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54/64 Unit 3 > Cancer Pharm And Prevention > Flashcards

Cancer Pharm And Prevention Flashcards

1
Q

What are the goals of cancer treatment?

A

Cure, control, palliation

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2
Q

What stage of cancer will always be palliative?

A

Stage IV

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3
Q

Cancer drugs in clinical trials will have _________ names

A

Protocol (ex: imatinib (Gleevec) was named STI-571 in a clinical trial)

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4
Q

Chemotherapy is most effective when used in a _________ dividing or _________ proliferative tumor

A

Rapidly; highly

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5
Q

What kind of cancer drugs work in different parts of the cell cycle?

A

Cell cycle specific agents

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6
Q

What kind of cancer drugs work in all phases of the cell cycle?

A

Cell cycle non-specific agents

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7
Q

For highly differentiated tumors, would you want to administer cell cycle specific or cell cycle non-specific agents?

A

Cell cycle specific

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8
Q

__________ inhibit cell growth by interfering with synthesis of compounds critical to cellular production including folic acid, purines, and pyrimidines.

A

Antimetabolites

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9
Q

Name 3 examples of antimetabolites

A

Capecitabine (Xeloda), fluorouracil (5-FU), methotrexate (MTX)

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10
Q

Side effects of capecitabine (Xeloda)

A

Peripheral neuropathy, N/V

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11
Q

Adverse effects of Methotrexate (MTX) and capecitabine (Xeloda)

A

Neuro, cardio, and pulmonary toxicity

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12
Q

Capecitabine (Xeloda) and methotrexate (MTX) are contraindicated in patients with

A

Renal dysfunction

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13
Q

Capecitabine (Xeloda) interacts with

A

Warfarin

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14
Q

Methotrexate is often used to treat brain cancer and can be administered

A

Orally and intrathecally (intrathecal administration MUST be preservative-free)

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15
Q

List two examples of mitotic inhibitors

A

Paclitaxel (Abraxane) and vincristine

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16
Q

Mitotic inhibitors such as Paclitaxel (Abraxane) and vincristine are

A

Vesicants

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17
Q

What cancer medication should NEVER be administered intrathecally?

A

Vincristine (black box warning: death)

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18
Q

Paclitaxel (Abraxane) nursing consideration

A

Always premedicate patient with Benadryl, dexamethasone (steroids), and famotidine

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19
Q

T or F: two nurses must verify when hanging chemotherapy

A

True

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20
Q

Irinoteacan (Camptosar) can cause severe diarrhea. What medication can be administered to stop diarrhea?

A

Atropine

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21
Q

Name an example of a topoisomerase I inhibitor

A

Irinoteacan (Camptosar)

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22
Q

Capecitabine (Xeloda), fluorouracil (5-FU), methotrexate (MTX), Paclitaxel (Abraxane), vincristine, and Irinoteacan (Camptosar) are all examples of what kind of cancer agents?

A

Cell cycle phase-specific

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23
Q

Bevacizumab (Avastin) is a form of target drug therapy used to treat lung cancer through antiangiogenic properties meaning it works by

A

Cutting off vasculature (blood supply) of tumors

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24
Q

What kind of cancer does Imatimib (Gleevec) treat and how does it work?

A

Treats leukemia by inhibiting enzymes thought to produce leukemia

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25
Q

Side effects of imatimib (Gleevec)

A

Fatigue, headaches, rash

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26
Q

Adverse effects of Femara

A

Osteoporosis, osteonecrosis of jaw, behavioral problems

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27
Q

Alkylating agents cause significant

A

Bone marrow suppression

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28
Q

Alkylating agents nursing consideration

A

Assess for anemia

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29
Q

Avastin and Gleevec are examples of

A

Target drug therapy

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30
Q

Adverse effects of Cisplatin (Platinol)

A

Nephrotoxicity, ototoxicity, peripheral neuropathy

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31
Q

What cancer drug requires a lifetime dose and holds a blackbox warning for cardiotoxicity

A

Doxirubicin (Adriamycin)

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32
Q

Doxirubicin (Adriamycin) nursing consideration

A

If EF is decreasing, reduce or stop the dose because it can lead to heart failure

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33
Q

Doxirubicin (Adriamycin) is a

A

Vesicant

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34
Q

A form of doxirubicin (Adriamycin) that is encapsulated in a liposomal covering to decrease the side effects of the drug

A

Liposomal doxirubicin (Doxil)

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35
Q

Cisplatin (Platinol), doxorubicin (Adriamycin), liposomal doxorubicin (Doxil), bevacizumab (Avastin), and imatinib (Gleevec) are all examples of what kind of cancer agents?

