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Questions and Answers
What is the prototype drug Doxorubicin (Adriamycin) used for?
What is the prototype drug Doxorubicin (Adriamycin) used for?
Monitor for cardiotoxicity, monitor results of liver/renal tests, monitor heart sounds, daily weight, blood pressure, pulse rate, and fluid retention.
What do hormones and hormone antagonists do in cancer treatment?
What do hormones and hormone antagonists do in cancer treatment?
Block the substances necessary for continued growth of tumors.
Which hormones are used in treating cancer? (Select all that apply)
Which hormones are used in treating cancer? (Select all that apply)
Hormones and hormone antagonists are cytotoxic.
Hormones and hormone antagonists are cytotoxic.
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What is the mechanism of action for Tamoxifen?
What is the mechanism of action for Tamoxifen?
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What are the therapeutic uses of Tamoxifen?
What are the therapeutic uses of Tamoxifen?
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What are some adverse effects of Tamoxifen? (Select all that apply)
What are some adverse effects of Tamoxifen? (Select all that apply)
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What is a significant black box warning for Tamoxifen?
What is a significant black box warning for Tamoxifen?
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What therapy does Vincristine belong to? (Select all that apply)
What therapy does Vincristine belong to? (Select all that apply)
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What is the mechanism of action for Vincristine?
What is the mechanism of action for Vincristine?
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What are some contraindications for Vincristine?
What are some contraindications for Vincristine?
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Biologic response modifiers enhance the body's ability to target tumor cells.
Biologic response modifiers enhance the body's ability to target tumor cells.
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What are two general classes of biologic response modifiers?
What are two general classes of biologic response modifiers?
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What is octreotide primarily used for?
What is octreotide primarily used for?
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Which of the following is a nursing responsibility when administering Octreotide? (Select all that apply)
Which of the following is a nursing responsibility when administering Octreotide? (Select all that apply)
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Nurses must wear _____ when preparing and administering antineoplastic medications.
Nurses must wear _____ when preparing and administering antineoplastic medications.
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What is the classification of Antineoplastic Drugs?
What is the classification of Antineoplastic Drugs?
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List some drugs included in this chapter.
List some drugs included in this chapter.
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Which of the following are types of Antineoplastic drugs? (Select all that apply)
Which of the following are types of Antineoplastic drugs? (Select all that apply)
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Antineoplastic drugs commonly produce serious adverse effects.
Antineoplastic drugs commonly produce serious adverse effects.
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What is a primary action when handling and administering vesicant drugs?
What is a primary action when handling and administering vesicant drugs?
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What mechanisms do antimetabolites use to inhibit cellular growth?
What mechanisms do antimetabolites use to inhibit cellular growth?
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What are the therapeutic effects of Methotrexate?
What are the therapeutic effects of Methotrexate?
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What is a characteristic of Antitumor Antibiotics?
What is a characteristic of Antitumor Antibiotics?
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Doxorubicin causes severe local necrosis if extravasation occurs.
Doxorubicin causes severe local necrosis if extravasation occurs.
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Cyclophosphamide is classified as a ________ drug.
Cyclophosphamide is classified as a ________ drug.
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What are some contraindications for Methotrexate?
What are some contraindications for Methotrexate?
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Study Notes
Antineoplastic Drugs Overview
- Antineoplastic agents are utilized to halt or kill cancer cells.
- Drugs can be classified based on their action, chemical structure, or mechanism.
Key Drugs in Antineoplastic Treatment
- Cyclophosphamide: Alkylating agent; used for various cancers.
- Methotrexate: Antimetabolite; affects cells in the S phase; effective for leukemias and solid tumors.
- Doxorubicin: Antitumor antibiotic; cardiotoxic effects; treats diverse tumors.
- Tamoxifen: Hormonal agent; estrogen receptor blocker; used in breast cancer therapy.
- Vincristine: Vinca alkaloid; mitotic inhibitor; derived from periwinkle plant.
- Octreotide: Synthetic somatostatin analogue; affects hormone secretion.
