Antineoplastic Drugs- Cell Cycle Specific

Question 1

Cell Cycle Specific means

Answer 1

Drugs have specific effect on particular point in the cell cycle

Question 2

Why are there no true contraindications to antineoplastic drugs?

Answer 2

The benefits outweigh the risks. Might adjust accordingly, or might just pretreat the patient for expected adverse effects.

Question 3

Mechanism of action of Antimetabolites

Answer 3

Inhibit cell growth by interfering with the synthesis of compounds needed for cell reproduction (folic acid, purines, and pyramidines)

Question 4

Indications for Antimetabolites

Answer 4

Solid tumors (tumor at some specific location in the body), leukemias, and non-Hodgkin’s lymphoma

Question 5

Nursing Considerations for Antimetabolites

Answer 5

Educate on potential for Adverse Effects: hair loss, nausea, vomiting, diarrhea, myelosuppression

Question 6

Antimetabolite Key drugs

Answer 6

Methotrexate

Cytarabine

Question 7

Indications for methotrexate

Answer 7

Antagonizes folic acid production– cells can no longer grow and reproduce. For treatment of solid tumors such as breast, head and neck, lung cancers, acute lymphocytic leukemia, and non-Hodgkin’s lymphomas

Question 8

Nursing Considerations for methotrexate

Answer 8

Severe bone marrow suppression with high doses. Will give “rescue” drug leucovorin to prevent myelosuppression.

Question 9

Indications for cytarabine

Answer 9

Pyradine antagonist. Treats acute myelocytic and lymphocytic leukemia, and non-Hodgkin’s lymphomas.

Question 10

Nursing Considerations for cytarabine

Answer 10

Can cause Cytarabine syndrome (6-12 hours after infusion): fever, muscle and bone pain, maculopapular rash (on arms), conjunctivitis, and malaise. Can pretreat with corticosteroids to prevent this.

Question 11

Mechanism of Action of Topoisomerase II Inhibitors

Answer 11

Inhibit enzyme topoisomerase II causing breaks in DNA strands, which leads to cell death.

Question 12

Indications for Topoisomerase II Inhibitors

Answer 12

Small cell lung cancer and testicular cancer

Question 13

Adverse Effects of Topoisomerase II Inhibitors

Answer 13

Hair loss, nausea, vomiting

Question 14

Nursing Considerations of Topoisomerase II Inhibitors

Answer 14

Causes reduced clearance of warfarin and cyclosporine- prolonged AE like increased bleeding tendencies. Watch INR and give lower warfarin dose.

Question 15

Topoisomerase II Inhibitor Key Drugs

Answer 15

Etoposide- same profile as general class

Question 16

Nursing Considerations for Etoposide

Answer 16

Treatment of small cell lung cancer and testicular cancer. Interacts with warfarin and cyclosporine.

Question 17

Mechanism of Action for Mitotic Inhibitors

Answer 17

Works before or during cell mitosis to inhibit cell division

Question 18

Indications for Mitotic Inhibitors

Answer 18

Variety of solid tumors and some hematologic malignancies (leukemias)

Question 19

Adverse Effects of Mitotic Inhibitors

Answer 19

Hair loss, nausea, vomiting, myelosuppression

Question 20

Nursing Considerations for Mitotic Inhibitors

Answer 20

Can pretreat with antiemetic to avoid nausea and vomiting

Question 21

Mitotic Inhibitors Key Drug

Answer 21

paclitaxel

vincristine

Question 22

Indications for paclitaxel

Answer 22

Treatment of ovarian cancer, breast cancer, non-small cell lung cancer, and kaposi’s sarcoma

Question 23

Nursing Considerations for paclitaxel

Answer 23

Can produce hypersensitivity during infusion. Pretreat with steroid (dexomethasone), H1 receptor antagonist (diphenhydramine), or H2 receptor agonist (renididine) to prevent reaction

Question 24

Indications for vincristine

Answer 24

Treatment of acute lymphocytic leukemia and other cancers (used in conjunction with other neoplastic drugs)

Question 25

Nursing considerations for vincristine

Answer 25

Do NOT give via intrathecal route, very safe IV

Question 26

Mechanism of Action for Antineoplastic Enzymes

Answer 26

Enzyme that catalyzes conversion of aspargine (amino acid needed for DNA synthesis) to aspartic acid and ammonia. It INHIBITS DNA synthesis.

Question 27

Indicatiosn for Antineoplastic Enzymes

Answer 27

ONLY aproved for acute lymphocytic leukemia

Question 28

Adverse Effects for Antineoplastic Enzymes

Answer 28

hair loss, nausea, vomiting, impaired pancreatic function, specifically in beta cells (causes hyperglycemia). Can also cause pancreatitis.

Question 29

Nursing Considerations for Antineoplastic Enzymes

Answer 29

Monitor blood sugars!

Question 30

Antineoplastic Enzymes Key Drugs

Answer 30

Asparaginase

Question 31

Nursing Considerations for Asparaginase

Answer 31

Treatment of acute lymphocytic leukemia, derived from E. coli bacterium. Common for patients to develop allergic reaction- monitor reaction... if it is severe enough, might use similar drug that is even more toxic, but less risk of hypersensitivity.