Week 15: Chemo/Immunology (12 Larkin) Flashcards
Potential Complications of
Antineoplastics (chemo drugs)
NO chemo if ANC less than 1000
less than 500 = severe neutropenia
Hemorrhagic Cystitis
-Increase hydration intake (before, during, after)
-Monitor (for hematuria, frequency, urgency, I&O)
-mesna (given w/ chemo; bladder protectant)
Cardiotoxicity
-Monitor ECG/EKG, Ejection Fraction
Constipation
-Educate client on taking laxative or stool softener, eat high protein, high fiber meals, increased fluid intake, ambulation
Learning or Cognitive issues for
prepubertal clients
Infertility
Cancer
Folate (Folic Acid) Antagonist-
MTX
Adverse effects?
What’s always given 24 hours after end of therapy?
Why is it given?
ANEMIA!!!!
Leukopenia
Thrombocytopenia
Tumor lysis syndrome
Leucovorin will always be given after HD MTX
Treats anemia caused by the lack of folic acid
Cancer
Vinca Alkaloids
vincristine
made from periwinkle plant
May cause progressive peripheral neuropathy
IV ONLY other routes can be fatal
Cancer
Alkylating Drugs:
Cisplatin
Use cautiously in
Hearing loss
Ototoxicity and tinnitus
Alkylating Drugs:
Cyclophosphamide
comes from?
can cause?
how to prevent?
Derivative of nitrogen mustard gas
Can cause hemorrhagic cystitis
Use to prevent:
-mesna
*Increase fluids to 2000-3000 mL/day!!!!!!!
-monitor for blood in urine
Bleomycin & Doxorubicin
What can increase overtime?
Bleomycin doesn’t cause?
Digoxin levels
Bone marrow suppression
Doxorubicin and Daunorubicin
Use cautiously in?
Turns urine what?
Cardiac disease and/or high doses of
doxorubicin
Bone marrow suppression
Hepatic impairment
Turns urine red (normal dont report)
Bleomycin
Adverse Effects
Pulmonary fibrosis, pneumonitis!!!!!
Monitor lung sounds!!!
tamoxifen is used to treat?
can’t give if?
Adverse effects?
Breast cancer
Concurrent warfarin therapy with history of DVT or PE
thromboembolism
stroke
hot flashes and menopause
Leuprolide (testes)
Causes what?
Most frequent adverse effect?
Increase in testosterone
w/ continuous administration, testosterone levels are decreased
Bone pain
Rituximab
Adverse effects?
Premedicate with?
Hypersensitivity reactions (including
anaphylaxis & angioedema)
Infusion reactions
Premedicate w/ acetaminophen & diphenhydramine to prevent
infusion-related adverse effects
Bevacizumab
Does what?
Blocks blood supply to the growing
tumor
Filgrastim
Does what?
BIggest adverse effect?
What’s the longer acting form?
Must be given?
Increase neutrophil count (WBC)
Bone pain!!!
Pegfilgrastim
Must be given BEFORE a client develops an infection;
given after 24 hours after
myelosuppressive chemotherap
Adalimumab
Contraindicated in?
Active infection
infliximab
Special considerations:
Contraindicated in?
Black box warning for?
Recommended that?
- Contraindication in severe heart failure; it will worsen this condition
FDA black box warning reporting cases of TB and fungal infections
Recommended that clients be tested for latent TB before starting this drug