Types of Antineoplastic Drugs
- Alkylating Agents: Non-specific cell cycle agents that alter DNA.
- Antimetabolites: Cell cycle-specific agents that mimic nutrients to disrupt DNA synthesis.
- Antitumor Antibiotics: Derived from bacteria; effective but restricted due to toxicity.
- Hormones and Hormone Antagonists: Target hormone-sensitive tumors.
- Natural Products and Miscellaneous: Include drugs from various plant and biological sources.
Adverse Effects
- Common side effects like nausea, vomiting, anorexia, alopecia, and myelosuppression occur with many antineoplastic agents.
- Severe reactions may include cardiotoxicity, pulmonary fibrosis, and risk of secondary malignancies.
Alkylating Agents Characteristics
- Change the structure of DNA, hindering normal cell division.
- Types include nitrogen mustards, nitrosoureas, and platinum compounds.
- Known for causing secondary malignancies and being strong vesicants.
Cyclophosphamide (Cytoxan)
- Mechanism: Converted in the liver, forms DNA cross-links, inhibits DNA synthesis.
- Uses: Treats a variety of cancers, including lymphomas and breast cancer.
- Adverse Effects: Common side effects alongside severe complications such as bone marrow suppression and hemorrhagic cystitis.
- Contraindications: Includes pregnancy, severe myelosuppression, and impaired liver function.
- Drug Interactions: Risk of increased toxicity with other antineoplastics and anticoagulants.
Methotrexate (MTX)
- Mechanism: Interrupts DNA synthesis during the S phase by inhibiting folic acid metabolism.
- Uses: Effective for osteosarcoma, leukemias, and certain solid tumors.
- Adverse Effects: Severe gastrointestinal upset, myelosuppression, and risk of pulmonary toxicity.
- Contraindications: Anemia, leukopenia, renal impairment, and concurrent use with hepatotoxic drugs.
- Drug Interactions: Increased levels with certain antibiotics; may alter effects of antiepileptics.
Doxorubicin (Adriamycin)
- Mechanism: Binds to DNA causing strand breaks and inhibits synthesis; cell cycle non-specific.
- Uses: Treats several tumors including breast and lung cancer.
- Adverse Effects: Notable for severe nausea, cardiotoxicity, and myelosuppression.
- Contraindications: Includes existing cardiac disease and significant liver dysfunction.
- Drug Interactions: Increased toxicity when combined with certain antineoplastics and agents affecting liver metabolism.
Hormonal Therapies
- Used primarily for hormone-sensitive cancers such as breast and prostate cancers.
- Types include corticosteroids, progestins, estrogens, and androgen receptor blockers.
Tamoxifen
- Mechanism: Blocks estrogen receptors; palliative for advanced ER-positive breast cancer.
- Uses: Off-label for various cancers; involved in systemic treatment regimens.
- Adverse Effects: Includes risk of endometrial cancer and thromboembolic events.
Nursing Considerations
- Monitor vital signs and signs of infection, especially with high-risk therapies.
- Ensure appropriate hydration and assess for potential drug interactions.
- Provide patient education on symptom management and the importance of adherence to treatment regimens.### Tamoxifen: Prototype Drug Overview
- Used for breast cancer prophylaxis in high-risk women and as adjunctive therapy post-mastectomy.
- Off-label uses include treatment of infertility and pain relief for gynecomastia in both genders.
Tamoxifen: Mechanism of Action
- Binds to estrogen receptors (ERs), exhibiting agonist effects in some tissues (like bone) and antagonist effects in breast tissue.
- Inhibition of ER binding in breast tissue prevents DNA replication and alters growth factors in cancer cells.
Tamoxifen: Adverse Effects
- Common effects: nausea, vomiting, hot flashes, irregular menses, vaginal discharge, bleeding, and headaches.
- Other reactions: fluid retention, light-headedness, and rash.
Tamoxifen: Black Box Warnings
- Increased risk of endometrial cancer.