A

Cell cycle phase-nonspecific

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36
Q

Name an example of an alkylating agent

A

Cisplatin (Platinol)

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37
Q

List two examples of cytotoxic antibiotics

A

Doxorubicin (Adriamycin) and liposomal doxorubicin (Doxil)

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38
Q

Cytotoxic antibiotics MOA

A

Interact with DNA and block DNA synthesis

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39
Q

Cytotoxic antibiotics nursing consideration

A

Toxicity increases when used with other drugs

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40
Q

_________ promote synthesis of different types of blood components

A

Hematopoietic

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41
Q

Examples of hematopoietic drugs

A

Epoetin Alfa (Procrit), Filgastrim (Neupogen), and Pegfilgastrim (Neulasta)

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42
Q

Filgastrim and Pegfilgastrim contraindication

A

Blast cells 10% or higher

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43
Q

Side effects of Filgastrim and Pegfilgastrim

A

Bone pain, muscle aches, neutropenia

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44
Q

Patients who take Filgastrim of Pegfilgastrim can develop neutropenia ___hr to ___ days after chemo known as the Nater Period

A

24hr to 7 days

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45
Q

_________ prevent cancer cells from dividing and replicating and increase cytotoxic activity of the natural killer cells

A

Interferons

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46
Q

Side effects of interferons

A

Flu-like symptoms, increased BUN/Creatinine, orthostatic hypotension

47
Q

What is the only contraindication for immunotherapy?

A

If the patient has an active infection (therapy will target the infection rather than cancer)

48
Q

Filgastrim dosing

A

5mcg/kg/day

49
Q

What are the most critical sites for infection in cancer patients?

A

Venous access devices such as CVC, IJ, PICC, etc.

50
Q

What are the 5 steps for bone marrow transplantation?

A

Stem cell obtained, conditioning, transplantation, engraftment, transplant recovery

51
Q

How are transplant conditioning days counted?

A

Reverse; T-10 days counting down

52
Q

How are post-transplant days counted?

A

In order; T-0 days counting up

53
Q

Late side effects of transplant conditioning

A

Veno-occlusive disease and secondary cancers

54
Q

Transplant side effects

A

Infection, DIC, flu-like symptoms, hypertension, fever

55
Q

What cancer drugs can cause hyperuricemia?

A

Alkylating agents such as vincristine

56
Q

Stomatitis is adverse reaction to chemo/cancer therapies. What education should the nurse provide the client?

A

Examine mouth daily for white plaque on tongue and cheeks, bleeding, ulcerations, and painful areas

57
Q

What cancer drug can cause hemorrhagic cystitis?

A

Mitomycin C

58
Q

Patient education related to adverse effect of chemo-brain

A

Remind the patient that this is a normal, temporary response to therapy

59
Q

What cancer medication can cause pneumonitis?

A

Bleomycin

60
Q

Pneumonitis patient education

A

Call provider immediately if experiencing a change in coughing, wheezing, or SOB

61
Q

The size of the tumor will decrease with this type of surgery and chemo effects will improve

A

Debulking surgery

62
Q

When is neoadjuvent chemotherapy given?

A

Before primary treatments such as surgery

63
Q

This chemo can cause severe enlargement of the heat which can be life-threatening

A

Doxorubicin (Adriamycin)

64
Q

Carcinogens are introduced during the _________ phase of Carcinogenesis

A

Promotion

65
Q

This cancer med is NEVER to be given intrathecally as it is fatal

A

Vincristine

66
Q

The size of the tumor, the lymphatic spread, and metastatic spread describes what?

A

TNM staging of cancer

67
Q

Cisplatin, used to treat bladder cancer, can cause which adverse effect?

A

Nephrotoxicity

68
Q

T or F: TNM is used to stage leukemia lymphomas

A

False

69
Q

Colony stimulating factors are administered in what time frame following chemotherapy?

A

24 hours

70
Q

Signs of an enlarged prostate

A

Dysuria, hematuria, urinary frequency

71
Q

Does the staging system determine the response to chemo?

A

NO

72
Q

5-FU can cause what side effect?

A

Stomatitis

73
Q

Methotrexate requires addition of what supplement?

A

Folic acid

74
Q

Replication inhibition, gene alteration, and migration describe what type of cancer cell?

A

Malignant

75
Q

What infection plays a role in the development of cervical cancer?

A

HPV

76
Q

Bevacicimab (Avastin) works through

A

Antiangiogenesis

77
Q

How big does a tumor need to be before it requires nutrition and oxygen?

