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Pharm II - Week 7

Anticancer Drugs

Cancer is a group of disorders characterized by (list 4) 1) rampant growth of invasive cells, 2) lack of feedback mechanism r/t growth, 3) metastasis, 4) immortality
Cancer can occur due to activation of ____ or inactivation of ___, d/t (list 5) Oncogenes; tumor suppression genes; UV, x-rays, radiotopes, drugs, viruses
The primary difficulty of anticancer drugs is... The effect of drugs on normal fast-growing tissues
Cancer drugs interrupt the cell cycle at different points. List the cellular phases: G1 phase - gap phase/undergoes growth. S phase - DNA synthesis. G2 phase - cap phase, prepares for cell division. M phase - mitosis. (G0 is resting phase)
True or false: solid tumor cells are slower/have low growth factor than leukemias True
Most cancer drugs _____ affect high growth fraction Nonspecifically
List four normal cell types that have high growth fraction Hair, GI epithelium, bone marrow blood cells, sperm forming cells
True or false: once there is less cancer, the drug dose can be adjusted to a lower amount False. Must keep doses high to kill every cancer cell
With solid tumors, drug Tx is given in combination with... Surgery and radiation
When normal cells grow faster than cancer cells, _____ _____ therapy is done Intermittent drug therapy
True or false: when used in combination, drug doses can be smaller True
Combination drug therapy's advantages: Generally more effective than single drug. Less drug resistance, increased killing of cancer cells, less impact on normal cells if drug selections cause different toxicities
True or false: combination drug therapy has more adverse effects and is more lethal False. More AE but less lethal
Bone marrow contains these types of cells and have these AE RBC, WBC, platelets. Anemia, infection, bleeding
_____ build RBC, ______- build WBC, ___ build platelets Epogen/erythropoetin, Neupogen/filgrastim, Neumega/oprelvekin
GI cells have these AE. You would premedicate with AE: N/V/D, stomatitis, dehydration, decreased food intake. Premedicate with Zofran/ondansetron, antidepressants, Marijuana, diet supplements
Sperm cells' AE and support offered Mutagenesis. Sperm/egg bank prior to Tx and contraception
Cancer drugs given IV have ______ potential. Which means.... Vesicant. When given IV, can kill surrounding tissues if leak out of vein. Vasoconstriction --> tissue necrosis
Carinogenesis means... More likely to develop other cancers in lifetime
Erythropoietan is also known as... Epogen/Procrit
Epogen is given via these routes and nurse should be aware of these SE SQ/IV. Painful injection. Hypersensitivity, seizures, HTN
When treating a pt. with low RBC production, do the following RN actions: Check fatigue, monitor O2 (NOT sat O2), safety, lab values to measure outcomes
True or false: when pt. has leukopenia, with bacterial infections will only display fever as symptom False. Can show only fever with infections of all kinds.
Treat leukopenia with ______ via ___ (route). SE include Filgrastim/Neupogen. SQ/IV, nausea, hypersensitivity
To manage leukopenia: Prevent infection/handwash, avoid crowds and contact, vigilant temp checks @ home
Pt. with thrombocytopenia is at danger of __ & __. Treat with this drug via __ (route). Major AE is ____ Bleeding and hemorrhage. Tx with oprelvekin/Neumega.
Nursing considerations with oprelvekin No NSAIDs/anticoagulants. Monitor for bleeding everywhere. Precautions (soft toothbrush). Safety
Common cause of non-adherence with cancer drugs is ____ (side effect) Severe diarrhea
To Tx GI SE, you would... Provide antiemetic (Zofran/ondansetron), antidepressants, antianxiety (lorazepam, Ativan), marijuana, diet supplements
True or false: pt. with Hx of cancer often immediately develop another cancer False. Usually happens many years later
What drug category is used to treat vesicant drug effects? Vasodilators (particularly alpha antagonist)
True or false: most agencies require RNs to have special training to give cancer drugs True
When handling anticancer drugs, what should a RN do for protection? Consistently glove, wear eye/face protection
Anticancer drugs cannot be given if what is too low? Blood components
The most common category of drugs used to cancer is... Cytotoxic drugs
List subcategories of cytotoxic drugs and their corresponding meds 1) antimetabolites (methotrexate), 2) alkylating (cytoxan), 3) antitumor antibiotics (streptomycin), 4) mitotic inhibitors (vincristine)
Methotrexate is given... and has what indications? PO/IV. Ectopic pg, severe autoimmune diseases, skin, cancer
Other AE of streptomycin include... Cardiomyopathies, dysrhythmias
True or false: vinblastine spares bone marrow and can cause neuropathies in extremities FALSE. Vincristine does this. Vinblastine is a completely different drug
The least toxic category of anticancer drugs: _____ Hormones and hormone antagonists/blockers
True or false: hormone/hormone antagonists are more selective in targeting cells True. See: breast, cervix, uterus, prostate
What is the mechanism of action for hormone drug Tx? Suppress production of hormone or block receptors for hormone that is supporting tumor's growth
List subcategories for hormone/hormone blockers 1) glucocorticoids, 2) antiestrogens, 3) SERMs (selective estrogen receptor modulators), 4) anti-androgens, 5) progestins
Glucocorticoids at a high dose will suppress ___ Lymphocytes
GCs are indicated for ___, _______, and ___ Leukemias, Hodgkins, lymphomas
Tamoxifen is a ____, which blocks ________ Antiestrogen/SERM, block estrogen receptors
True or false: SERMs can stimulate estrogen receptors True. Some can also block estrogen R.
SERMs is used as _____ as well as treatment. Preventative
List some good side effects of SERMs Increased bone density, decreased LDL, increased HDL
AE of SERMs include Uterine cancer, thrombophlebitis (DVT)
Anti-androgens used to treat... Prostate cancer
Progrestins are used to _____ and also known as Suppress uterine cancer; Depo-provera
CAM is known as _____ and can be used to cure or help with AE of meds complementary and alternative medicine
Created by: choel



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