- Slight rise in the likelihood of thromboembolic diseases such as stroke and deep vein thrombosis (DVT).
Tamoxifen: Contraindications and Precautions
- Not advised for patients undergoing anticoagulant therapy or with preexisting endometrial hyperplasia.
- History of thromboembolic disease, pregnancy, lactation, and leukopenia are cautionary factors.
Tamoxifen: Drug Interactions
- Potential interactions with CYP enzyme inducers or inhibitors may affect efficacy.
- Co-administration with warfarin heightens bleeding risks; SSRIs may reduce effectiveness.
- Avoid use alongside oral contraceptives and cytotoxic antineoplastics.
Tamoxifen: Additional Information
- Black cohosh should only be taken under medical advice.
- Pregnancy category D indicates risks during pregnancy.
- Overdose treatment focuses on symptomatic relief for seizures and neurotoxicity.
Vincristine: Prototype Drug Overview
- Classified as an antineoplastic and a vinca alkaloid mitotic inhibitor, targeting M phase of the cell cycle.
- Used for treating various cancers, including acute lymphocytic leukemia and Hodgkin's/ non-Hodgkin's lymphomas.
Vincristine: Mechanism of Action
- Binds to tubulin, inhibiting microtubule formation necessary for mitosis, leading to cell death.
Vincristine: Adverse Effects
- Notable neurotoxicity with symptoms like peripheral neuropathy and motor difficulties.
- Gastrointestinal issues include nausea, vomiting, and severe constipation. Can also cause alopecia and hepatotoxicity.
Vincristine: Black Box Warnings
- Myelosuppression and risk of extravasation must be monitored closely.
Vincristine: Contraindications and Precautions
- Not recommended for patients with obstructive jaundice, active infections, or preexisting neurological conditions.
- Caution in pregnant or lactating individuals and those with liver impairment.
Vincristine: Drug Interactions
- Inducers of CYP3A4 can reduce effectiveness; concurrent administration with certain drugs may enhance toxicity or decrease effectiveness.
Vincristine: Nursing Responsibilities
- Administer only via intravenous route, ensuring dilution and avoiding syringe dispensing.
- Fatal if given intrathecally; monitor closely to prevent complications.
Biologic Response Modifiers and Targeted Therapies
- Enhance the body's immune response to eliminate tumor cells effectively.
- Include cytokines like interferons and interleukin-2, alongside monoclonal antibodies (MABs), to target specific cancer cell receptors.
Medications for Reducing Adverse Effects
- Antiemetics aim to prevent nausea and vomiting during chemotherapy.
- Additional drugs help manage bowel disorders, ensuring comfort for patients.
Drugs for Myelosuppression Complications
- Epoetin alfa and colony-stimulating factors such as filgrastim mitigate severe drops in blood cell counts.
Octreotide: Prototype Drug Overview
- Classified as an antineoplastic with a miscellaneous pharmacological classification, specifically used for carcinoid crisis and VIPoma-related diarrhea.
Octreotide: Contraindications and Precautions
- Not suitable for patients with known sensitivity, kidney disease, liver disease, or cardiac issues.
Octreotide: Drug Interactions
- May interact adversely with cyclosporine and insulin, affecting absorption of vitamin B12.
Octreotide: Nursing Responsibilities
- Monitor vital signs and metabolic parameters; administer subcutaneously while assessing for thyroid and electrolyte imbalances.
Patient Education for Octreotide
- Instruct patients to take between meals; monitor for side effects such as severe abdominal pain or jaundice.
- Highlight treatment costs and advise against breastfeeding without medical approval.
Handling Antineoplastics Safely
- Healthcare workers must use protective gear when preparing and administering antineoplastic drugs to prevent skin absorption.
- Follow established guidelines from the Oncology Nursing Society and OSHA for safe handling practices.
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Description
Explore key classifications and examples of antineoplastic drugs with this set of flashcards. Understand the various types and their mechanisms, such as alkylating agents and antimetabolites, crucial for cancer treatment. Perfect for students in pharmacology or medical fields.
