Cancer medications – Flashcards
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Cancer cells
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are rapid, uncontrolled, cell devision
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What does metastasize mean?
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travels to another area
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In cancer cell lose normal function and
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invade normal tissue.
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Neoplasm is a
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tumor
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What is a slow growing tumor that does not metastasize and rarely requires drug treatment called?
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benign
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What is a cancer of the epithelial tissue. It is the most common type of malignant neoplasm. It grows rapidly and metastasizes quickly?
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carcinoma
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What is an adenoma, papilloma, and lipoma, stoma, meningioma?
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benign tumors
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What are malignant melanomas, renal cell carcina, adeoncarcinom, hepatocellular carcinoma?
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malignant neoplasms
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What is leukemia?
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cancer of the blood-forming cells in bone marrow.
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Is leukemia chronic or acute?
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can be either
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What is lymphoma?
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cancer of the lymphoid tissue: hodgekins, lymphoblastic lymphoma
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What is a melanoma?
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malignant melanoma that grows rapidly and is deadly.
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Sarcoma is a cancer of what?
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connective tissue; grows rapidly
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What is responsible for one-third of all cancers?
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tobacco
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Asbestos is a big cause of ?
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lung cancer
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Benzene is a chemical that causes?
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Leukemia
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What physical things can cause cancer?
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sun, uv light, and x-rays
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15% of all cancer are caused from?
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viruses: herpes CMV ebstein barr HPV
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What is an oncogene?
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It means you have a genetic predisposition
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Cancer attacks when the immune system is taxed, like in?
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HIV Transplant patients taking immunosuppressants steriods patients
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What is something that happens to us when we age that causes one a greater chance in getting cancer?
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damage to the tumor suppressor genes
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What is something we can teach our patients to help them not get cancer?
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adopt a health life style no smoking limit alcohol eat more veggies stay a health weight exercise limit sun decrease animal fats
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What is an OTC that Professor Gibson says helps ward off cancer?
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Selinian, Vitamin E
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What are tests we need to get as we age?
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mammograms prostate exams fecal occult blood test pelvic exam colonoscopy
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Teach our patient to check their body monthly for?
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skin lesions, and abnormal lumps
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What is debunking?
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surgery to remove a significant amount of cancer cells.
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Cancer treatment varies name the three general treatments?
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chemo radiation surgery
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On men where should we check closely for skin cancer?
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top of their ears
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Cancer is usually ?
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localized Infiltrated blended into many organs or tissues
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Localized cancer has
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a hard shell, solid tumor, and not a heavy blood supply so chemotherapy is not usually a good option.
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Infiltrated usually has
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a good blood supply, chemo is used.
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On localized cancer what is the treatment?
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radiation
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Chemotherapy goes into the blood stream and
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has potential to reach all the cancer cells.
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Some chemo drugs can cross the?
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blood brain barrier
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Tumors don't always necessarily go away but if they become?
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inactive the cancer is gone.
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Cancer therapy is usually adjuvant therapy. What does this mean?
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often combined treatments:surgery, chemo, radiation.
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What is growth fraction?
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how many cells are undergoing mitosis, multiplying. Ratio of replicating cells to resting cells.
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The main thing we look at with chemo is
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growth fraction
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Growth fraction is a major factor determining if?
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chemotherapy will be successful.
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Chemotherapy is most affective against?
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rapidly deviding cells.
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Leukemia and lymphomas has a high growth fraction, so what therapy would be good?
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chemotherapy, works good on rapidly deciding cells
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What are the three major side effects of chemo, because they also are rapidly growing cells?
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hair follicle, alopecia bone marrow, anemia gastrointestinal, nausea and vomiting
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Three stages of chemotherapy are?
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Induction phase * Decrease cancer cells as fast as possible *80% is the goal Intensification stage *bombard the tumor *chemo,radiation, bone marrow transplant Maintenance therapy *Patient is in remission *2 years monitoring *Labs *CT *watch for return
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What is one thing a nurse must do prior to administering chemotherapy?
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Have the patient labs drawn, and check results prior to administration. You have to check his wbc's . If too low we cannot give chemo.
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Chemo therapy can cause what to someone mouth?
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severe ulcers
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The goal of chemo therapy is to sometimes give a combination of drugs so you hit the
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cell at different replication phases
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The goal of chemo is to kill all the
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cancer cells
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It is important to
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diagnose cancer early
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Liver and pancreatic cancer have a high
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death rate
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Using multiple-drug strategy also helps
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reduce drug resistance
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Do we give chemo through a normal IV line?
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no, it is very causative to the skin. Use central line.
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When giving chemo through a central line what do you check first prior to administering?
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placement
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How is chemo dosing done?
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They want to give as much chemo as they can while still allowing normal cells a chance to recover. Remember chemo kills good and bad cells.
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Many chemo patients will receive what to help rejuvenate blood cells?
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nuepogen erythpogen
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What is mucositis?