A

0.6 sonometers

78
Q

Does liposomal doxorubicin have a lifetime dose?

A

No

79
Q

How long do you hold pressure for a thrombocytopenic patient?

A

5 min

80
Q

In bone marrow suppression, what is the main component of blood cells that decrease first?

A

Hemoglobin (which causes anemia)

81
Q

List an example of a nitrogen mustard chemotherapy

A

Cyclophosphamide (Cytoxan)

82
Q

What is the single, most preventable cancer cause?

A

Chemical carcinogens such as tobacco

83
Q

Examples of physical carcinogens

A

UV, scans/X-rays, tanning beds, germicidal lamps

84
Q

Dietary risk factors for cancer

A

Low fiber, high red meat and animal fats, preservatives, additives, artificial sweeteners

85
Q

Immunity risk factors for cancer

A

Immunosuppressive agents, transplantation, stage III HIV

86
Q

What is the single most important and unpreventable risk factor for cancer?

A

Advancing age (median age for diagnosis is 66)

87
Q

CAUTION cancer symptoms

A

Change in bowel/bladder habits, A sore throat that does not heal, Unusual bleeding or discharge, Thickening or lumps in breast, Indigestion or difficulty swallowing, Obvious changes in wart or mole, Nagging cough or hoarseness

88
Q

Inherited cancers include

A

Colon, prostate, breast

89
Q

Strategies to prevent the occurrence of cancer

A

Primary prevention

90
Q

Use of screening strategies to detect cancer early, at a time when cure of control is more likely

A

Secondary prevention

91
Q

Modifiable factors to prevent cancer

A

Decrease alcohol intake (1 oz/day), increase fiber, decrease fat, limit sexual partners, smoking cessation

92
Q

T or F: smoking cessation decreases risk for cancer

A

True, BUT still at higher risk than non-smokers

93
Q

Medication that can be given to premenopausal women to reduce risk for breast cancer if BRCA gene is present

A

Tamoxifen

94
Q

Soft foods for cancer patients

A

Scrambled eggs, cheese/cottage cheese, nut butters, cold protein shakes

95
Q

Normal prealbumin levels

A

15-36 mg/dL

96
Q

Normal cholesterol levels

A

160-200 mg/dL

97
Q

Number one lab to assess when patient is Cachexic or malnourished

A

Prealbumin

98
Q

S/S of undernutrition/malnutrition

A

Thin, brittle hair and nails, decreased HR, BP, and RR, muscle wasting, increased susceptibility to infections

99
Q

To increase nutritional intake, what can the nurse expect to be ordered?

A

Carnation instant breakfast, ensure, Greek yogurt

100
Q

_________ feedings are given if patient is unable to maintain adequate nutrition orally

A

Enteral

101
Q

What should the nurse assess prior to instituting enteral feedings?

A

Advanced directives

102
Q

Enteral feeding given through port or triple lumen catheter with infusion pump for long-term use

A

TPN

103
Q

T or F: TPN is associated with more complications and is more conducive to infection d/t sugar-based feedings

A

True

104
Q

Nasally inserted tubes and PEG tubes should be verified for placement with an

A

X-Ray

105
Q

Enteral feeding that is endoscopically and percutaneously placed in the stomach

A

PEG tube

106
Q

Enteral feeding that bypasses the stomach and goes into jejunum indicated for patients with stomach cancer

A

Jejunostomy tube

107
Q

What is the most common complication of TPN?

A

Tube obstruction

108
Q

Interventions for TPN tube obstruction

A

Verify correct placement, then push 30mL of water through tube for dislodgement

109
Q

How often should residuals be checked in patients with TPN?

A

Every 6 hrs

110
Q

If the pharmacy does not deliver TPN in time for next feeding, what can the nurse hang until TPN is ready?

A

D10

111
Q

Cancer patient education

A

Keep food diary, report fever >100.4, call if increased or uncontrolled vomiting, report new onset of bleeding, changes in bowel habits, inability to eat and drink, and desire to end life

112
Q

Survivorship plan includes

A

Detailed description of treatment plan, when to call provider, follow-up appointment dates

113
Q

Lymphedema is treated through

A

Physical therapy

114
Q

What are the 6 ethical principles?

A

1) autonomy (self-determination), 2) beneficence (positive action to help others), 3) nonmaleficence (preventing harm), 4) fidelity (keeping promises), 5) veracity (truth-telling), 6) social justice (equality and fairness to all patients regardless of age, race, gender, ethnicity, etc.)

54/64 Unit 3 (8 decks)

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