Pharma W12: Chemotherapy and Biological Response Modifiers

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Questions and Answers

What is the primary characteristic of malignant tumors?

They do not metastasize to other organs.

They primarily consist of benign cells.

They consist of cancer cells that can invade surrounding tissues. (correct)

They are encapsulated and non-invasive.

Which type of tissue gives rise to carcinomas?

Blood and Bone Marrow

Lymphatic tissue

Epithelial tissue (correct)

Connective tissue

What term describes the original site of cancer growth?

Neoplasm

Primary lesion (correct)

Metastasis

Secondary lesion

Which factor is NOT known to initiate genetic mutations leading to cancer?

Ballistic trauma Signup and view all the answers

Which term is used to describe a mass of new cells that can also be referred to as a tumor?

Neoplasm Signup and view all the answers

What is the primary purpose of antineoplastic drugs?

To treat cancer Signup and view all the answers

Which of the following side effects is commonly associated with chemotherapy?

Alopecia Signup and view all the answers

What is the term 'nadir' referring to in the context of chemotherapy?

The lowest level of white blood cells post-treatment Signup and view all the answers

Which cells are affected by chemotherapy due to their rapid division?

Hair follicles Signup and view all the answers

What type of drug therapy targets specific molecules associated with cancer cells?

Targeted drug therapy Signup and view all the answers

In which context is the term 'myelosuppression' used?

Bone marrow suppression Signup and view all the answers

What should be monitored in patients experiencing bone marrow suppression?

Baseline blood counts Signup and view all the answers

What is the greatest risk during pregnancy associated with chemotherapy?

Fetal complications during the first trimester Signup and view all the answers

Which of the following is a nursing intervention when monitoring for extravasation of chemotherapy drugs?

Leave the IV catheter in place if extravasation occurs Signup and view all the answers

Which of the following is not considered a dose-limiting adverse effect of chemotherapy?

Skin irritation Signup and view all the answers

Why is chemotherapy considered harmful to normal cells?

It affects rapidly dividing cells Signup and view all the answers

What should nurses do to help prevent infection in patients with neutropenia?

Monitor temperature closely Signup and view all the answers

Which cancers often require hormonal antineoplastic drugs for treatment?

Breast and prostate cancer Signup and view all the answers

What is the primary purpose of immunomodulating drugs?

To alter the immune response against tumors Signup and view all the answers

Which of the following is NOT a disease for which biological response-modifying drugs are used?

Hypertension Signup and view all the answers

What action is NOT typically included in the mechanism of action for biological response-modifying drugs?

Directly killing cancer cells Signup and view all the answers

Which safety measure is important when handling antineoplastics?

Using personal protective equipment (PPE) Signup and view all the answers

What must nurses continuously assess in patients receiving chemotherapy?

Signs of oncological emergencies Signup and view all the answers

Study Notes

Chemotherapy and Biological Response Modifiers

Cancer: A group of diseases with uncontrolled cell growth and division. Cancer cells can invade surrounding tissues (metastasis) via blood or lymphatic systems.
Terminology:
- Primary lesion: Original site of cancer.
- Metastasis: Spread of cancer to other parts of the body.
- Neoplasm: New tissue growth (tumor).
- Tumor: A mass of cells.
- Benign: Non-cancerous; typically encapsulated and doesn't spread.
- Malignant: Cancerous; invades surrounding tissues and spreads.
- Carcinomas: Cancers originating from epithelial tissues.
- Sarcomas: Cancers originating from connective tissues.
- Lymphomas: Cancers originating from lymphatic tissue.
- Leukemias: Cancers originating from blood and bone marrow cells (circulating tumors).
Cancer Development: Initiated by genetic mutations from various factors (viruses, hormones, radiation, chemicals, hereditary, unknown).
Cancer Treatment: Includes surgery, radiation, and chemotherapy.

Chemotherapy

Definition: Pharmacological treatment of cancer using antineoplastic drugs.
Drug Types: Cell cycle-specific, cell cycle-non-specific, or both.
Mechanism: Toxic to rapidly dividing cells (both cancerous and healthy). Healthy cells impacted include hair follicles, GI tract, and bone marrow.
Therapeutic Index: Narrow; a cocktail of drugs typically more effective than single drugs. Harmful side effects result in dose limits.
Adverse Effects (Dose-Limiting): GI tract and bone marrow damage (nausea, vomiting, diarrhea, stomatitis), hair loss (alopecia), bone marrow suppression (low WBC, RBC, and platelets), and extravasation (unintended leakage into surrounding tissues). "Nadir" is the lowest blood cell count.
Targeted therapy: Drugs that specifically target cancer cells with minimal effects on healthy cells.

Nursing Implications – Chemotherapy

Pre-Administration: Assess baseline blood counts (RBC, WBC, platelets)
Administration: Follow specific administration guidelines.
Adverse Effects Monitoring: Monitor for GI tract issues (stomatitis, altered bowel function, nausea, vomiting, diarrhea), bone marrow suppression (anemia, leukopenia, thrombocytopenia; increased risk of infection, bleeding), hair loss, and extravasation.
Infection Prevention: Crucial due to potential for immunosuppression. Monitor for fever, assess oral cavity, and implement infection control measures (hand hygiene).
Antiemetics: Administer 30-60 minutes before chemotherapy to reduce nausea and vomiting.
Contraception: Women of childbearing age need nondrug contraception due to potential effects on pregnancy.
Oncological Emergencies: Monitor for infection, high fever, bleeding, and GI or oral cavity changes, especially for indications of extravasation.

Safe Nursing Practice – Chemotherapy

Extravasation: Immediately stop infusion, notify prescriber, maintain IV access, and document incident. Follow specific guidelines for antidotes and care of the affected area.
Handling: Adhere to hospital policies regarding PPE use.
Supportive Care: Provide emotional support to patients and families.

Biological Response Modifiers

Definition: Drugs that alter the body's immune response against cancer cells.
Mechanism of Action: Enhance or regulate the immune system's ability to fight cancer, or inhibit metastases, cell division or maturation
Use: Part of comprehensive cancer treatment in addition to surgery, chemotherapy, and radiation; also used for other illnesses (autoimmune, inflammatory, infectious).
General Precautions: All antineoplastics need careful handling and administration. Expect many and severe adverse effects. Proactive management of nausea and vomiting, infection, and IV site monitoring is imperative. Monitor for any oncological emergency signs/symptoms.