NR203 4th semester Chemotherapy
Terms
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Alkylating Agents: Name 3
Hint: All C words -
Cisplatin (Platinol)
Carboplatin (Paraplatin)
Cyclophosphamide (Cytoxan) - Alkalyting agent-is it cell cycle specific?
- No It is non cell cycle specific
- Cisplatin (Platinol) S.E.
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SEVERE NAUSEA AND VOMITING
Renal Damage
OTOTOXICITY
Bone Marrow Depression
Neurotoxicity - Carboplatin (Paraplatin) S.E. compared to Cisplatin (Platinol)
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Less N/V
Neuro/Nephro toxic,
Better therapeutic effects - Nursing Implications for Cisplatin (Platinol) and Carboplatin (Paraplatin)
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Monitor the lab work closely
for bone marrow and renal damage.
Ovserve closely for hearing or renal damage
give meds to prevent/treat N/V - Cyclophosphamide S.E.
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HEMORRHAGIC CYSTITIS-diffuse inflammation of the bladder leading to hemorrhage.
Bone marrow depression
N/V
alopecia - Cyclophosphamide (Cytoxan) Nursing Implications
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Provide Adequate daily fluid intake to avoid hemorrhagic cystitis.
Monitor labs for bone marrow depression
Avoid pregnancy - Name the Recombinant monoclonal antibody IgG1-produced by recombinant DNA technology
- Rituximab (Rituxan)
- Rituximab (Rituxan) Binds to surface of normal and _______ _______ ________
- normal and malignant B-Lymphocytes
- Rituximab Common Side Effects
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Allergic reaction
Anaphylaxis
Renal and Hepatic Toxic
Cardiac arrythmias,
TLS=Tumor Lysis syndrome - Rituximab Nursing Implications
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Monitor CBC, Platelets, Liver, renal function
Monitor BP and HR
hydration and allopurinol for hyperuricemia - Name 2 Anti-Metabolite
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5-Fluorouracil (5-FU)
Methotrexate (MTX) - Antimetabolites-Cell cycle affected?
- Cell cycle specific for S (Synthesis phase)
- 5 Fluorouracil (5-FU) S.E.
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ORAL AND GI ULCERATION
MUCOCITIS-Mucositis is a painful condition that significantly impairs chewing and swallowing. Previously referred to as "stomatitis" or "mouth sores," mucositis presents as redness and/or ulcerative sores in the soft tissues of the mouth. Mucositis is seen in patients with reduced white blood cell counts due to cancer chemotherapy and/or therapeutic irradiation.
N/V/D
bone marrow depression
alopecia - Methotrexate (MTX) S.E.
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BONE MARROW SUPPRESSION
ULCERATIVE STOMATITIS
N/V/D - 5 Fluorouracil (5-FU) N.I.
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Leucovorin used with 5-FU to neutralize toxic effects and enhance therapeutic effects
Monitor labs for signs of bone marrow suppression
Monitor for oral and GI ulceration - Methotrexate (MTX) N.I.
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Leucovorin is used to neutralize the toxic effects on the hematological system
USE sunscreen
Avoid pregnancy - Leucovoran Calcium (Folinic Acid) S.E.
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Allergic reactions
S/S OF HYPERCALCEMIA
-LETHARGY
-HEADACHE
-WEAKNESS
-MUSCLE FLACCIDITY
-HEART BLOCK
-N/V - Leucovoran Calcium (Nursing Implications)
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used to treat delayed excretion of MTX or O.D. of MTX. or as rescue after high dose of MTX therapy.
Given with 5-FU to enhance therapeutic effects and neutralize toxicities. - Name 1 Plant Alkaloid
- Etoposide (VePesid) (VP-16)
- Etoposide (VePesid) (VP-16) Cell Cycle Affected
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G2 Phase
VP-G2 -
Etoposide (VePesid) (VP-16)
S.E. -
Peripheral Neuropathy ***
Irritation at injection site
Alopecia
N/V
Constipation
Ulcerative Stomatitis - Etoposide N.I.
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Anaphylaxis
Monitor s/s of neurotoxicity
Avoid extravasation (is a vesicant)
Stool softeners
Bone marrow suppression -
Doxorubicin (Ruby-Big red)
Antibiotic
Cell Cycle Specific? -
No
Non-Cell-Cycle Specific -
Doxorubicin (Ruby-Big red)
Antibiotic
S.E. -
Cardiac Toxicity
Irritation at injection site
Bone Marrow Depression
Nausea/Vomiting
Alopecia -
Doxorubicin (Ruby-Big red)
Antibiotic N.I. -
Monitor for signs of cardiotoxicity
Monitor labs
May produce red urine for 1-2 days, but it is Not Hematuria
Is a vesicant (Apply ice packs and elevate IV site) -
Bleomycin (Blenoxane)
Antibiotic
Cell Cycle Specific? -
yes
Cell-Cycle specific to G-2 (second growth phase) -
Bleomycin (Blenoxane)
Antibiotic S.E. -
PULMONARY TOXICITY
pneumonitis
Pulmonary fibrosis
N/V
Rashes
Fever -
Bleomycin (Blenoxane)
Antibiotic
N.I. - Monitor Pulmonary Status closely
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Paclitaxel (Taxol)
Cell Cycle Specific? -
Yes
Cell Cycle specific for M (mitosis phases) - Paclitaxel (Taxol) S.E.
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BONE MARROW TOXICITY
Allergic reactions
Peripheral Neuropathy
Respiratory reactions - Paclitaxel (Taxol) N.I.
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Severe Neutropenia (Nadir level on day 11,
Severe thrombocytopenia (day 8-9), severe anemia -
Gemcitabine Hydrochloride (Gemzar)
Cell Cycle Specific -
YES
Cell Cycle Specific for S-Phase and G1 Phase - Gemcitabine Hydrochloride (Gemzar) S.E.
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PULMONARY AND HEPATIC TOXICITIES
Bone marrow suppression
N/V Alopecia
Bone pain - Gemcitabine Hydrochloride (Gemzar) N.I.
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Monitor CBC, liver function
Monitor pulmonary status
Treat Nausea
Treat bone pain