Anticancer Drugs Class II Flashcards

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Questions and Answers

What is cancer?

Cancer is a group of disorders characterized by the abnormal growth of cells.

What do anticancer drugs do?

Anticancer drugs cause cell death by interfering with cell replication.

What are cell-cycle nonspecific drugs?

Cell cycle-nonspecific drugs act during any phase of the cell cycle, including the G0 phase.

What are cell-cycle specific drugs?

Cell cycle-specific drugs influence a specific phase of the cell cycle. Signup and view all the answers

The four main classes of anticancer drugs are: ________, hormones and hormone antagonists, immunomodulating agents, and targeted drugs.

cytotoxic agents Signup and view all the answers

Chemotherapy refers only to cytotoxic drugs.

True Signup and view all the answers

What is the most common route of administration for chemotherapy?

Intravenous (IV) Signup and view all the answers

Match the following anticancer drugs with their characteristics:

Cytotoxic agents = Directly kill cancer cells Hormonal agents = Suppress action of endogenous hormones Biologic response modifiers = Alter the body's response to disease Targeted drugs = Bind with and destroy specific molecules in cancer cells Signup and view all the answers

What type of cancer is gefitinib used to treat?

Non-small cell lung cancer Signup and view all the answers

How does imatinib suppress cell proliferation?

Imatinib suppresses the activation of BCR-ABL tyrosine kinase. Signup and view all the answers

What is a common adverse effect of gefitinib?

Diarrhea Signup and view all the answers

What are some contraindications for gefitinib?

Severe hypersensitivity to gefitinib. Signup and view all the answers

What is the preferred drug for treating chronic myeloid leukemia (CML)?

Imatinib Signup and view all the answers

What should be included in the pre-administration assessment for gefitinib?

Detailed medication history and baseline information including vital signs and lab values. Signup and view all the answers

What affects the absorption of gefitinib?

All of the above Signup and view all the answers

What are the usual dosages for gefitinib?

250 mg PO once a day, taken with or without food. Signup and view all the answers

What precautions should nurses take when administering chemotherapy agents?

Use disposable gloves and protective clothing. Signup and view all the answers

What should patients seek immediate medical attention for while on gefitinib?

Chest pain, symptoms of stroke, severe abdominal pain, or swelling with redness or pain in one leg. Signup and view all the answers

What is a recommended dietary consideration while taking imatinib?

Take with food or 240 mL of water to reduce gastric irritation. Signup and view all the answers

What is a potential interaction between targeted drugs and CYP3A4 inhibiting drugs?

Drugs that inhibit CYP3A4 can reduce metabolism of targeted drugs. Signup and view all the answers

Prior to administering gefitinib, the nurse should obtain which information?

Food and drug allergies Signup and view all the answers

If Mr. Williams experiences diarrhea while on gefitinib, which condition should prompt him to seek immediate medical attention?

Chest pain Signup and view all the answers

What is a priority nursing assessment prior to administration of anticancer drugs?

Liver function test. Signup and view all the answers

Why is it important to encourage patients taking anticancer drugs to take the medications with fluids?

Adequate fluid intake reduces gastric irritation. Signup and view all the answers

Which statement regarding breastfeeding while on anticancer medication requires nurse intervention?

I can resume breastfeeding my child 1 month after completing my medication. Signup and view all the answers

If a patient with chronic myeloid leukemia (CML) does not respond to imatinib, what is the most likely reason?

Cancer cells have become resistant to imatinib. Signup and view all the answers

Which patient should a nurse assess first in the oncology unit?

A patient with a history of recent radiation therapy who is receiving gefitinib. Signup and view all the answers

What is the appropriate scheduling for monitoring a cancer patient's complete blood count (CBC) after starting anticancer medication?

Weekly for the first month, bi-weekly for the second month, and periodically thereafter. Signup and view all the answers

What health assessment items should be reported immediately before administering imatinib?

All of the above Signup and view all the answers

What should a patient taking imatinib be advised regarding potential symptoms of fever, chills, and a persistent sore throat?