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severe nausea, and vomiting and diarrhea
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What is something we can do to help reduce the chances of mucositis?
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anti-emmetic:zofran, compazine, reglan, ativan
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What is severe toxic side effect of chemo?
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severe anemia: decreased platelets, high chance of a bleed.
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If there ANC falls below 500. What does this mean?
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they need reverse isolation. Their immune system is taxed.
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Bone marrow depression:anemia, leukopenia, throbocytopenia can be treated with?
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bone marrow transplant platelet infusion growth factor:nupogin, erthroypetin
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If you are administering a chemo drug you must have the antidote on your floor ready to go in case of an emergency!! Always check first.
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Different chemos have different antidotes.
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Vesicants can cause?
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extravasation, tissue injury
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What is the long term consequences of cancer treatments?
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infertility secondary cancer from the cures, radiation
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There are five types of chemo medications, antineoplastics. Name them?
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*alkylating agents *antimetabolites *antitumor antibiotics *hormones *natural products
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Alkylating agents work by
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forming bonds with DNA then break them and prevents cell devision.
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How do antimetabolites work?
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*resemble the building blocks of cells,distribut replication
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How do anti-tumor antibiotics work?
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some antibiotics can kill tumors
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How do hormones and hormone agents work on tumor suppression?
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slow growth of hormone dependant tumor. Like prostate or ovarian, uterine.
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How do natural products work on killing cancer?
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some plants prevent cell division of cancer cells.
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Cytotoxins in chemo drugs are harmful to the bladder. Teach patient to?
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empty their bladder often Hydrate The goal is to get cytotoxins out of bladder because they can cause cystitis, and hemorrhagic cystitis. Bladder is irratated and starts to bleed.
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Cancer patients can have mucosal, mucosistis, problems from the
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mouth to the anus. n/v/d/bleeding from mouth to anus. Remember GI is rapid deviding cells.
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Ventristine is a **alkylating agent to kill cancer. Nursing interventions are?
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watch cbc carefully, ***** big bone marrow suppressor this can cause nerve damage tingling, numbness Peripheral nerve damage GI tract nerve damage constipation
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How does cytoxin work?
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attaches to cell; changes structure of dna in cancer cells and destructs them: alkylating agent.
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Watch for nerve damage anywhere. Watch for bowel sounds can cause an ileus due to?
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nerve stimulation decrease and bowel obstruction occurring.
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Cytoxan come from the
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vincristine flower
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Cytoxan big issues are?
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severe immunosuppressant thrombocytopenia;watch bleeding
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Your patient has cancer and is severely immuno-compromise. Chemo therapy treatment has just finished. What three thing can they not do for six months?
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immunization anti-inflammatories pregnancy
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Cytoxan can cause Steven Johnson syndrome. What do you watch for?
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Severely immunocompromised patients such as ones on chemo can develop this. It is an erupting skin rash. Vessicles and Bulla all over the body; which are severe fluid filled blister everywhere; bleeding and painful.
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Cytoxan can cause hemorrhagic cystitis. What do you teach your patient to avoid this?
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Hemorrhagic cystitis is from the toxins from the chemo being in the bladder causing bladder irritation and hemorrhage. Teach the patient to hydrate. Take the chemo in am so they can empty bladder hourly if not more.
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Can a patient take St Johns Wart and Cytoxan together?
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no, it increases the toxicity.
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What is nadir?
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platelets, wbc's and rbc's are drastically reduced from taking Cytoxan. You'll see it in 7-14 days after the dose. Always check cbc prior to administer a dose of chemo.
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Do patients who are getting chemo take steroids?
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yes, it helps with the side effects but one needs to watch the patient closely for immunosuppression since they both immunosuppress.
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Watch drug category is Cytoxan and methotrexate?
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category X !! No pregnancy. It kills rapidly dividing cells and pregnancy is rapid dividing cells. No pregnancy for six months after last does.
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What are other things to teach patient about taking Cytoxan's?
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monitor for signs of hearing loss maintain strict medical asepsis
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Can a patient get sick years later from the cure , Cytoxan.
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Yes, up to five years later they can develop leukemia.
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What do we give Cytoxan for?
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Hodgkin's disease;lymphoma;multiple myeloma; breast cancer; ovarian cancer.
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Should patients who are immunocompromised avoid large crowds?
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yes
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If your patient ANC falls below 500 taking Cytoxan, what do you do?
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Do not administer the Cytoxan. There wbc, rbc, and platlets are too low. They have virtually no immune system. They will have to wait until lab value come up to get another dose.
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What is blood dyscrasisas from Cytoxan?
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irregular blood levels either up or down
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Watch should the nurse check on patient who are taking Cytoxan
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nutritional intake: need protein offer ice chips or ice pops for mouth pain
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What is the anti-metabolite medication she wants us to know?
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methotrexate
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Cancer cell can mimic nutritional cells our body needs to trick the body into grabbing onto it and then
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killing it.
