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Nusing Pharmacology: Chemotherapy Drugs

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Types of cancer used for:
Cyclophosphamide
(Cytoxan)
Affects all rapidly proliferating cells.
Brest cancer
Burkitt's Lymphoma
Embryonal Rhabdomyosarcoma
Ewing's Sarcoma
Diffuse Histiocytic lymphoma
Osteogenic Sarcoma
Wilms' Tumor
Classification of:
Cyclophosphamide
(Cytoxan)
Antineoplastic agent: Alkylating agents
Mechanism of:
Cyclophosphamide
(Cytoxan)
1. Cell cycle nonspecific
2. Unite with DNA molecules
3. Prevent the separation of double-coiled DNA molecules
4. "Act by interfering the chemical structure of DNA and by causing abnormal chemical bonding between adjacent DNA molecules."
Main side/adverse effects of:
Cyclophosphamide
(Cytoxan)
1. nausea and vomiting
2. bone marrow depression
3. hemorrhagic cystitis
4. alopecia
5. hypersensitivity
6. blurred vision
Nursing implications for:
Cyclophosphamide
(Cytoxan)
1. provide adequate daily fluid intake to avoid hemorragic cystitis.
2. monitor clent for signs of hematological changes.
3. Drug is potentially teratogenic. Avoid pregnancy during treatment and for 4 months after.
4. Administered in the morning so that the kidneys can eliminate it by night time.
Type of cancers used for:
methotrexate
(Mexate, MTX)
Used for rapidly proliferating cancers:
1. breast cancer
2. Burkitt's lymphoma
3. choriocarcinoma
4. diffuse histiocytic lymphoma
5. osteogenic sarcoma
Classification of:
methotrexate
(Mexate, MTX)
Antineoplastic agent: Antimetabolites
Mechaniam of:
methotrexate
(Mexate, MTX)
1. Folate antagonist
2. starve cells
3. cell-specific (s-phase)
4. "interfere with various metabolic actions of the cell and thereby result in cell destruction or inability to replicate itself."
Main side/adverse effects of:
methotrexate
(Mexate, MTX)
1. ulcerative stomatitis
2. nausea and vomiting
3. bone marrow depression
4. diarrhea
Nursing implications for:
methotrexate
(Mexate, MTX)
1. Avoid use with nonsteroidal, anti-inflammatory drugs(NSAIDs)
2. Also indicated for use in the treatment of rheumatoid arthitis and psoriasis.
3. Sunscreen should be use to protect skin exposed to sunlight.
4. because of abortion and anomaly risks, client sholud avoid conception during and immediately following treatment.
What is used to neutralize the toxic effects of methotrexate on the hematological system.
Leucovorin
(citrovorum factor)
Mechanism of Leucovorin
1. competes with methotrexate sodium to neutralize it.
2. Decrease elevated uric acid level.
3. compound similar to folic acid.
Type of cancer used for:
vincristine sulfate
(Oncovin)
1. Acute lymphoblastic leukemia
2. Burkitt's lymphoma
3. embryonal rhabdomysarcoma
4. Ewing's sarcoma
5. Hodgkin's disease
6. Diffuse histiocytic lymphoma
7. Wilms' tumor
Classification of:
vincristine sulfate
(Oncovin)
Antineoplastic agent: Mitotic Inhibitors
Mechanism of:
vincristine sulfate
(Oncovin)
"Act by specifically interfering with cell division or mitosis, i.e., the M phase of the cell cycle."
Main side/adverse effects of:
vincristine sulfate
(Oncovin)
1. peripheral neuropathy
2. alopecia
3. irritation at injection site
Nursing implications for:
vincristine sulfate
(Oncovin)
1. Avoid leakage of drug solution into surrounding tissue during injection.
2. monitor client for development of neuromuscular changes.
3. do not mix with anything but normal saline or glucose in water.
4. stool softner maybe use in preventing constipation
5. reconstitued refigerated solution maybe kept for 2 weeks.
Types of cancer used for:
doxorubicin hydrochloride
(Adriamycin)
1. breast cancer
2. embryonal rhabdomyosarcoma
3. Ewing's sarcoma
4. Hodgkin's disease
5. diffuse histiocytic lymphoma
6. osteogenic sarcoma
7. Wilms' tumor
Classification of:
doxorubicin hydrochloride
(Adriamycin)
antineoplastic: antibiotics
Mechanism of:
doxorubicin hydrochloride
(Adriamycin)
1. inhibit protein RNA synthesis, binds to DNA
2. "act by interfering with one or more stages of RNA and/or DNA synthesis. This actins interferes with cell's ability to grow and reproduce normally."
3. Cell-cycle nonspecific.
Main side/adverse effects of:
doxorubicin hydrochloride
(Adriamycin)
1. bone marrow depression
2. cardiac toxicity
3. nausea and vomiting
4. alopecia
5. irritation at injection site
Nursing Implications for:
doxorubicin hydrochloride
(Adriamycin)
1. monitor for the developent of bone marrow depression and cardiotoxicity.
2. avoid leakage of drug solution into surrounding tissue during injecton.
3. may produce red urine for 1-2 days, but this is not hematouria.
4. observed for changes in nail beds on fingers and toes.
5. refrigerated, reconstitued solution is stable for 48 hours.
List 5 antiemetic medications used for control of nausea and vomitting for client recieving chemotherapy
1. Zofran
2. Kytril
3. Anzemet
4. Marinol
5. Reglan
What classification are interferons?
Biologic Response Modifiers- Antineoplastic agents
What is/are the mechanism of interferons?
1. Alter response of host to tumor cells.
2. Inhibits DNA and protein synthesis in tumor cells.
3. Stimulates tumor-associated antigens
What classifications are tomoxifen citrate (Nolvadex)?
Hormones- Antineoplastic agents
What are the mechanism/usage of hormons-antineoplastic agents such as tomoxifen citrate (Nolvadex)?
1. cell-cycle nonspecifics
2. treat hormonally sensitive tumors.
3. Block hormone-dependent tumors.

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