Instruct the patient to immediately call and report the symptoms to the prescriber. Signup and view all the answers

What class of anticancer drugs does chemotherapy fall into?

Cytotoxic drug therapy. Signup and view all the answers

What drug class is most commonly used for the treatment of prostate cancer?

Hormone antagonists. Signup and view all the answers

To which class of anticancer drugs do hematopoietic drugs and immunomodulating drugs belong?

Biologic response modifiers. Signup and view all the answers

How do monoclonal antibodies halt proliferation of cells?

They bind with and prevent activation of EGFR tyrosine kinase. Signup and view all the answers

When will maximum levels of gefitinib be present in the blood after administration?

3-7 hours after administration. Signup and view all the answers

What should a nurse instruct a patient regarding alcohol intake while taking imatinib?

Alcohol intake can impair liver metabolism of imatinib. Signup and view all the answers

What adverse response to gefitinib should a patient report immediately?

Dyspnea. Signup and view all the answers

What does tamoxifen do?

Tamoxifen blocks the actions of estrogen, a female hormone. Signup and view all the answers

What is the worst risk associated with tamoxifen?

Tamoxifen can increase your risk for endometrial cancer. Signup and view all the answers

Study Notes

Cancer Overview

Cancer is a collection of diseases characterized by uncontrolled cell growth; it is a leading cause of death in the U.S., second only to heart disease.
In 2016, an estimated 1,685,210 new cancer cases and 595,690 cancer-related deaths were expected in the U.S.
Treatment must be individualized based on the specific cancer type, cellular behavior, and patient response.

Anticancer Drug Classes

Four primary classes of anticancer drugs:
- Cytotoxic agents: Kill cells directly.
- Hormones and hormone antagonists: Modify hormone action.
- Biologic response modifiers (BRMs): Alter immune response.
- Targeted drugs: Attack specific molecules involved in cancer growth.

Mechanism of Action

Anticancer drugs work by interfering with cell replication, leading to cell death.
Cytotoxic drugs (chemotherapy) are the most common and are administered intravenously.

Drug Types

Cell-cycle nonspecific (CCNS) drugs: Effective in any cell cycle phase, including the G0 phase (e.g., alkylating agents, antitumor antibiotics).
Cell-cycle specific (CCS) drugs: Target specific phases of the cell cycle, particularly effective against rapidly dividing cells (e.g., antimetabolites, vinca alkaloids).

Cytotoxic Agents

Largest class of anticancer drugs, targeting DNA or RNA and disrupting cell division.
Particularly toxic to rapidly dividing tissues like hair and skin.

Hormonal Agents

Used mainly for hormonally sensitive cancers like prostate and breast cancer.
Often have fewer side effects compared to cytotoxic agents, such as less severe nausea and bone marrow suppression.

Biologic Response Modifiers (BRMs)

Include hematopoietic and immunomodulating drugs, enhancing the body's response to cancer.
Examples include cytokines, monoclonal antibodies, and vaccines.

Targeted Anticancer Drugs

Designed to bind specific molecules in cancer cells, suppressing tumor growth while sparing normal cells.
Examples include imatinib and gefitinib; both demonstrate selectivity and milder side effects in some patients.

Tyrosine Kinase Inhibitors

EGFR Tyrosine Kinase Inhibitors: Inhibit signaling pathways regulating cell growth and survival, promoting apoptosis (e.g., gefitinib).
BCR-ABL Tyrosine Kinase Inhibitors: Specifically for chronic myeloid leukemia (CML), including imatinib; inhibit BCR-ABL tyrosine kinase activity.

Pharmacokinetics of Gefitinib

Absorbed slowly from the GI tract; peak plasma levels in 3–7 hours.
Extensive liver metabolism and excreted mainly through feces.
Half-life of 48 hours.

Pharmacokinetics of Imatinib

Rapid absorption with high bioavailability (98%).
Metabolized in the liver, with elimination half-lives of 18 hours for imatinib and 40 hours for its primary metabolite.