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How does methotrexate work, anti-metabolite?
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It blocks the reproduction of cells by blocking the synthesis of B9.
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What cancers do we treat with methotrexate, anti-metabolite?
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choriocarcinoma, ostogenic sarcoma, leukemias, head and neck cancers, breast carcinomas, lung carcinomas.
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What is 5FU?
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Its a cytotoxin we give in the hospital to kill cancer it is given iv and then the patient is sent home on Zolloto, which is a p o drug.
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What is the problem with patients taking zolotto?
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compliance must take five time a day and has a lot of side affects, but you can take it at home because its a p o.
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Methotrexate is also bone marrow suppressor at high doses and also causes mucocytitis. Watch your patients?
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cbc and blood counts; watch for gastrointestinal bleeding, measure abdominal girth; hematest for blood in stool; listen for bowel sounds.
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Your patient is taking anti-metabolite methotrexate what OTC can they not take?
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NSAIDS
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Can your patient on methotrexate, anti-metabolite have coffee?
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No more than three cups of regular coffee per day. It decreases the effectiveness of methotrexate.
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The doctor order methotrexate with Lukapron rescue. What is this?
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This helps to save some of the good blood cells: rbc's, wbc's ; platelets.
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Teaching for patients on methotrexate and chemo drugs?q
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photosensitivity; stay out of the sun good oral hygiene oral fluid>2000/day
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If your patient is getting chemo drug through a regular peripheral line you must?
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watch the IV very closely. Central line is recommended do to evisceration of tissues.
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What is the anti-tumor drug she wants us to know?
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doxyrubicin
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How does doxyrubicin work?
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it attaches to DNA and distorts double helical structure and prevents normal DNA and RNA synthesis.
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What is a big adverse reaction that can occur within days to years later on patients taking doxyrubicin?
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arrhythmias, from heart failure
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All of these drugs are what warning?
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Black box
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What drugs do you need to watch with doxyrubicin?
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dig Dilantin for seizures **decreases both
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Can a patient taking doxyrubicin have green tea?
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No, increases the toxicity of the drug.
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What temperature should we never do on chemo patients?
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rectal, they have thrombocytopenia many times or ulcers in the rectum due to toxins of the drugs. They can hemorrhage.
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How does the nurse prepare chemo drugs?
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protective gloves, mask and apron, and she has had chemo training.
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What IV should you give antitumor drug through, doxyrubicin?
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large bore IV . Central line is preferred due to vesicant to skin.
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What is the natural product prototype drug named?
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vincristine
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Vincristine is used on?
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Hodkins, kaposi's sarcoma, Wilms tumor, bladder carcinoma, breast carcinoma
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What are the adverse effects of vincristine?
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**nervous system toxicity muscular weakness loss of neural reflexes paralytic ileus/constipation alopecia
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Teach patient they will get alopecia but the hair will
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grow back possibly a different texture and possibly a different color.
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How does vincritstine work?
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inhibits the cell from mitosis occurring
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For overdose of vincristine what to you give?
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lecovorin (flolinic acid)
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Viscristine can cause
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acute bronchospasms and rash
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Teach patient taking viscritine to avoid constipation do?
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drink a lot of fluids increase fiber
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Vincristine can cause depression asses the patient for
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possible suicidal ideation.
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Hormone and Hormone antagonists
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are given with chemo drugs to help slow the growth of reproductive -related tumors:prostate;breast;uterine
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Name some of the hormone and hormone agonist used for neoplasms?
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decadron prednisone lupron estradoil tamoxifen
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How do the hormone antagonist work?
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target cell therapies attack a specific cell
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What type of cancer is tamoxifen used on?
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breast cancer
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How does tamoxifen work?
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blocks estrogen receptors
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Women who carry the Bracca gene and are high risk for breast cancer can also get
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tamoxifen
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Adverse affects of tomoxifen?
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n/v thrombolytic disease hot flashes fluid retention vaginal discharge is common vaginal spotting
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Tomoxifen can have an idiosyncratic effect which is?
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tumor flair, an increase in tumor size but this is a therapeutic expected event occurs 3 weeks to 3 months.
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One on tomoxifen cannot take
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anti-coagulants estrogens
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Teach your patients taking hormone and hormone antagonist that they may develop?
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develop secondary cross-gender sexual characteristics decreases fertility in women
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What are biologic response modifiers?
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stimulates the immune system to rid itself of cancer cells. These help to limit immunosuppressant effects. They are given with antineoplastics.
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Name the biological modifiers?
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interferons interleukins monoclonal antibodies
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Avastin is a new drug on the market it works by suppressing
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anti-angion genic/can't make new vessels.
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Teach patient who are on immunosuppressant, chemo drugs?
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hydrate protein cbc weekly cooked foods only nutrition is very important no tylenol no aspirin no rectal temps call dr if temp over 100.5 use straws in restaurants wipe silverware down in restaurants no spicy food
