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Flashcards in Drugs Affecting Immune System Deck (102)
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1

Goal of Chemotherapy

Maximize therapeutic effects, while reducing toxic effects

2

Purpose of Chemotherapy

Achieve a cure
Control growth
Provide palliation
Attempts to increase survival rates and times

3

What does cytotoxic mean?

Kills all cells (healthy and cancerous)

4

What labs are best to monitor during chemotherapy?

RBC, WBC, platelets

5

When does chemotherapy act?

During reproductive cycle, most active on rapidly dividing cells

6

What is remission?

Cancer is not actively growing

7

What is Induction Therapy?

High dose therapy to get the client into remission

8

What is Consolidation Therapy?

Administered after induction therapy to increase cure rate or prolong survival

9

Why would a patient receive Intensification Therapy?

High dose therapy during remission to increase cure rate or prolong remission

10

What are drawbacks of Induction Therapy?

Depletes immune system Lowers RBC,WBC, platelet

11

What is Adjuvant Therapy used for?

To destroy or reduce the spread of cancer after surgery or radiation therapy

12

How is Pallatative Therapy used?

To control symptoms, provide comfort, and improve quality of life when cure is not possible

13

Benefits of Combination Therapy

1. Different chemotherapy drugs act on different phases of the cell cycle
2. Decreases drug resistance
3. Increases drug effectiveness for remission/cure
4. Reduces toxic effects to normal cells
5. Can give lower doses with multiple drugs

14

Chemo vs Combo Therapy on cell cycle

Chemo drugs work best on rapidly multiplying cells
Combo drugs work on all phases

15

What is the purpose of chlorambucil?

non-cell cycle specific; react chemically with portions of RNA, DNA, or other cellular proteins to produce cytotoxic effects

16

What drug class is chlorambucil?

Alkylating Agents

17

Therapeutic uses for Chlorambucil

Treat slow-growing cancers such as lymphomas, leukemias, and myelomas.

18

Adverse Effects of Chlorambucil

1. Highly neurotoxic (tremors/muscle twitching)
2. Nephrotoxic, Hepatotoxic
3. Alopecia (7-10 after starting drugs)
4. Sterility
5. N/V/A

19

How soon will patient experience alopecia after taking Chlorambucil?

7-10 days

20

Nursing Interventions for Chlorambucil

1. Monitor CBC frequently
2. Monitor liver and kidney function
3. Monitor uric acid levels (Allopurinol)
4. Administer Antiemetics 30 minutes before chemo dose

21

What should a nurse educate the patient about when administering Chlorambucil?

1. Increase fluid intake
2. Infection precautions, patients are immunosupressed
3. Use contraceptives during treatment

22

Why is allopurinol given in conjunction with chemo therapy?

Chemo increases risk for gout.

Allopurinol decreases uric acid production

23

Purpose of Antimetabolites

1. inhibit DNA production in cells that depend on certain natural metabolites to produce DNA, preventing normal cellular function.
2. Most effective in rapidly dividing cells

24

Methotrexate is an

Antimetabolites

25

What are the therapeutic uses for methotrexate?

treatment of leukemias and some GI and basal cell cancers. Also used as treatment for rheumatoid arthritis.

26

How is methotrexate typically given and why?

Used in combination therapy because of increased resistance to treatment.

27

Adverse effects of Methotrexate

1. Fatigue / malaise
2. Rashes
3. Alopecia
4. Ulcerative stomatitis
5. Hepatic toxicity
6. Severe bone marrow suppression
7. Interstitial pneumonitis
8. Chills/ fever/ anaphylaxis

28

Nursing Interventions for Methotrexate

1. Assess lung sounds! Don’t administer if hearing wheezing or abnormal sound at base
2. Always pre-medicate with nausea meds
3. Frequent vitals to watch for reactions
4. Pre-hydrate with sodium bicarb to alkalize urine
5. Send urine samples to the lab if frequent urination

29

Why should the nurse rehydrate a patient with sodium bicarb when administering methotrexate?

Sodium bicarb alkalizes urine.
Acidic urine can cause crystals to form and shutdown kidneys

30

What is the rescue drug for methotrexate? How long is it given?

Leucovorin
4 days