Test 3 - ANTINEOPLASTIC DRUGS (ANTI-CANCER) CCNS, MISC & HORMONE ECT.

Question 1

What are the 5 GROUPS OF ANTINEOPLASTICS:

Answer 1

• CELL CYCLE-NONSPECIFIC (CCNS)
• CELL CYCLE-SPECIFIC (CCS)
• MISC ANTINEOPLASTICS
• HORMONAL ANTINEOPLASTIC DRUGS
• RADIOPHARMACEUTICALS

Question 2

Occurs during any phase of the cell cycle

Answer 2

•Cytotoxic DRUGS

Question 3

CELL CYCLE-NONSPECIFIC (CCNS)

Answer 3

Which class of drugs are effective at any stage in the growth cycle of cancer cells

More effective against large, slowly growing tumors

Question 4

Which class of drugs prevent cancer cells from reproducing with the process of alkylation?

Answer 4

ALKYLATING DRUGS

Question 5

What are the most common alkylating drugs?

Answer 5

o Classic alkylators (nitrogen mustards)
	cyclophosphamide (Procytox)
	mechlorethamine (Mustargen)
o Nitrosoureas
	carmustine
	lomustine
	streptozocin
o Probable alkylators
	Cisplatin

Question 6

***Do not administer ______________ with _________ as it increases risk of_______________

Answer 6

AMINOGLYCOSIDES, with CISPLATIN as it increases the risk of NEPHROTOXICITY*

Question 7

**What are the serious adverse effects of ALKYLATING drugs? **

Answer 7

• Nephrotoxicity, peripheral neuropathy, ototoxicity (Hydration can prevent nephrotoxicity)
• Extravasation causes tissue damage and necrosis

Question 8

Important nursing considerations for ALKYLATING DRUGS! (6)

Answer 8

•Monitor for expected effects of bone marrow suppression
•Expect nausea, vomiting, diarrhea, stomatitis (mouth ulcers – very painful)
Stomatitis: avoid high fiber, spicy, citric acid foods or foods of extreme temperature to decrease discomfort. Use soft bristle toothbrushes, etc… ****
**Hydration is important to prevent nephrotoxicity***
•Report ANY ringing/roaring in the ears—possible ototoxicity
•Peripheral neuropathies may occur—report tingling, numbness, pain in extremities

Question 9

Which type of tumor is CISPLATIN used for?

Answer 9

solid tumors

Question 10

Which is the only Cytotoxic drug that does not supress bone marrow?

Answer 10

BLEOMYCIN

Question 11

•Used to treat cancer – too toxic to treat infections

Answer 11

CYTOTOXIC ANTIBIOTICS

Question 12

What are the COMMONLY USED DRUG FOR CYTOTOXIC ANTIBIOTICS

o Anthracycline antibiotics (2)
o Anthracenedione antibiotics (1)
o Other cytotoxic antibiotics (1)

Answer 12

o Anthracycline antibiotics
Daunorubicin
Doxorubicin

o Anthracenedione antibiotics
Mitoxantrone

o Other cytotoxic antibiotics
Bleomycin

Question 13

Cytotoxic antibiotic drugs can supress ?

Answer 13

bone marrow

Question 14

**What are the serious ADVERSE EFFECTS of “Other cytotoxic antibiotics” - BLEOMYCIN? ***

ON TEST

Answer 14

Can produce pulmonary toxicity or fibrosis

Question 15

True or False

Cytotoxic drugs are active in all phases of the cell cycle?

Answer 15

TRUE

Question 16

What are the two classes of HORMONAL ANTINEOPLASTIC DRUGS

Answer 16

FEMALE SPECIFIC NEOPLASMS

MALE SPECIFIC NEOPLAMS

THESE CANCERS ARE CAUSED BY HORMONES

Question 17

What is an indication for CYTOTOXIC ANTIBIOTICS

Answer 17

Used to treat AIDS related Kaposi’s sarcoma

Question 18

What are the serious ADVERSE EFFECTS of Anthracycline antibiotics - (Daunorubicin)?

Answer 18

•Can produce heart failure

Question 19

What are the serious ADVERSE EFFECTS of Anthracycline antibiotics - (Doxorubicin)

Answer 19

cardio myopathy

Question 20

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS:

Answer 20

• Expect bone marrow suppression, nausea, vomiting, diarrhea, stomatitis
• Monitor pulmonary status
• Monitor for nephrotoxicity, liver toxicity
• Monitor cardiovascular status

Question 21

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS:

Daunorubicin may turn the urine a ______ _____!

Answer 21

reddish color

Question 22

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS for STOMATITIS

Answer 22

avoid high fiber, spicy, citric acid foods or foods of extreme temperature to decrease discomfort. Use soft bristle toothbrushes, etc…

Question 23

What should be monitored during treatment of cancer drugs?

Answer 23

IV SITE FOR EXTRAVASATION

REST & ELEVATE AFFECTED LIMB

Question 24

List the steps if extravasation occurs:

Answer 24

o STOP INFUSION. CALL DR. 
o LEAVE CATHETER IN PLACE
o ATTEMPT TO ASPIRATE ANY RESIDUAL DRUG AND BLOOD FROM CATHETER
o ADMINISTER ANDIDOTE AS PER PHARMACIST.
o USE HOT/COLD PACKS AS INDICATED

Question 25

What is the best approach for extravasation & continuous monitoring of IV site is essential?

Answer 25

PREVENTION

Question 26

Assess ___________ _________ ________before giving ANY antineoplastic drugs (drugs cause bone marrow suppression)

Answer 26

baseline blood counts Norm WBCs=5000-15000

Question 27

TRUE OR FALSE | If allergic to medication the client should still take the medication. Unless anaphylactic.

Answer 27

TRUE

Question 28

If allergic monitor closely for?

Answer 28

anaphylactic reactions

Question 29

What should be kept close in case of allergic reaction?

Answer 29

epinephrine, antihistamines, and anti-inflammatory drugs on hand

Question 30

Monitor closely for complications associated with bone marrow suppression

Answer 30

o Anemia o Thrombocytopenia o Neutropenia

Question 31

What are some oncological emergencies that should be monitored?

Answer 31

``` o Infections o Pulmonary toxicity o Allergic reactions o Stomatitis with severe ulcerations o Bleeding o Metabolic aberrations o Bowel irritability with diarrhea o Renal, liver, cardiac toxicity ```

Question 32

What drugs may be used to reduce toxicities?

Answer 32

•Cytoprotective

Question 33

Cytoprotective drugs may be used Intravenous (IV) amifostine (Ethyol) for ?

Answer 33

reduce renal toxicity associated with CISPLATIN

Question 34

Cytoprotective drugs may be used IV or oral allopurinol (Alloprim) to _______ ________?

Answer 34

to reduce hyperuricemia

Question 35

CAREFUL WHEN ADMINISTERING ___________MEDICATIONS. DO NOT MIX THEM UP AS THEY HAVE DIFFERENT SIDE EFFECTS & INDICATIONS

Answer 35

‘RUBICIN’