Clinical Considerations

Pre-administration assessments are crucial to avoid drug-drug interactions and monitor adverse effects.
While administering these drugs, specific precautions should be taken to minimize nursing exposure to hazardous agents.

Contraindications

Gefitinib: Contraindicated in severe hypersensitivity cases, requires liver function monitoring.
Imatinib: Contraindicated during pregnancy/lactation; use cautiously in patients with renal/hepatic impairments.

Drug Interactions

Gefitinib: Interactions with CYP3A4 inhibitors can increase levels; indducers may decrease them.
Imatinib: Inhibitors can raise levels; inducers may lower them.

Dosing Guidelines

Gefitinib: Typical dosage of 250 mg orally once a day. Adjustments may be needed based on tolerability and liver enzyme status.
Imatinib: Administered with food; standard dosage for adults with CML is 400 mg daily.

Adverse Effects

Gefitinib: Common side effects include diarrhea and rash; others include nausea, dry skin, and increased liver enzymes.
Imatinib: Side effects often include nausea, vomiting, fluid retention, and potential hematological issues like neutropenia.

Patient Education

Monitoring patient weight and reporting significant changes is crucial for both drugs.
Patients should be warned about severe symptoms that require immediate medical attention.
Female patients are advised to avoid pregnancy during and post-treatment.

Evaluation

Regular assessments for skin reactions, signs of infection, and thromboembolic events are vital.
Monitor organ function and report any serious side effects, ensuring thorough patient education on treatment protocols and potential side effects.### Medication Guidelines and Precautions
Women of childbearing age should avoid pregnancy during imatinib treatment and for 12 months afterward.
Breastfeeding must cease during imatinib treatment and for 60 days after completion.
Grapefruit juice can elevate imatinib blood levels, intensifying side effects; it should be avoided.
St. John's wort reduces imatinib's effectiveness; its use is discouraged.
Avoid alcohol and drugs that stress the liver, like acetaminophen.

Adverse Effect Reporting

Report symptoms like fever, chills, persistent sore throat, swelling, weight gain, or increasing shortness of breath immediately.
Symptoms of bleeding, including black stools, coffee ground emesis, or easy bruising, require urgent reporting.
Liver impairment signs—stomach pain, jaundice, dark urine, unusual fatigue—must be communicated right away.

Drug Interactions and Administration

CYP3A4 inhibitors lower metabolism and effectiveness of targeted drugs; caution is required when combining these medications.
Liver function tests are crucial assessments before administering anticancer drugs, prioritizing patient safety.

Nursing Assessments and Patient Education

Baseline assessments for new patients on gefitinib include chest x-rays, allergies, skin evaluations, and medication history.
Patients on anticancer therapy should maintain high fluid intake to prevent gastric irritation and promote drug metabolism.
Educate breastfeeding mothers on the correct timelines for cessation and resumption of breastfeeding when taking imatinib.

Specific Patient Cases

For Mr. Williams on gefitinib, immediate medical attention is warranted if chest pain occurs.
If chronic myeloid leukemia (CML) does not respond to imatinib, it may indicate cancer cell resistance.
Monitor complete blood count (CBC) weekly for the first month of anticancer therapy.

Side Effects and Interventions

Patients on imatinib should report symptoms indicating adverse reactions such as dyspnea, fever, or chills.
Tamoxifen is an estrogen receptor blocker used in breast cancer treatment; avoid if pregnant due to harm to unborn children.

Chemotherapy Drug Classes

Cytotoxic drug therapy encompasses various chemotherapy agents, while hormone antagonists are pivotal in treating prostate cancer.
Monoclonal antibodies inhibit cell proliferation by targeting EGFR tyrosine kinase activation.

Post-Administration Monitoring

Peak blood levels of gefitinib occur 3-7 hours post oral administration; understanding this can guide monitoring efforts.
Encourage patients to disclose any new symptoms or health changes during treatment, ensuring timely interventions.

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Description

Test your knowledge on the second class of anticancer drugs with these flashcards. This quiz explores key definitions and concepts related to cancer treatment. Enhance your understanding of the different classes of anticancer medications and their effects on cancer cells.