignancies |
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Etoposide vespid vp16
maximizing threaputic effects |
prevent crystallization via proper dilution
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Etoposide vespid vp16
minimizing adverse reactions |
apply warm compress to IV site, monitor hepatic and renal functinon and daily dose s/not exceed 8000 MG
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mitotic inhibitor - tanes
pacilataxel TAXOL treats ovarian and breast cancer and Karposi sarcoma metabolized in hepatically |
mitotic inhibitor - tanes
pacilataxel TAXOL can cause hypersenstivity reaction, neurutoxic, cutaneous reactions and cardiotoxic |
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mitotic inhibitor - tanes
pacilataxel TAXOL neurotoxicity s/s |
numbness, tingling & pain to hands & feet
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what does nurse need with cardiotoxic
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baseline EKG and ejection fration MUGA SCAN
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mitotic inhibitor - tanes
pacilataxel TAXOL what does nurse need to to |
premedicate d/t hypersitivity
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camptothecines: topotecan
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treats metastic ovarian cancer, small cell lung and all
hepatic metabolism |
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camptothecines: topotecan
contracindications and issues |
poor bone marrow reserves can cause head ache, fever and flu-like symptoms
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Hydroxyurea for hematologic cancers = bbb penetration donts use in severe anemia, severely depressed bone marrox
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hydroxyurea can cause renal problems, CNS effects are drowsiness, HA, dizziness, hallucinations
"think hydro = high= hallucinations" |
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with hydroxyura use patients actual or ideal body weight for dosage pretreat will allopurinol if necessary
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Alkylating agents: Cytoxan ( cyclophoshamide) treats hematologic malignancies, acute and chronic leukemias, stem cell transplants and solid tumors, hepatic metabolism
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Cytoxan ( cyclophoshamide
precautions and complications are |
poor renal or hepatic function
dose limiting = leukopenia, sterile hemorrhagic cystitis, secondary malignicies, dizzy, nnasal stuffiness, rhinnorrhea with rapid infusion |
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what is sterile hemorrhagic cystitis
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you will have pain, burning and hematuria give uroprotectant drug mensa (Mesnex) and hydrate patient well before, during and after treatment
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Cytoxan ( cyclophoshamide
what are adverse effects |
nephrotoxicty, neurotoxicity, ototoxicity, anaphylaxis like reaction and electrolyte imbalance
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Nitrosoureas: carmustine
pallative care threapy of brain tumors hodgkin - renal and respiratory excretion crosses bbb |
Carmustine can cause irreversible pulmonary fibrosis and need pulmonary assessments avoid aspirin
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anitumor antibiotics: doxorubicin red drug hepatic metabolism may turn urine red
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antitumor antibiotics: doxorubicin red drugcardiotoxicity is the dose-limiting toxicity it is cumulative and may manifest in weeks or months
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anitumor antibiotics: doxorubicin red drug
contraindications |
severe congestive heart failure, cardiomyopahty and myelosupression can cause renal insufficency
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hormones and hormone antagonists
used in lymphomas, squamous cell carcinoma ad testicular cancer high risk for pulmonary toxicity |
hormones and hormone antagonists treat neoplasma inhibit tumor proliferation alter cellular environment, affect permeability of cell membrane have pallative benefits, anti-inflammatory
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antiestrogens: tamoxifen
treats advanced breast cancer adjuvant therapy for axillary node-negative breast cancer |
Tamoxifen is well absorbed, highly protein bound, hepatic metabolised, competes with estrogen for binding sites
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tamoxifen
hypersensitvity, causes hot flashes, mild nausea, all s/s of menapause and bone and tumor pain is sign it is working |
tamoxifen
assess serum calcuim levels and corneal changes with decreased visual acutiy |